NP1 Nursing Board Exam December 2007 Answer Key 'Foundation of Professional Nursing Practice'

100 Nursing Board Exam test questions of December 2007 Nurse Licensure Examination (NLE)
Nursing Practice 1 – Foundation of Professional Nursing Practice
Fundamentals of Nursing

PART 2 Board Exam test questions 51 - 100

Situation 8 – The practice of nursing goes with responsibilities and accountability whether you work in a hospital or in the community setting you main objective is to provide safe nursing to your clients?

51. To provide safe, quality nursing care to various clients in any setting, the most important tool of the nurse is:

A. critical thinking to decide appropriate nursing actions

B. understanding of various nursing diagnoses

C. observation skills for data collection

D. possession of in scientific knowledge about client needs

52. You ensure the appropriateness and safety of your nursing interventions while caring for various client groups by:

A. creating plans of care for particular clientele

B. identifying the correct nursing diagnoses for clients

C. making a thorough assessment of client needs and problems

D. using standards of nursing care as your criteria for evaluation

53. The effectiveness of your nursing care plan for your clients is determined by

A. the number of nursing procedures performed to comfort the client

B. the amount of medications administered to the client as ordered

C. the number of times the client calls the nurse

D. the outcome of nursing interventions based on plan of care

54. You are assigned to Mrs. Amado, age 49, who was admitted for possible surgey. She complained of recurrent pain at the right upper quadrant of the abdomen 1-2 hours after ingestion of fatty food. She also had frequent bouts of dizziness, blood pressure of 170/100, hot flashes. Which of the above symptoms would be an objective cue?

A. Blood pressure measurement of 170/100

B. Complaint of hot flashes

C. Report of pain after ingestion of fatty food

D. Complaint of frequent bouts of dizziness

55. While talking with Mrs. Amado, it is most important for the nurse to:

A. schedule the laboratory exams ordered for her

B. do an assessment of the client to determine priority needs

C. tell the client that your shift ends after eight hours

D. have the client sign an informed consent

Situation 9 – Oral care is an important part of hygienic practices and promoting client

comfort.

56. An elderly client, 84 years old, is unconscious. Assessment of the mouth reveals excessive dryness and presence of sores. Which of the following is BEST to use for oral care?

A. lemon glycerine

B. hydrogen peroxide

C. Mineral oil

D. Normal saline solution

57. When performing oral care to an unconscious client, which of the following is a special consideration to prevent aspiration of fluids into the lungs?

A. Put the client on a sidelying position with head of bed lowered

B. Keep the client dry by placing towel under the chin

C. Wash hands and observe appropriate infection control

D. Clean mouth with oral swabs in a careful and an orderly progression

58. The advantages of oral care for a client include all of the following, EXCEPT:

A. decreases bacteria in the mouth and teeth

B. reduces need to use commercial mouthwash which irritate the buccal

mucosa

C. improves client’s appearance and self-confidence

D. improves appetite and taste of food

59. A possible problem while providing oral care to unconscious clients is the risk of fluid aspiration to lungs. This can be avoided by:

A. Cleaning teeth and mouth with cotton swabs soaked with mouthwash to avoid rinsing the buccal cavity

B. swabbing the inside of the cheeks and lips, tongue and gums with dry cotton swabs

C. use fingers wrapped with wet cotton washcloth to rub inside the cheeks, tongue, lips and gums

D. suctioning as needed while cleaning the buccal cavity

60. Your client has difficulty of breathing and is mouth breathing most of the time. This causes dryness of the mouth with unpleasant odor. Oral hygiene is recommended for the client and in addition, you will keep the mouth moistened by using:

A. salt solution

B. water

C. petroleum jelly

D. mentholated ointment

Situation 10 – Errors while providing nursing care to patients must be avoided and minimized at all time. Effective management of available resources enables the nurse to provide safe, quality patient care.

61. In the hospital where you work, increased incidence of medication error was identified as the number one problem in the unit. During the brainstorming session of the nursing service department, probable causes were identified. Which of the following is process related?

