Practice Test (Difficult)

Part 3 – Difficult

"Correct practice makes perfect" 

Make most of your time, the answer will be provided. Good luck and God Bless!

1. Which element in the circular chain of infection can be eliminated by preserving skin integrity?
1. Host
2. Reservoir
3. Mode of transmission
4. Portal of entry
2. Which of the following will probably result in a break in sterile technique for respiratory isolation?
1. Opening the patient’s window to the outside environment
2. Turning on the patient’s room ventilator
3. Opening the door of the patient’s room leading into the hospital corridor
4. Failing to wear gloves when administering a bed bath
3. Which of the following patients is at greater risk for contracting an infection?
1. A patient with leukopenia
2. A patient receiving broad-spectrum antibiotics
3. A postoperative patient who has undergone orthopedic surgery
4. A newly diagnosed diabetic patient
4. Effective [1]hand washing requires the use of:
1. Soap or detergent to promote emulsification
2. Hot water to destroy bacteria
3. A disinfectant to increase surface tension
4. All of the above
5. After routine patient contact, [1]handwashing should last at least:
1. 30 seconds
2. 1 minute
3. 2 minute
4. 3 minutes
6. Which of the following procedures always requires surgical asepsis?
1. Vaginal instillation of conjugated estrogen
2. [2]urinary catheterization
3. [3] nasogastric tube insertion
4. [4] colostomy
7. Sterile technique is used whenever:
1. Strict isolation is required
2. Terminal disinfection is performed
3. Invasive procedures are performed
4. Protective isolation is necessary
8. Which of the following constitutes a break in sterile technique while preparing a sterile field for a dressing change?
1. Using sterile forceps, rather than sterile gloves, to handle a sterile item
2. Touching the outside wrapper of sterilized material without sterile gloves
3. Placing a sterile object on the edge of the sterile field
4. Pouring out a small amount of solution (15 to 30 ml) before pouring the solution into a sterile container
9. A natural body defense that plays an active role in preventing infection is:
1. Yawning
2. Body hair
3. Hiccupping
4. Rapid eye movements
10. All of the following statement are true about [5]donning sterile gloves except:
1. The first glove should be picked up by grasping the inside of the cuff.
2. The second glove should be picked up by inserting the gloved fingers under the cuff outside the glove.
3. The gloves should be adjusted by sliding the gloved fingers under the sterile cuff and pulling the glove over the wrist
4. The inside of the glove is considered sterile
11. When removing a contaminated gown, the nurse should be careful that the first thing she touches is the:
1. Waist tie and neck tie at the back of the gown
2. Waist tie in front of the gown
3. Cuffs of the gown
4. Inside of the gown
12. Which of the following nursing interventions is considered the most effective form or universal precautions?
1. Cap all used needles before removing them from their syringes
2. Discard all used uncapped needles and syringes in an impenetrable protective container
3. Wear gloves when administering IM injections
4. Follow enteric precautions
13. All of the following measures are recommended to prevent pressure ulcers except:
1. Massaging the reddened are with lotion
2. Using a water or air mattress
3. Adhering to a schedule for positioning and turning
4. Providing meticulous skin care

