FNP-QUEASTIONS-EXAMPLES.pdf

1. A child is admitted to the pediatric unit with a preparing for his admission, which of the diagnosis of suspected meningococcal following is the most important nursing action? meningitis. Which of the following nursing measures should the nurse do FIRST?...

1. A child is admitted to the pediatric unit with a preparing for his admission, which of the diagnosis of suspected meningococcal following is the most important nursing action? meningitis. Which of the following nursing measures should the nurse do FIRST? A. Order a stat admission CBC. B. Place a urine collection bag and A. Institute seizure precautions specimen cup at the bedside. B. Assess neurologic status C. Place a cooling mattress on his C. Place in respiratory isolation bed. D. Assess vital signs D. Pad the side rails of his bed. 2. A client is diagnosed with methicillin resistant 7. A young adult is being treated for second and staphylococcus aureus pneumonia. What type of third degree burns over 25% of his body and is isolation is MOST appropriate for this client? now ready for discharge. The nurse evaluates his understanding of discharge instructions relating to wound care and is satisfied that he is A. Reverse isolation prepared for home care when he makes which B. Respiratory isolation statement? C. Standard precautions D. Contact isolation A. “I will need to take sponge baths at home to avoid exposing the 3. Several clients are admitted to an adult wounds to unsterile bath water.” medical unit. The nurse would ensure airborne B. “If any healed areas break open I precautions for a client with which of the should first cover them with a following medical conditions? sterile dressing and then report it.” A. A diagnosis of AIDS and C. “I must wear my Jobst elastic cytomegalovirus garment all day and can only B. A positive PPD with an abnormal remove it when I’m going to bed.” chest x-ray D. “I can expect occasional periods of C. A tentative diagnosis of viral low-grade fever and can take pneumonia Tylenol every 4 hours.” D. Advanced carcinoma of the lung 8. An eighty five year old man was admitted for 4. Which of the following is the FIRST priority in surgery for benign prostatic hypertrophy. preventing infections when providing care for a Preoperatively he was alert, oriented, client? cooperative, and knowledgeable about his surgery. Several hours after surgery, the evening nurse found him acutely confused, agitated, and A. Handwashing trying to climb over the protective side rails on B. Wearing gloves his bed. The most appropriate nursing C. Using a barrier between client’s intervention that will calm an agitated client is furniture and nurse’s bag D. Wearing gowns and goggles A. limit visits by staff. B. encourage family phone calls. 5. An adult woman is admitted to an isolation C. position in a bright, busy area. unit in the hospital after tuberculosis was D. speak soothingly and provide detected during a pre-employment physical. quiet music. Although frightened about her diagnosis, she is anxious to cooperate with the therapeutic regimen. The teaching plan includes information 9. Ms. Smith is admitted for internal radiation for regarding the most common means of cancer of the cervix. The nurse knows the client transmitting the tubercle bacillus from one understands the procedure when she makes individual to another. Which contamination is which of the following remarks the night before usually responsible? the procedure? A. Hands. A. She says to her husband, “Please B. Droplet nuclei. bring me a hamburger and french C. Milk products. fries tomorrow when you come. I D. Eating utensils. hate hospital food.” B. “I told my daughter who is pregnant to either come to see 6. A 2 year old is to be admitted in the pediatric unit. He is diagnosed with febrile seizures. In  me tonight or wait until I go 13. Mrs. Jones will have to change the dressing home from the hospital.” on her injured right leg twice a day. The dressing C. “I understand it will be several will be a sterile dressing, using 4 X 4s, normal weeks before all the radiation saline irrigant, and abdominal pads. Which leaves my body.” statement best indicates that Mrs. Jones D. “I brought several craft projects to understands the importance of maintaining do while the radium is inserted.” asepsis? 