A. interruptions

B. use of unofficial abbreviations

C. lack of knowledge

D. failure to identify client

62. Miscommunication of drug orders was identified as a probable cause of medication errors. Which of the following is safe medication practice related to this?

A. Maintain medication in its unit dose package until point of actual administration

B. Note both generic and brand name of the medication in the Medication

Administration Method

C. Only officially approved abbreviations maybe used in prescription orders

D. Encourage clients to ask question about their medications.

63. The hospital has an ongoing quality assurance program. Which of the following indicates implementation of process standards?

A. The nurses check client’s identification band before giving medications

B. The nurse reports adverse reaction to drugs

C. Average waiting time for medication administration is measured

D. The unit has well ventilated medication room

64. Which of the following actions indicate that Nurse Jerome is performing outcome evaluation of quality care?

A. Interviews nurses for comments regarding staffing

B. Measures waiting time for client’s per nurse’s call

C. Checks equipment for its calibration schedule

D. Determines whether nurses perform skin assessment every shift

65. An order for a client was given and the nurse in charge of the client reports that she has no experience of doing the procedure before. Which of the following is the most appropriate action of the nurse supervisor?

A. Assign another nurse to perform the procedure

B. Ask the nurse to find way to learn the procedure

C. Tell the nurse to read the procedure manual

D. Do the procedure with the nurse

Situation 11 – Mr. Jose’s chart is the permanent legal recording of all information that relates to his health care management. As such, the entries in the chart must have accurate data.

66. Mr. Jose’s chart contains all information about his health care. The functions of records include all except:

A. means of communication that health team members use to communicate their contributions to the client’s health care

B. the client’s record also shows a document of how much health care agencies will be reimbursed for their services

C. educational resource for student of nursing and medicine

D. recording of actions in advance to save time

67. An advantage of automated or computerized client care system is:

A. The nursing diagnoses for a client’s data can be accurately determined

B. Cost of confinement will be reduced

C. Information concerning the client can b easily updated

D. The number of people to take care of the client will be reduced

68. Information in the patient’s chart is inadmissible in court as evidence when:

A. The client’s family refuses to have it used

B. The client objects to its use

C. The handwriting is not legible

D. It has too many abbreviations that are “unofficial”

69. Nursing audit aims to:

A. provide research data to hospital personnel

B. study client’s illness and treatment regimen closely

C. compare actual nursing done to established standards

D. provide information to health-care providers

70. A telephone order is given for a client in your ward. What is your most appropriate action?

A. Copy the order on to the chart and sign the physician’s name as close to his original signature as possible

B. Repeat the order back to the physician, copy onto the order sheet and indicate that it is a telephone order

C. Write the order in the client’s chart and have the head nurse co-sign it

D. Tell the physician that you can not take the order but you will call the nurse supervisor

Situation 12 – Nurse Roque, a newly hired nurse, is asked to take over an absent nurse in another unit. She will take care of clients with various conditions.

71. Which of the following client conditions should be Miss Roque’s priority in the pediatric unit?

A. The baby whose fantanelle is bulging and firm while asleep

B. The infant who is brought in for upper respiratory tract infection whose

temperature is slightly elevated

C. A baby who is wailing after being awakened by the banging door

D. A baby boy whose circumcision has yellowish exudate

72. When suctioning the endotracheal tube, the nurse should:

A. Explain procedure to patient; insert catheter gently applying suction. Withdrawn using twisting motion

B. Insert catheter until resistance is met, then withdraw slightly, applying suction intermittently as catheter is withdrawn

C. Hyperoxygenate client insert catheter using back and forth motion

D. Insert suction catheter four inches into the tube, suction 30 seconds using twirling motion as catheter is withdrawn

73. Nurse Roque is giving instructions to Doris, the daughter of a comatose patient, to give a sponge bath. While Doris is doing spone bath, what action of Doris needs correction?

