Question 1
Nursing Exam Q&A. The nurse is caring for a client diagnosed with cirrhosis and bleeding esophageal varices. Which findings indicate the client’s condition is improving? Select all that apply.
- Alanine aminotransferase (ALT) is decreasing.
- Blood pressure has decreased to 100/58 mmHg.
- Aspartate aminotransferase (AST) is decreasing.
- Heart rate has increased to 118 per minute.
- Platelet count has decreased to 89,000 (150,000- 400,000)
- Hemoglobin and hematocrit are increasing. Nursing Exam Q&A
Question 2
The nurse is caring for a client with acute appendicitis. Which assessment finding is priority for the nurse? Nursing Exam Q&A
- Rigid, board-like abdomen
- Blood pressure 124/75
- Pain report 5 on 0 to 10 scale
- Complaint of no appetite
Question 3
The nurse is providing education for a client with Crohn’s disease about a prescription for prednisone 20 mg by mouth daily. Which statement by the client shows understanding of the information provided about the medication?
- “There are no specific concerns for me when taking the medicine.”
- “I will be able to sleep better when taking this medication.”
- “I should weigh myself daily while taking the medication.”
- “I can just stop taking the medication when I feel better.”
Question 4
A nurse is providing discharge teaching for a client with Crohn’s disease. Which dietary instruction should the nurse include in the teaching?
- Drink canned protein supplements.
- Take a bulk-forming laxative daily.
- Increase intake of high fiber foods.
- Decrease intake of high calorie foods.
Question 5
The nurse is caring for a client following an episode of GI bleeding, with the pictured device inserted. Which intervention should the nurse include in the plan of care?
- Check the device for placement every 24 hours.
- Remove the tube every 12 hours to allow the client time to rest.
- Provide frequent care to the mouth and nares.
- Ensure that portable suction is on a high, continuous setting.
Question 6
The nurse is planning care for a client admitted with acute appendicitis. Which interventions should the nurse include in the plan of care? Select all that apply.
- Administer a laxative or enema.
- Maintain client in a semi Fowler’s position.
- Assess the client’s sexual activity and preferences.
- Apply warm compress to the right upper abdominal quadrant.
- Maintain the client on NPO status.
- Administer intravenous fluids as prescribed.
Question 7
The nurse is caring for a client with peptic ulcer disease (PUD) who is taking famotidine. Which assessment finding indicates the therapy is effective?
- Relief of heartburn.
- Absence of constipation.
- Cessation of diarrhea.
- Passage of flatus.
Question 8
The nurse is caring for a confused client, admitted with jaundice and hepatitis B. Which intervention should the nurse include in the care plan?
- Provide the client with a low carbohydrate diet.
- Administer acetaminophen as needed for mild pain.
- Instruct the client to ambulate three times a day.
- Encourage client to use the bed side commode.
Question 9
The nurse is teaching a client about primary prevention of Hepatitis A. Which statement by the client indicates the teaching has been effective?
- “I will call my provider for a fever.”
- “I will avoid being with sick people.”
- “I will wear a mask in crowded places.”
- “I will wash my hands frequently.”
Question 10
The nurse is preparing to administer an oral dose of pantoprazole to a client with a duodenal ulcer who recently suffered a stroke and has difficulty swallowing. Which action by the nurse is appropriate?
- Ask a family member for assistance with administration
- Administer the medication with small sips of water
- Hold the medication and notify the health care provider
- Crush the medication and administer in applesauce
Question 11
Case Study Summary
The client is a 66-year-old male admitted with complications of advanced cirrhosis stemming from a chronic Hepatitis B infection acquired via a needlestick injury. He presents with significant fluid volume overload, characterized by a 12-pound weight gain over the past month, extreme abdominal swelling (ascites), and bilateral pitting lower extremity edema.
Clinical Assessment Findings
- Respiratory Distress: The client is very short of breath, with a respiratory rate of 28, oxygen saturation of 92% on room air, and visible use of accessory muscles for breathing.
- Physical Signs of Liver Failure: Assessment reveals jaundice (yellowing of the skin and sclera), spider angiomas on the chest and back, and a “distended, taut” abdomen with palpable splenomegaly.
- Vital Signs: He is tachycardic (HR 114) and hypertensive (BP 144/86).
- Neurological/Safety: The client reports an inability to sleep and is noted to be confused.
Relevant Laboratory Data
The client’s laboratory results reflect multi-system impairment related to liver dysfunction:
- Hematology: Low Hemoglobin (12.2) and Hematocrit (37), indicating a risk for bleeding or anemia.
- Liver Enzymes: Elevated ALT (41) and AST (49).