10. The nurse in charge is evaluating the A. “If I drop the 4 X 4s on the floor, I infection control procedures on the unit. Which can use them as long as they are finding indicates a break in technique and the not soiled.” need for education of staff? B. “If I drop the 4 X 4s on the floor, I can use them if I rinse them with sterile normal saline.” A. The nurse aide is not wearing C. “If I question the sterility of any gloves when feeding an elderly dressing material, I should not client. use it.” B. A client with active tuberculosis is D. “I should put on my sterile gloves, asked to wear a mask when he then open the bottle of saline to leaves his room to go to another soak the 4 X 4s.” department for testing. C. A nurse with open, weeping lesions of the hands puts on 14. A client has been placed in blood and body gloves before giving direct client fluid isolation. The nurse is instructing auxiliary care. personnel in the correct procedures. Which D. The nurse puts on a mask, a gown, statement by the nursing assistant indicates the and gloves before entering the best understanding of the correct protocol for room of a client on strict isolation. blood and body fluid isolation? 11. The charge nurse observes a new staff A. Masks should be worn with all client nurse who is changing a dressing on a surgical contact. wound. After carefully washing her hands the B. Gloves should be worn for nurse dons sterile gloves to remove the old contact with nonintact skin, dressing. After removing the dirty dressing, the mucous membranes, or soiled nurse removes the gloves and dons a new pair items. of sterile gloves in preparation for cleaning and C. Isolation gowns are not needed. redressing the wound. The most appropriate D. A private room is always indicated. action for the charge nurse is to: 15. A client has been placed in blood and body A. interrupt the procedure to inform fluid isolation. The nurse is instructing auxiliary the staff nurse that sterile gloves personnel in the correct procedures. Which are not needed to remove the old statement by the nursing assistant indicates the dressing. best understanding of the correct protocol for B. congratulate the nurse on the use blood and body fluid isolation? of good technique. C. discuss dressing change technique A. Masks should be worn with all client with the nurse at a later date. contact. D. interrupt the procedure to inform B. Gloves should be worn for the nurse of the need to wash contact with nonintact skin, her hands after removal of the mucous membranes, or soiled dirty dressing and gloves. items. C. Isolation gowns are not needed. 12. Nurse Jane is visiting a client at home and is D. A private room is always indicated. assessing him for risk of a fall. The most important factor to consider in this assessment 16. The nurse is evaluating whether is: nonprofessional staff understand how to prevent transmission of HIV. Which of the following A. Correct illumination of the behaviors indicates correct application of environment. universal precautions? B. amount of regular exercise. C. the resting pulse rate. A. A lab technician rests his hand on D. status of salt intake. the desk to steady it while  recapping the needle after drawing D. using a bedpan for elimination blood. needs. B. An aide wears gloves to feed a helpless client. 21. The parents of a child, age 6, who will begin C. An assistant puts on a mask and school in the fall ask the nurse for anticipatory protective eye wear before guidance. The nurse should explain that a child assisting the nurse to suction a of this age: tracheostomy. D. A pregnant worker refuses to care for a client known to have AIDS. A. Still depends on the parents B. Rebels against scheduled activities C. Is highly sensitive to criticism 17. Jayson, 1 year old child has a staph skin D. Loves to tattle infection. Her brother has also developed the same infection. Which behavior by the children is most likely to have caused the transmission of 22. While preparing to discharge an 8-month-old the organism? infant who is recovering from gastroenteritis and dehydration, the nurse teaches the parents about their infant’s dietary and fluid A. Bathing together. requirements. The nurse should include which B. Coughing on each other. other topic in the teaching session? C. Sharing pacifiers. D. Eating off the same plate. A. Nursery schools B. Toilet Training 18. Jessie, a young man with newly diagnosed C. Safety guidelines acquired immune deficiency syndrome (AIDS) is D. Preparation for surgery being discharged from the hospital. The nurse knows that teaching regarding prevention of AIDS transmission has been effective when the 23. Nurse Betina should begin screening for client: lead poisoning when a child reaches which age? A. verbalizes the role of sexual A. 6 months activity in spread of the disorder. B. 12 months B. states he will make arrangements C. 18 months to drop his college classes. D. 24 months C. acknowledges the need to avoid all contact sports. D. says he will avoid close contact 24. When caring for an 11-month-old infant with with his three-year-old niece. dehydration and metabolic acidosis, the nurse expects to see which of the following? 