A. Answering the phone while wearing gloves used for sponge bath

B. Rolling the patient like a log to do back rub

C. Lining the rubber mat with bed sheet as incontinence pad for the patient

D. Turning the patient on the left side with head slightly elevated

74. Dina sustained a fracture of the ulna and a cast will be applied. What nursing action before cast application is most important for Nurse Roque to do?

A. Use baby powder to reduce irritation under the cast

B. Assess sensation of each arm

C. Evaluate skin temperature in the area

D. Check radial pulses bilaterally and compare

75. To obtain specimen for sputum culture and sensitivity, which of the following instruction is best?

A. Upon waking up, cough deeply and expectorate into container

B. Cough after pursed lip breathing

C. Save sputum for two days in covered container

D. After respiratory treatment, expectorate into a container

Situation 13 – Infections are quite commonly the reasons for a client’s hospitalization. Appropriate interpretation of diagnostic tests and measures for infection control are helpful in the management of patient care.

76. Dorothy underwent diagnostic test and the result of the blood examination are back. On reviewing the result the nurse notices which of the following as abnormal finding?

A. Neutrophils 60%

B. White blood cells (WBC) 9000/mm

C. Erythrocyte sedimentation rate (ESR) is 39 mm/hr

D. Iron 75 mg/100 ml

77. Surgical sepsis is observed when:

A. inserting an intravenous catheter

B. disposing of syringes and needles in puncture proof containers

C. washing hands before changing wound dressing

D. placing dirty soiled linen in moisture resistant bags

78. A client with viral infection will most likely manifest which of the following during the illness stage of the infection?

A. Client was exposed to the infection 2 days ago but without any symptoms

B. Oral temperature shows fever

C. Acute symptoms are no longer visible

D. Client “feels sick” but can do normal activities

79. Which of the following laboratory test result indicate presence of an infectious process?

A. Erythrocyte sedimentation rate (ESR) 12 mm/hr

B. White blood cells (WBC) 18,000/mm3

C. Iron 90 g/100ml

D. Neutrophils 67%

80. Among the clients you are assigned to take care of, who is the most susceptible to infection?

A. Diabetic client

B. Client with burns

C. client with pulmonary emphysema

D. client with myocardial infarction

Situation 14 – You are a newly hired nurse in a tertiary hospital. You have finished your

orientation program recently and you are beginning to assimilate the culture of the profession.

81. Using Benner’s stages of nursing expertise, you are a beginning nurse practitioner. You will rank yourself as a/an:

A. competent nurse

B. novice nurse

C. proficient nurse

D. advanced beginner

82. Benner’s “Proficient” nurse level is different from the other levels in nursing expertise in the context of having:

A. the ability to organize and plan activities

B. having attained an advanced level of education

C. a holistic understanding and perception of the client

D. intuitive and analytic ability in new situations

83. As you become socialized into the nursing “culture” you become a patient advocate.

Advocacy is explained by the following EXCEPT:

A. respecting a person’s right to be autonomous

B. demonstrating loyalty to the institution’s rights

C. shared respect, trust and collaboration in meeting health needs

D. protecting and supporting another person’s rights

84. Modern day nursing has led to the led development of the expanded role of the nurse as seen in the function of a:

A. Clinical nurse specialist C. community health nurse

B. Critical care nurse D. staff nurse

85. You join a continuing education program to help you:

A. Earn credits for license renewal

B. Get in touch with colleagues in nursing

C. Enhance your basic knowledge

D. Update your knowledge and skills related to field of interest

Situation 15 – When creating your lesson plan for cerebrovascular disease or STROKE. It is important to include the risk factors of stroke.

86. The most important risk factor is:

A. Cigarette smoking

B. Hypertension

C. binge drinking

D. heredity

87. Part of your lesson plan is to talk about etiology or cause of stroke. The types of stroke based on cause are the following EXCEPT:

A. Embolic stroke

B. Hemorrhagic stroke

C. diabetic stroke

D. thrombotic stroke

88. Hemmorhagic stroke occurs suddenly usually when the person is active. All are causes of hemorrhage, EXCEPT:

A. phlebitis

B. trauma

C. damage to blood vessel

D. aneurysm

89. The nurse emphasizes that intravenous drug abuse carries a high risk of stroke. Which drug is closely linked to this?