- Metabolic/Fluid: Low Albumin (2.9) contributing to fluid shifts, and hyponatremia (Sodium 128) due to fluid retention.
- Renal/Waste: Elevated Bilirubin (1.6) and BUN (22).
On initial assessment, the nurse recognizes which findings to be important and an immediate concern? For each assessment finding select “Important” or “Not Important” as appropriate.
| Assessment Finding | Selection |
| Yellow sclera | Not Important (Expected with jaundice) |
| Jaundice | Not Important (Expected for this diagnosis) |
| Distended abdomen | Important (Due to extreme distension/ascites) |
| Spider angiomas | Not Important (Common in cirrhosis) |
| Oxygen saturation | Important (Currently 92% on RA with accessory muscle use) |
| Hgb and Hct | Important (Low values: 12.2 and 37; potential for bleeding) |
| Heart rate | Important (Tachycardia at 114 bpm) |
| Blood pressure | Important (Elevated at 144/86) |
Question 12
The nurse understands which lab values are most closely related to the client’s primary complaints? Select five lab values from the list.
- creatinine 1.3
- RBC 4.6
- ALT 41
- BUN 22
- albumin 2.9
- AST 49
- bilirubin 1.6
- ALP 136
Question 14
Which interventions should the nurse include in the plan of care for this client? For each intervention select “Include” or “Do Not Include”. Nursing Exam Q&A
| Intervention | Selection |
| Ambulate as tolerated | Do Not Include |
| Assess for asterixis | Include |
| Assess neuro status | Include |
| Encourage visitors | Do Not Include |
| Keep the room dark | Do Not Include |
| Monitor VS frequently | Include |
| Order regular diet | Do Not Include |
Question 15
The nurse recognizes which order to be the highest priority in providing initial care for the client? Click on the appropriate highlighted order.
- Furosemide 40 mg PO daily
- 1 Gm sodium diet
- IV 1/2 NS at 20 mL/hour
- Potassium 20 mEq in 100 mL NS over 2 hours
- Cefotaxime 1 Gm in 100 mL 1/2 NS IV every 12 hours
- Strict I and O
- Bedrest
Question 15
The nurse recognizes which order to be the highest priority in providing initial care for the client? Click on the appropriate highlighted order.
- Furosemide 40 mg PO daily
- 1 Gm sodium diet
- IV 1/2 NS at 20 mL/hour
- Potassium 20 mEq in 100 mL NS over 2 hours
- Cefotaxime 1 Gm in 100 mL 1/2 NS IV every 12 hours
- Strict I and O
- Bedrest
Question 16
On reassessment, the nurse determines which findings indicate bleeding esophageal varices? Select five (5) assessment findings.
- Blood glucose of 108
- Urine output of 50 mL in three hours
- Oxygen saturation of 91%
- Increase in hemoglobin and hematocrit
- Heart rate of 128
- Respiratory rate of 30
- Blood pressure of 100/52
- Bright red emesis
- Decreased abdominal girth
Question 18
The nurse is reviewing the lab results for the client. Which lab result is priority for the nurse to follow up?
- Sodium 128 mEq/L
- Potassium 3.1 mEq/L
- Albumin 2.9 g/dL
- AST 49 U/L
Question 21
The nurse is caring for a client with cirrhosis. Which of the following should the nurse include in the client’s plan of care? Select all that apply. Nursing Exam Q&A
- Administer prescribed diuretics.
- Monitor daily weight.
- Monitor abdominal girth.
- Provide a low sodium diet.
- Encourage a high protein diet.
- Monitor for signs of hepatic encephalopathy. Nursing Exam Q&A.
Question 22
The nurse is preparing to administer spironolactone to a client with cirrhosis and ascites. The nurse should monitor the client for which of the following?
- Hyperkalemia
- Hypokalemia
- Hypernatremia
- Hypoglycemia
Question 23
A client with an ascending colostomy angrily declares, “I can’t stand this thing on my body! This nasty thing is not me.” Which response is appropriate for the nurse?
- “Would you like for me to change the bag so that it isn’t nasty?”
- “You may want to talk to others who have also been through this.”
- “The colostomy is a part of who you are now.”
- “What bothers you the most about the colostomy?”
Question 24
The nurse is providing discharge education for an older client with ascites related to cirrhosis and end stage liver disease. Which of the following precautions should the nurse include in the teaching?
- “Be careful when walking because the increased abdominal weight increases risk for falls.”
- “Increased abdominal weight means you should no longer exercise.”
- “Tight fitting clothing can help support the extra weight in your abdomen.”
- “The increased weight in the abdomen can cause problems when you lie down to sleep.”
Question 25
The nurse is providing education to a client newly diagnosed with Crohn’s disease. Which information, given by the nurse, offers the most understandable description of the disorder?