19. Which question is least useful in the A. A reduced white blood cell count assessment of a client with AIDS? B. A decreased platelet count C. Shallow respirations A. Are you a drug user? D. Tachypnea B. Do you have many sex partners? C. What is your method of birth control? 25. After the nurse provides dietary restrictions D. How old were you when you to the parents of a child with celiac disease, became sexually active? which statement by the parents indicates effective teaching? 20. Mrs. Parker, a 70-year-old woman with A. “Well follow these instructions until severe macular degeneration, is admitted to the our child’s symptoms disappear.” hospital the day before scheduled surgery. The B. “Our child must maintain these nurse’s dietary restrictions until adulthood.” preoperative goals for Mrs. M. would include: C. “Our child must maintain these dietary restrictions lifelong.” A. independently ambulating around D. “We’ll follow these instructions until the unit. our child has completely grown and B. reading the routine preoperative developed.” education materials. C. maneuvering safely after orientation to the room. 26. A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse D. Allow the child to eat at a small expects to find? table and chair by herself A. Closed anterior fontanel and open 31. Nurse Roy is administering total parental posterior fontanel nutrition (TPN) through a peripheral I.V. line to a B. Open anterior and fontanel and school-age child. What’s the smallest amount of closed posterior fontanel glucose that’s considered safe and not caustic to C. Closed anterior and posterior small veins, while also providing adequate TPN? fontanels D. Open anterior and posterior A. 5% glucose fontanels B. 10% glucose C. 15% glucose 27. Patrick, a healthy adolescent has meningitis D. 17% glucose and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because 32. David, age 15 months, is recovering from fluid overload may cause: surgery to remove Wilms’ tumor. Which findings best indicates that the child is free from pain? A. Cerebral edema B. Dehydration A. Decreased appetite C. Heart failure B. Increased heart rate D. Hypovolemic shock C. Decreased urine output D. Increased interest in play 28. An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing 33. When planning care for a 8-year-old boy with action is most appropriate for this infant? Down syndrome, the nurse should: A. Encouraging the infant to hold a A. Plan interventions according to the bottle developmental level of a 7-year-old B. Keeping the infant on bed rest to child because that’s the child’s age conserve energy B. Plan interventions according to the C. Rotating caregivers to provide more developmental levels of a stimulation 5-year-old because the child will D. Maintaining a consistent, have developmental delays structured environment C. Assess the child’s current developmental level and plan 29. The mother of Gian, a preschooler with care accordingly spina bifida tells the nurse that her daughter D. Direct all teaching to the parents sneezes and gets a rash when playing with because the child can’t understand brightly colored balloons, and that she recently had an allergic reaction after eating kiwifruit and 34. Nurse Vincent is teaching the parents of a bananas. The nurse would suspect that the child school-age child. Which teaching topic should may have an allergy to: take priority? A. Bananas A. Prevent accidents B. Latex B. Keeping a night light on to allay C. Kiwifruit fears D. Color dyes C. Explaining normalcy of fears about body integrity 30. Cristina, a mother of a 4-year-old child tells D. Encouraging the child to dress the nurse that her child is a very poor eater. without help What’s the nurse’s best recommendation for helping the mother increase her child’s 35. The nurse is finishing her shift on the nutritional intake? pediatric unit. Because her shift is ending, which intervention takes top priority? A. Allow the child to feed herself B. Use specially designed dishes for A. Changing the linens on the clients’ children – for example, a plate with beds the child’s favorite cartoon B. Restocking the bedside supplies character needed for a dressing change on C. Only serve the child’s favorite foods the upcoming shift  