Download RN/LPN MedSurg Test

PROFESSIONAL SERVICES
CLINICAL DIVISION
RN/LPN MEDSURG TEST
1.
Rank the following routes of drug administration according to the usual rate of absorption
from the most rapid to the slowest.
1.
2.
3.
Intramuscular
Intravenous
Subcutaneous
a)
b)
c)
d)
2.
Hypoglycemic reactions may occur in which of the following cases:
a)
b)
c)
d)
3.
Too little insulin, too little food, or too much exercise
Too much exercise, too much insulin, or too little food
Too little food, too little exercise, or too little insulin
Too little exercise, too much insulin, or too little food
The insulin used for a random blood sugar (glucometer) coverage is which of the following?
a)
b)
c)
d)
4.
1-2-3
2-3-1
3-2-1
2-1-3
NPH
Regular
Ultralente
Protamine Zinc
The drug of choice for anaphylactic shock is which of the following?
a)
b)
c)
d)
Atropine
Benadryl
Aramine
Epinephrine
5.
Nitroglycerin is which of the following types of drugs?
a)
b)
c)
d)
6.
Opiate over-dosage is best treated with which of the following?
a)
b)
c)
d)
7.
Drowsiness, ataxia, dizziness, headache
Rash, fever, dry mouth, chills
Nausea, vomiting, confusion
Jaundice, increased which blood count, diarrhea
Which of the following drugs is least likely to lead to dependence?
a)
b)
c)
d)
9.
Narcan
Amphetamines
Phenobarb
Epinephrine
Patients taking any of the minor tranquilizers are cautioned against activities such as driving
automobiles, operating dangerous machinery, or performing tasks requiring precision
because of the common occurrence of which of the following side effects?
a)
b)
c)
d)
8.
Antiarrhythmic
Vasoconstrictor
Vasodilator
Ganglionic blocking agent
Morphine
Codeine
Demerol
Heroin
Culture and sensitivity tests are done prior to prescribing certain antibiotics because:
a)
b)
c)
d)
Many people are allergic to certain medications
The correct dosage must be determined
Microorganisms vary greatly in their resistance to drugs
Other drugs being taken by the patient may be incompatible
10. Then reconstituting drugs for injection, it is important for the nurse to use the type of diluent
that the pharmaceutical company suggests for which of these reasons?
a)
b)
c)
d)
To insure the solubility of the drug
To minimize side effects from the drug
To render the solution sterile
To insure appropriate dosage of the drug
11. A patient with Bell’s palsy does not blink the affected eye. The nurse should:
a)
b)
c)
d)
Apply an eye patch to the affected eye at all times
Ask the patient to keep both eyes closed
Assess pupil reaction to light and accommodation
Obtain medical orders for eye lubrication
12. A patient with right hemiplegia is awake and alert. The patient is given exercise to do during
the day. One afternoon the patient seems very discouraged, so the nurse plans to motivate
her by:
a) Reassuring her that there is no need for her to feel discouraged
b) Reinforcing the small gains she has made
c) Suggesting that she could rest today and exercise again tomorrow
d) Explaining that exercise is necessary to get better
13. Pupil checks every hour are ordered for a patient with CVA. This is an important assessment
because:
a)
b)
c)
d)
Blurred vision is a sign of increasing ICP
Cranial nerve III exits from the brain stem
Dilated and fixed pupils indicate cardiac arrest
Pinpoint pupils result from CNS depressant drugs
14. If a cerebrovascular injury involves the pyramidal tract the nurse expects to observe:
a)
b)
c)
d)
Intention tremors
Loss of pain and temperature sensation
Loss of equilibrium
Paralysis of voluntary movement
15. A female patient with CVA sometimes has difficulty “finding” the words she wants to say.
The nurse will encourage the patient’s visitors to:
a)
b)
c)
d)
Be patient with her while she thinks of a word
End the visit if she becomes frustrated and angry
Finish her sentence for her if they know what she wants to say
Tactfully change the subject when she cannot find the word she wants to use
16. A patient has had a CVA with expressive aphasia. When assisting the patient to
communicate during the early period after the CVA, it is most important for the nurse to:
a)
b)
c)
d)
Create signals for the patient to use
Speak loudly and clearly
Stand directly in front of the client
Write directions in large letters
17. In a patient with left hemiplegia, the nurse is applying pain by pressing on the base of the
patient’s fingernail to access level of consciousness. The patient’s best response is:
a)
b)
c)
d)
Flexion of both arms
Flexion of the unaffected arm and unaffected leg
Grimacing (making a face)
Pulling the hand away
18. After a head injury, a client’s vital signs are stabilized and he is posted for a CT scan. To
prepare him for this test, the nurse needs to understand that a CT scan:
a) Involves injection of a radiopaque contrast medium into an artery, which causes a
burning sensation
b) Is a measure of electrical energy flowing away from the brain
c) Lasts only a few minutes, but he will have to remain flat for 12 hours after the test.