A. Amphetamines

B. Cocaine

C. shabu

D. Demerol

90. A participant in the STROKE class asks what is a risk factor of stroke. Your best response is:

A. “More red blood cells thicken blood and make clots more possible.”

B. “Increased RBC count is linked to high cholesterol.”

C. “More red blood cell increases hemoglobin content.”

D. “High RBC count increases blood pressure.”

Situation 16 – Accurate computation prior to drug administration is a basic skill all nurses must have.

91. Rudolf is diagnosed with amoebiasis and is to received Metronidazole (Flagyl) tablets 1.5 gm daily in 3 divided doses for 7 consecutive days. Which of the following is the correct dose of the drug that the client will received per oral administration?

A. 1,000 mg tid

B. 500 mg tid

C. 1,500 mg tid

D. 50 mg tid

92. Rhona, a 2 year old female was prescribed to receive 62.5 mg suspension three times a day. The available dose is 125 mg/ml. which of the following should Nurse Paolo prepare for each oral dose?

A. 0.5 ml

B. 1.5 ml

C. 2.5 ml

D. 10 ml

93. The physician ordered Potassium Chloride (KCL) in D5W 1 liter to be infused in 24 hours for Mrs. Gomez. Since Potassium Chloride is a high risk drug, Nurse Robert used an intravenous pump. Which of the following should Nurse Robert do to safely administer this drug?

A. Check the pump setting every 2 hours

B. Teach the client how the infusion pump operates

C. Have another nurse check the infusion pump setting

D. Set the alarm of the pump loud enough to be heard

94. Baby Liza, 3 months old, with a congenital heart deformity, has an order from her physician: “give 3.00 cc of Lanoxin today for 1 dose only”. Which of the following is the most appropriate action by the nurse?

A. Clarify order with the attending physician

B. Discuss the order with the pediatric heart specialist in the unit

C. Administer Lanoxin intravenously as it is the usual route of administration

D. Refer to the medication administration record for previous administration of Lanoxin

95. When Nurse Norma was about to administer the medications of client Lennie, the relative of Lennie told the nurse that they buy her medicines and showed the container of medications of the client. Which of the following is the most appropriate action by the nurse?

A. Hold the nurse administration of the client’s medication and refer to the head nurse

B. Put aside the medications she prepared and instead administer the client’s

medications

C. Tell the client that she will inform the physician about this

D. Bring the medications of the client to the nurse’s station and prepare accordingly

Situation 17 – You are taking care of Mrs. Santillan a 48 year old woman who is unconscious after a cerebrovascular accident. You are aware that there are many physical complications due to immobility.

96. You should be alert for the following complications she may experience EXCEPT:

A. Impaired mobility

B. Contractures and muscle atrophy

C. hypostatic pneumonia

D. pressure sores

97. Proper positioning of an immobilized unconsciousness client is important for the following reasons EXCEPT:

A. Maintain skin integrity

B. Promotes optimal lung expansion

C. Prevent injuries and deformities of the musculo-skeletal system

D. Facilitates rest and sleep

98. When positioning your client, you should observe good body mechanics for yourself and the client. This means that the nurse:

A. Uses back muscles

B. Assumes correct body alignment and efficient use of muscles to avoid injury

C. Observes rhythmic movements when moving about

D. Uses large muscles only

99. You are going to move Mrs. Santillan, a 150 lbs unconscious woman. Some principles to use when moving the client include the following EXCEPT:

A. prepare to move client by taking deep breath and tightening abdominal and gluteal

muscles

B. maintain wide base of support with feet and with knees flexed

C. push and pull using arms and legs instead of lifting

D. move close to the object to be moved leaning or bending at the waist

100. After moving Mrs. Santillan to the desired position, which action will you avoid?

A. Avoid friction between bony prominences

B. Place pillows to position client’s extremeties

C. Apply restraints

D. Raise bed rails

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