C. Documenting the care provided A. Prevent metabolic breakdown of during her shift xanthine to uric acid D. Emptying the trash cans in the B. Prevent uric acid from precipitating assigned client room in the ureters C. Enhance the production of uric acid to ensure adequate excretion of 36. Nurse Harry is providing cardiopulmonary urine resuscitation (CPR) to a child, age 4. the nurse D. Ensure that the chemotherapy should: doesn’t adversely affect the bone marrow A. Compress the sternum with both hands at a depth of 1½ to 2” (4 to 5 41. A 10-year-old client contracted severe acute cm) respiratory syndrome (SARS) when traveling B. Deliver 12 breaths/minute abroad with her parents. The nurse knows she C. Perform only two-person CPR must put on personal protective equipment to D. Use the heel of one hand for protect herself while providing care. Based on sternal compressions the mode of SARS transmission, which personal protective should the nurse wear? 37. A 4-month-old with meningococcal meningitis has just been admitted to the A. Gloves pediatric unit. Which nursing intervention has the B. Gown and gloves highest priority? C. Gown, gloves, and mask D. Gown, gloves, mask, and eye A. Instituting droplet precautions goggles or eye shield B. Administering acetaminophen (Tylenol) 42. A tuberculosis intradermal skin test to detect C. Obtaining history information from tuberculosis infection is given to a high-risk the parents adolescent. How long after the test is D. Orienting the parents to the administered should the result be evaluated? pediatric unit A. Immediately 38. Shane tells the nurse that she wants to B. Within 24 hours begin toilet training her 22-month-old child. The C. In 48 to 72 hours most important factor for the nurse to stress to D. After 5 days the mother is: 43. Nurse Oliver s teaching a mother who plans A. Developmental readiness of the to discontinue breast-feeding after 5 months. child The nurse should advise her to include which B. Consistency in approach foods in her infant’s diet? C. The mother’s positive attitude D. Developmental level of the child’s peers A. Iron-rich formula and baby food B. Whole milk and baby food C. Skim milk and baby food 39. An infant who has been in foster care since D. Iron-rich formula only birth requires a blood transfusion. Who is authorized to give written, informed consent for the procedure? 44. Gracie, the mother of a 3-month-old infant calls the clinic and states that her child has a diaper rash. What should the nurse advice? A. The foster mother B. The social worker who placed the infant in the foster home A. “Switch to cloth diapers until the C. The registered nurse caring for the rash is gone” infant B. “Use baby wipes with each diaper D. The nurse-manager change.” C. “Leave the diaper off while the infant sleeps.” 40. A child is undergoing remission induction D. “Offer extra fluids to the infant until therapy to treat leukemia. Allopurinol is included the rash improves.” in the regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to: 45. Nurse Kelly is teaching the parents of a B. Use sterile applicators to scratch young child how to handle poisoning. If the child the itch ingests poison, what should the parents do first? C. Apply cool water under the cast D. Apply hydrocortisone cream under the cast using sterile applicator. A. Administer ipecac syrup B. Call an ambulance immediately C. Call the poison control center D. Punish the child for being bad 46. A child has third-degree burns of the hands, face, and chest. Which nursing diagnosis takes priority? A. Ineffective airway clearance related to edema B. Disturbed body image related to physical appearance C. Impaired urinary elimination related to fluid loss D. Risk for infection related to epidermal disruption 47. A 3-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Which sign or symptom suggests excessive I.V. fluid intake? A. Worsening dyspnea B. Gastric distension C. Nausea and vomiting D. Temperature of 102°F (38.9° C) 48. Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation? A. Oxygen saturation of 95% B. Mild work of breathing C. Absence of intercostals or substernal retractions D. History of steroid-dependent asthma 49. Nurse Mariane is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus? A. Measuring head circumference B. Obtaining skull X-ray C. Performing a lumbar puncture D. Magnetic resonance imaging (MRI) 50. An adolescent who sustained a tibia fracture in a motor vehicle accident has a cast. What should the nurse do to help relieve the itching? A. Apply cool air under the cast with a blow-dryer