- Crohn’s disease is a continuous inflammation of the lining of the colon and rectal areas.
- Crohn’s disease is a transmural granulomatous inflammation that can affect any part of the gastrointestinal tract.
- Crohn’s disease has a patchwork appearance, with some areas that are clear and some with inflammation.
- Crohn’s disease has an appearance similar to second degree burns of the colon and rectum areas.
Question 26
The nurse is providing education to a client newly diagnosed with Crohn’s disease. Which information, given by the nurse, offers the most understandable description of the…
- Eating contaminated food or drinking contaminated water causes hepatitis C.
- Hepatitis C is transmitted through contaminated blood, such as from a shared needle.
- Drinking large amounts of alcohol can lead to hepatitis C infection.
- Hepatitis C can be transmitted through body fluids like sweat and saliva.
Question 27
The nurse is providing education to a client newly diagnosed with Crohn’s disease. Which information, given by the nurse, offers the most understandable description of the nurse to include in the plan of care?
- Low sodium diet
- Fall prevention
- Bleeding precautions
- Braden assessment
Question 28
The nurse is providing education for a client diagnosed with thrombocytopenia. Which instruction should the nurse include in the teaching? Nursing Exam Q&A.
- Use an ice pack over a bleeding wound
- Wear short sleeves to visualize skin more easily
- Use a pick instead of dental floss
- Use a soft bristle toothbrush
Question 29
The nurse is educating a client with cirrhosis about self care measures to improve symptoms. Which information should the nurse include in the teaching?
- “Eat three large meals a day to get enough calories.”
- “Avoid high sodium foods like canned soup and processed meats.”
- “Stop all activities and walk only when necessary.”
- “Take acetaminophen to treat any pain or discomfort.”
Question 30
The nurse is caring for a client admitted for metastatic renal carcinoma. Which response by the nurse is correct when the client asks for an explanation of metastasis?
- “Metastasis means the cancer cells have evolved into other types of tissue cells.”
- “Metastasis occurs when the cells within the kidney grow abnormally.”
- “Metastasis means the cancer has spread to areas of you body outside of the kidney.”
- “Metastasis simply means the cancer cells are no longer growing.”
Question 31
The nurse is caring for a client admitted for metastatic renal carcinoma. Which response by the nurse is correct when the client asks for an explanation of metastasis?
- Breast cancer can occur in any part of the breast, but ductal carcinoma is most common.
- Screening mammograms should begin at age 35 and repeat every ten years.
- Breastfeeding increases the risk of breast cancer as women age.
- BRCA1 and BRCA2 indicate a lower risk of developing breast cancer
Question 32
The nurse is caring for a client admitted for metastatic renal carcinoma. Which response by the nurse is correct when the client asks for an explanation of metastasis?
- Brain tumors are typically determined to be benign.
- Brain tumors often spread to other parts of the body.
- Malignant brain tumors often metastasize from another part of the body.
- Brain tumors can also be referred to as spinal tumors.
Question 33
The nurse is caring for a sedentary client diagnosed with stage IV lung cancer who has been prescribed opioids for pain. Which adverse effect should the nurse anticipate? Nursing Exam Q&A
- Bleeding
- Impaction
- Diarrhea
- Mucositis
Question 34
The nurse is caring for a client with advanced cancer who is exhibiting signs of cognitive difficulties, confusion, and altered awareness. Which complication of cancer does the nurse recognize the client is experiencing?
- Delirium
- Fatigue
- Concentration problems
- Neuropathy
Medication Calculation
Question: How many mL of tacrolimus should the nurse add to the normal saline? Round to tenths (one decimal place) if rounding is needed at the end of calculations. Use leading or trailing zero if necessary and enter your response as numbers only.
- Provider Orders: Tacrolimus infusion 0.03 mg/kg diluted in 200 mL normal saline over 24 hours.
- Client weight: 185 lb
- Drug Label: Prograf (tacrolimus) injection 5mg/1mL
Answer: 0.5
Oncology Case Study Summary
- Client Profile: A 45-year-old with a history of hypertension and colon cancer.
- Presenting Symptoms: Admitted via ambulance with nausea, vomiting, lethargy, abdominal pain (7/10), and muscle weakness starting two days after their first chemotherapy dose (Cisplatin).
- Clinical Status: The client is drowsy, disoriented to time/place, and exhibits an irregular heart rhythm with several beats of ventricular tachycardia.
- Vital Signs: Temp 99.1F, HR 102 bpm, BP 108/56 mmHg, and O_2 Sat 96%.