14. Which of the following blood tests should be performed before a blood transfusion?
1. Prothrombin and coagulation time
2. Blood typing and cross-matching
3. Bleeding and clotting time
4. Complete blood count (CBC) and electrolyte levels.
15. The primary purpose of a platelet count is to evaluate the:
1. Potential for clot formation
2. Potential for bleeding
3. Presence of an antigen-antibody response
4. Presence of cardiac enzymes
16. Which of the following white blood cell (WBC) counts clearly indicates leukocytosis?
1. 4,500/mm³
2. 7,000/mm³
3. 10,000/mm³
4. 25,000/mm³
17. After 5 days of diuretic therapy with 20mg of [6]furosemide (Lasix) daily, a patient begins to exhibit fatigue, muscle cramping and muscle weakness. These symptoms probably indicate that the patient is experiencing:
1. Hypokalemia
2. Hyperkalemia
3. Anorexia
4. Dysphagia
18. Which of the following statements about chest X-ray is false?
1. No contradictions exist for this test
2. Before the procedure, the patient should remove all jewelry, metallic objects, and buttons above the waist
3. A signed consent is not required
4. Eating, drinking, and medications are allowed before this test
19. The most appropriate time for the nurse to obtain a sputum specimen for culture is:
1. Early in the morning
2. After the patient eats a light breakfast
3. After aerosol therapy
4. After chest physiotherapy
20. A patient with no known allergies is to receive penicillin every 6 hours. When administering the medication, the nurse observes a fine rash on the patient’s skin. The most appropriate nursing action would be to:
1. Withhold the moderation and notify the physician
2. Administer the medication and notify the physician
3. Administer the medication with an antihistamine
4. Apply corn starch soaks to the rash
21. All of the following nursing interventions are correct when using the Z-track method of drug injection except:
1. Prepare the injection site with alcohol
2. Use a needle that’s a least 1” long
3. Aspirate for blood before injection
4. Rub the site vigorously after the injection to promote absorption
22. The correct method for determining the vastus lateralis site for I.M. injection is to:
1. Locate the upper aspect of the upper outer quadrant of the buttock about 5 to 8 cm below the iliac crest
2. Palpate the lower edge of the acromion process and the midpoint lateral aspect of the arm
3. Palpate a 1” circular area anterior to the umbilicus
4. Divide the area between the greater femoral trochanter and the lateral femoral condyle into thirds, and select the middle third on the anterior of the thigh
23. The mid-deltoid injection site is seldom used for I.M. injections because it:
1. Can accommodate only 1 ml or less of medication
2. Bruises too easily
3. Can be used only when the patient is lying down
4. Does not readily parenteral medication
24. The appropriate needle size for insulin injection is:
1. 18G, 1 ½” long
2. 22G, 1” long
3. 22G, 1 ½” long
4. 25G, 5/8” long
25. The appropriate needle gauge for intradermal injection is:
1. 20G
2. 22G
3. 25G
4. 26G
26. Parenteral penicillin can be administered as an:
1. IM injection or an IV solution
2. IV or an intradermal injection
3. Intradermal or subcutaneous injection
4. IM or a subcutaneous injection
27. The physician orders gr 10 of aspirin for a patient. The equivalent dose in milligrams is:
1. 0.6 mg
2. 10 mg
3. 60 mg
4. 600 mg