d) Requires him to lie very still during the examination
19. A male patient with herniated nucleus pulposis (HNP) had a myelogram this morning. To
prevent headache, the nurse instructs him to remain flat in bed for 6 hours, and the nurse
will:
a)
b)
c)
d)
Dim the lights in his room
Force fluids
Offer analgesic medication
Turn him every 2 hours from side to side
20. After a cerebral angiogram, the nurse will encourage the patient to:
a)
b)
c)
d)
Ask for assistance with ambulation
Drink fluids
Turn, cough, and deep breathe
Void
21. To prepare a female patient for an MRI, the nurse explains that the patient will:
a)
b)
c)
d)
Be asked to lie still during the entire procedure and will hear a humming noise
Have an injection of a radiopaque contrast medium into her vein
Have many small electrodes placed on her scalp
Need to stay in bed with the head of the bed elevated for 6-8 hours after the
procedure
22. A patient with Guillaine-Barre syndrome is going to undergo plasmapheresis and is
concerned about what it means. The nurse’s response is based on the understanding that
plasmaphersis:
a)
b)
c)
d)
Alleviates symptoms by removing autoimmune autibodies from the blood
May cause mild allergic reaction with generalized itching
Prevents secondary bacterial infection to the nervous system
Reduces the need for Oxygen while the patient is on a respirator
23. To help prevent tonic-clonic type seizures due to epilepsy, the nurse will teach a patient to:
a)
b)
c)
d)
Avoid any situation that produces fatigue
Refrain from participating in competitive sports
Take extra medication if an infection is present
Try to determine factors that consistently precede a seizure
24. Which of the following assessments most likely indicates a complication of total hip
replacement during the early postoperative period?
a)
b)
c)
d)
Both legs cool to touch
Calf tenderness when the foot is dorsiflexed
Tenderness at the surgical site
Lightheadedness when standing
25. The nurse expects a person with rheumatoid arthritis to have the most difficulty with pain
and stiffness after:
a)
b)
c)
d)
ADL
Heat application
Meals
Sleep
26. Then counseling women about exercise to prevent osteoporosis, the nurse knows the best
exercise is:
a)
b)
c)
d)
Isometric exercises of all major muscle groups
Leg raises with the knees bent
Swimming
Walking
27. The primary purpose of Buck’s traction for the immediate treatment of hip fracture is to:
a)
b)
c)
d)
Eliminate rotation of the femur
Immobilize the fracture
Maintain abduction
Reduce the fracture
28. When assessing a patient in Buck’s traction, the nurse observes the patient’s affected foot
resting on the foot of the bed. The appropriate intervention is to:
a)
b)
c)
d)
Place a pillow between the affected foot and the foot of the bed
Pull the patient up in bed
Take no action
Turn the patient to the side
29. The nurse is assessing a 46-year old man with a fractured pelvis due to an automobile
accident. Which of the following signs or symptoms alerts the nurse to a serious
complication of pelvic fracture?
a)
b)
c)
d)
Eccymosis of the perineum
Edema over the symphysis pubis
Hematuria
Discomfort at the fracture site
30. Which of the following is an early sign of fat embolism and should alert the nurse to the need
for medical intervention?
a)
b)
c)
d)
Irritability and confusion
Fat in the stool
Hyperglycemia
Pruritus
31. Following an injury, the nurse should access for fat embolism:
a)
b)
c)
d)
During the first 12 hours
During the first 48 hours
If the client has chronic respiratory disease
If the client is in skeletal traction
32. To best assess circulation to extremities, the nurse should check:
a)
b)
c)
d)
Capillary refill
Motion and sensation
Pain and pallor
Skin temperature
33. After and above-the-knee amputation, the nurse will encourage the client to lie prone
periodically to:
a)
b)
c)
d)
Extend the client’s hip joint
Increase the client’s vital lung capacity
Prepare the client by lifting weights for crutch walking
Provide diversion
34. When accessing a client with obstructive cholelithiasis, the nurse might expect to find:
a)
b)
c)
d)
Abdominal distention
Dark urine
Diminished bowel sounds
Loose stools
35. In a client with a stone lodged in the cystic duct, the nurse would expect to observe:
a)
b)
c)
d)
Beginning jaundice, dark urine, and clay-colored stools
Burning and frequency in voiding, cloudy urine
Colicky pain after a fatty meal
Petechiae, melena, and possible hematemesis
36. After a cholecystectomy, a client asks why he has to have a nasogastric (NG) tube. The nurse
states the purpose of the NG tube is to:
a)
b)
c)
d)
Administer high-caloric liquid feeding
Facilitate collection of gastric secretions
Prevent postoperative distention
Simplify administration of medications
37. A client with cholescystectomy and exploration of a the common bile duct has a T-tube and a
Jackson-Pratt drain. Because of the location of the incision, an important nursing action is to
encourage the client to:
a)
b)
c)
d)
Lie on the inoperative side
Remain in a semi-Fowler position
Splint the incision when moving
Turn, cough, and deep breathe
38. The nurse expects which of the following laboratory results for a client with jaundice?
a)
b)
c)
d)
Decreased PT
Elevated serum bilirubin
Elevated serum potassium
Metabolic acidosis
39. Which of the following is most likely to put a client with cirrhosis at risk for hepatic
encephalopathy?