- Critical Lab Findings:
- Hyperkalemia: 6.0\ mEq/L (Normal: 3.5\5
- Hyperphosphatemia: Phosphate 8.2 mg/dL (Normal: 3\4.5).
- Hyperuricemia: Uric acid 10.7\ mg/dL (Normal: 4.0\8.5).
- Renal Failure: Creatinine 3.9 mg/dL (Normal: 0.5,1.1) and BUN 30\mg/dL (Normal: 10-20).
- Hypernatremia: Na+ 155 mEq/L (Normal: 135-145).
Question 33
The nurse is caring for a sedentary client diagnosed with stage IV lung cancer who has been prescribed opioids for pain. Which adverse effect should the nurse anticipate?
- Bleeding
- Impaction
- Diarrhea
- Mucositis
Question 34
The nurse is caring for a client with advanced cancer who is exhibiting signs of cognitive difficulties, confusion, and altered awareness. Which complication of cancer does the nurse recognize the client is experiencing?
- Delirium
- Fatigue
- Concentration problems
- Neuropathy
Question 38
The nurse identifies which assessment findings as significant? For each assessment finding indicate “Significant” or “Not Significant”
| Assessment Finding | Status |
| Creatinine (3.9 mg/dL) | Significant |
| O_2 Saturation (96%) | Not significant |
| Beats of ventricular tachycardia | Significant |
| Nausea | Significant |
| Vomiting | Significant |
| Blood pressure (108/56\mmHg) | Significant |
| Uric acid ($10.7\text{ mg/dL}$) | Significant |
Question 39
The nurse reviews assessment findings and uses the information to determine if the client’s symptoms are caused by the bowel tumor or tumor lysis syndrome (TLS). For each assessment finding select either “Tumor Lysis Syndrome”, “Bowel Tumor”, or “Both Conditions”.
- Elevated Phosphorous:
- Elevated potassium:
- Low magnesium:
- Weakness:
- Constipation:
- Decreased calcium:
- Low sodium:
Question 40
The nurse recognizes the client is experiencing Tumor Lysis Syndrome and needs immediate IV fluids as initial treatment.
Question 41
The nurse is planning care for the client. For each intervention, indicate if the intervention is “Indicated” or “Contraindicated.”
- Provide diet high in potassium: Contraindicated
- Administer allopurinol: Indicated
- Prepare client for dialysis: Indicated
- Initiate cardiac monitoring: Indicated
- Administer normal saline infusion: Indicated
- Encourage fluid restriction: Contraindicated
Question 44
The nurse is providing discharge education for the client who experienced tumor lysis syndrome. Which information should the nurse include in the teaching?
- “Be sure to restrict your fluid intake to 1 liter per day.”
- “Maintain a high fluid intake of at least 2 to 3 liters per day.”
- “You should avoid all physical activity for the next month.”
- “Increase your intake of potassium-rich foods like bananas.”
Question 46
The nurse is planning care for a client with hypercalcemia secondary to bone cancer metastasis. Which intervention should the nurse include in the plan?
- Administer IV Normal Saline.
- Place an oral airway at bedside.
- Monitor for Chvostek’s sign.
- Implement seizure precautions.
Question 47
The nurse is planning care for a client with hypercalcemia secondary to bone cancer metastasis. Which intervention should the nurse include in the plan? the priority information the nurse should obtain?
- “Have you begun to lose clumps of hair?”
- “How have you been sleeping at night?”
- “Have you had any nausea and vomiting?”
- “How has your energy level been lately?”
Question 48
The nurse is planning care for a client with hypercalcemia secondary to bone cancer metastasis. Which intervention should the nurse include in the plan?
- “I can eat foods that appeal to me.”
- “I should treat my nausea before I eat.”
- “I should drink 10 oz. of fluid before I eat.”
- “I will eat small frequent meals.”
Question 49
The nurse is caring for a client undergoing chemotherapy with a white blood count (WBC) of 4,200 (5,000-10,000); hemoglobin of 9.8 (14-18); platelet count of 80 (150-400) and potassium of 3.8 (3.5-5). The nurse should notify the healthcare provider immediately for which assessment finding?
- Blood pressure of 142/90
- Urine output of 80mL in two hours
- Temperature of 100.5 degrees F
- 150 mL of clear, frothy emesis
Question 50
An Unlicensed Assistive Personnel (UAP) is performing AM care for a client with a sealed radiation implant in place for cervical cancer. Which actions by the UAP would require the nurse to intervene? Select all that apply
- Places all soiled linens in a bag in the room.
- Wears a lead apron during client care.
- Places a “Caution: Radioactive Material” sign on the door.
- Places radiation dosimeter on the door.
- Encourages the family to stay for a few hours.
- Keeps the door open so the client doesn’t feel isolated.
