1. A nurse in an emergency department completes an assessment on an adolescent

client that has conduct disorder. The client threatened suicide to teacher

at school. Which of the following statements should the nurse include in the

assessment?

a) Tell me about your siblings

b) Tell me what kind of music you like

c) Tell me how often do you drink alcohol

d) Tell me about your school schedule

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1) *A nurse is observing bonding to the client her new born. Which of following actions by the

client requiresthe nurse to intervene?

a) Holding the new born in an en face position

b) Asking the father to change the new-born’s diaper

c) Requesting the nurse take the new born nursery so she can rest

d) Viewing the new-born’s actions to be uncooperative

2) A nurse is caring for client who is taking levothyroxine. Which of the following findings

should indicate that the medication is effective?

a) Weight loss (this drug acts as T4 and will normalize the effects of hypothyroidism)

b) Decreased blood pressure

c) Absence of seizures

d) Decrease inflammation

3) A nurse is planning discharge teaching for cord care for the parent of a new born. Which

instructions would you include in the teaching?

a) Contact provider if the cord still turns black ( it’s going to turn black)

b) Clean the base of the cord with hydrogen peroxide daily (clean with neutral pH cleanser

)

c) Keep the cord dry until it falls off (cord should be kept clean and dry to prevent infection)

d) The cord stump will fall off in five days ( cord falls off in 10-14 days)

4) A nurse is assessing a client in the PACU. Which of the following findingsindicates

decreased cardiac output?

a) Shivering

b) Oliguria

c) Bradypnea

d) Constricted pupils

5) A nurse is assisting with mass casualty triage : explosion at a local factory. Which of the

following client should the nurse identify as the priority ?

a) A client that has massive head trauma

b) A client has full thickness burns to face and trunk

c) A client with indications of hypovolemic shock

d) A client with open fracture of the lower extremity

6) A nurse is a receiving report on four clients. Which of the following clients should the nurse

assess first?

a) A client who has illeal conduit and mucus in the pouch

b) Client pleasant arteriovenous additional vibration palpated

c) A client whose chronic kidney disease with cloudy diasylate outflow

d) A client was transurethral resection of the prostate with a red tinged urine in the bag

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