a)
b)
c)
d)
Anorexia and weight loss
Diarrhea and tenesmus
GI Bleeding
Nausea and vomiting
40. When caring for a client with advanced cirrhosis, the nurse is alret for changes in all of the
following. Which change suggests hepatic encephalopathy?
a)
b)
c)
d)
Level of consciousness
Respiratory status
Urine output
Vital signs
41. Your order reads Penicillin 400,000 units. You have on hand a vial of 500,000 units in 10 cc’s.
How many cc’s would you give?
a)
b)
c)
d)
6
9
8
5
42. To give Ganstrisin 1 GM, you would need to give how many 250mg tablets?
a)
b)
c)
d)
4
2
8
3
43. A patient is to receive 800ml of intravenous fluids in 6 hours. The infusion pump should be
set to deliver how many milliliters per hour?
a)
b)
c)
d)
125
150
133
115
44. You have on hand a tubex syringe labeled Digoxin 0.5mg in 2 cc’s. How many cc (s) would
you need to administer 0.125 mg?
a)
b)
c)
d)
0.5
2.5
1
0.25
45. IV fluids are ordered at the rate of 50 cc’s per hour. In 24 hours, your patient should receive
how many cc’s?
a)
b)
c)
d)
1000
800
1200
1800
46. MOM ½ ounce is ordered. You would give how many cc’s?
a)
b)
c)
d)
30
10
15
60
47. The doctor orders lasix 40 mg by injection. Since the label on the ampule reads Lasix 20 mg
per 2 ml, you would give how many milliliters?
a)
b)
c)
d)
10
4
2
6
48. Nitroglycerin 0.4 mg has been ordered. The drug label states gr 1/150 equals 1 tablet. How
many tablets would the nurse give?
a)
b)
c)
d)
1
½
2
1½
49. Cephalexin monohydrate (Keflex) 0.5 g has been ordered. The drug comes in 250 mg per
capsule. How many capsules would the nurse give?
a)
b)
c)
d)
5
4
2
1
50. Penicillin V potassium (Pen-Vee K) suspension 0.75 g has been ordered. The drug is
available as 250 mg per 5 ml. How many milliliters would the nurse give?
a)
b)
c)
d)
10
15
3
20
51. Cyclophsphamide (Cytoxan) 4 mg/kg per day po has been ordered. The client weighs 154
lb. How much would the nurse give each day?
a)
b)
c)
d)
100 mg
120 mg
240 mg
280 mg
52. Vitamin K is available as 1 mg per 0.5 ml. Vitamin K 0.5 mg has been ordered. The amount
of vitamin K to be administered is:
a)
b)
c)
d)
2.5 ml
0.5 ml
0.25 ml
1 ml
53. Digoxin is available as 0.125 mg per tablet. Digoxin 0.25 mg has been ordered. The number
of tablets to be administered is:
a)
b)
c)
d)
1
½
2
1½
54. Meperidine (Demerol) is available as 75 mg/ml. Meperidine 50 mg has been ordered. The
amount of drug to be administered is:
a)
b)
c)
d)
0.5 ml
0.6 ml
0.7 ml
1.5 ml
55. Hydroxyzine (Vistaril) is available as 25 mg/ml. The amount ordered is 100 mg po q 4-6
hours prn. How many milliliters would the nurse give for each prn dose?
a)
b)
c)
d)
0.25 ml
2.5 ml
4 ml
40 ml
56. The amount of solution and amount of aminophylline received by a client IV each hour when
there is 500 mg of aminophylline in 250 m. given every 24 hours is:
a)
b)
c)
d)
12.5 ml/hr and 0.33 mg/hr
10 ml/hr and 21 mg/hr
21 ml/hr and 20 mg/hr
20 ml/hr and 40 mg/hr
57. The amount of solution and the amount of aminophylline received by a client IV each hour
when there in 500 mg of aminophylline in 500 ml over 12 hours is:
a)
b)
c)
d)
21 ml/hr and 20 mg/hr
20 ml/hr and 40 mg/hr
50 ml/hr and 21 mg/hr
42 ml/hr and 42 mg/hr
58. If the client is ordered to received insulin at 3 units per hour with a solution of 50 units per
100 ml in normal saline, the rate of infusion in milliliters would be:
a)
b)
c)
d)
4 ml/hour
12 gtts/ml
10 ml/hour
6 ml/hour
59. Hydroxyzine 25 mg IM has been ordered. The vital reads 100 mg in 2 ml. How many
milliliters would the nurse give?
a)
b)
c)
d)
5 ml
4 ml
0.5 ml
1.4 ml
60. The nurse is to infuse 1000 ml of IV fluid in 8 hours. Set calibration is 10 gtts/ml. How many
drops per minute would the nurse give?
a)
b)
c)
d)
20 gtt/min
21 gtt/min
125 gtt/min
12.5 gtt/min