28. The physician orders an IV solution of dextrose 5% in water at 100ml/hour. What would the flow rate be if the drop factor is 15 gtt = 1 ml?
1. 5 gtt/minute
2. 13 gtt/minute
3. 25 gtt/minute
4. 50 gtt/minute
29. Which of the following is a sign or symptom of a hemolytic reaction to blood transfusion?
1. Hemoglobinuria
2. Chest pain
3. Urticaria
4. Distended neck veins
30. Which of the following conditions may require fluid restriction?
1. Fever
2. Chronic Obstructive Pulmonary Disease
3. Renal Failure
4. Dehydration
31. All of the following are common signs and symptoms of phlebitis except:
1. Pain or discomfort at the IV insertion site
2. Edema and warmth at the IV insertion site
3. A red streak exiting the IV insertion site
4. Frank bleeding at the insertion site
32. The best way of determining whether a patient has learned to instill ear medication properly is for the nurse to:
1. Ask the patient if he/she has used ear drops before
2. Have the patient repeat the nurse’s instructions using her own words
3. Demonstrate the procedure to the patient and encourage to ask questions
4. Ask the patient to demonstrate the procedure
33. Which of the following types of medications can be administered via gastrostomy tube?
1. Any oral medications
2. Capsules whole contents are dissolve in water
3. Enteric-coated tablets that are thoroughly dissolved in water
4. Most tablets designed for oral use, except for extended-duration compounds
34. A patient who develops hives after receiving an antibiotic is exhibiting drug:
1. Tolerance
2. Idiosyncrasy
3. Synergism
4. Allergy
35. A patient has returned to his room after femoral arteriography. All of the following are appropriate nursing interventions except:
1. Assess femoral, popliteal, and pedal pulses every 15 minutes for 2 hours
2. Check the pressure dressing for sanguineous drainage
3. Assess a vital signs every 15 minutes for 2 hours
4. Order a hemoglobin and hematocrit count 1 hour after the arteriography
36. The nurse explains to a patient that a cough:
1. Is a protective response to clear the respiratory tract of irritants
2. Is primarily a voluntary action
3. Is induced by the administration of an antitussive drug
4. Can be inhibited by “splinting” the abdomen
37. An infected patient has chills and begins shivering. The best nursing intervention is to:
1. Apply iced alcohol sponges
2. Provide increased cool liquids
3. Provide additional bedclothes
4. Provide increased ventilation
38. A clinical nurse specialist is a nurse who has:
1. Been certified by the National League for Nursing
2. Received credentials from the Philippine Nurses’ Association
3. Graduated from an associate degree program and is a registered professional nurse
4. Completed a master’s degree in the prescribed clinical area and is a registered professional nurse.
39. The purpose of increasing urine acidity through dietary means is to:
1. Decrease burning sensations
2. Change the urine’s color
3. Change the urine’s concentration
4. Inhibit the growth of microorganisms
40. Clay colored stools indicate:
1. Upper GI bleeding
2. Impending constipation
3. An effect of medication
4. Bile obstruction
41. In which step of the nursing process would the nurse ask a patient if the medication she administered relieved his pain?
1. Assessment
2. Analysis
3. Planning
4. evaluation
42. All of the following are good sources of vitamin A except:
1. White potatoes
2. Carrots
3. Apricots
4. Egg yolks
43. Which of the following is a primary nursing intervention necessary for all patients with a Foley Catheter in place?
1. Maintain the drainage tubing and collection bag level with the patient’s bladder
2. Irrigate the patient with 1% Neosporin solution three times a daily
3. Clamp the catheter for 1 hour every 4 hours to maintain the bladder’s elasticity
4. Maintain the drainage tubing and collection bag below bladder level to facilitate drainage by gravity
44. The ELISA test is used to:
1. Screen blood donors for antibodies to human immunodeficiency virus (HIV)
2. Test blood to be used for transfusion for HIV antibodies
3. Aid in diagnosing a patient with AIDS
4. All of the above
45. The two blood vessels most commonly used for TPN infusion are the:
1. Subclavian and jugular veins
2. Brachial and subclavian veins
3. Femoral and subclavian veins
4. Brachial and femoral veins
46. Effective skin disinfection before a surgical procedure includes which of the following methods?
1. Shaving the site on the day before surgery
2. Applying a topical antiseptic to the skin on the evening before surgery
3. Having the patient take a tub bath on the morning of surgery
4. Having the patient shower with an antiseptic soap on the evening v=before and the morning of surgery
47. When transferring a patient from a bed to a chair, the nurse should use which muscles to avoid back injury?
1. Abdominal muscles
2. Back muscles
3. Leg muscles
4. Upper arm muscles
48. Thrombophlebitis typically develops in patients with which of the following conditions?
1. Increases partial thromboplastin time
2. Acute pulsus paradoxus
3. An impaired or traumatized blood vessel wall
4. Chronic Obstructive Pulmonary Disease (COPD)
49. In a recumbent, immobilized patient, lung ventilation can become altered, leading to such respiratory complications as:
1. Respiratory acidosis, ateclectasis, and hypostatic pneumonia
2. Appneustic breathing, atypical pneumonia and respiratory alkalosis
3. Cheyne-Strokes respirations and spontaneous pneumothorax
4. Kussmail’s respirations and hypoventilation
50. Immobility impairs bladder elimination, resulting in such disorders as
1. Increased urine acidity and relaxation of the perineal muscles, causing incontinence
2. Urine retention, bladder distention, and infection
3. Diuresis, natriuresis, and decreased urine specific gravity
4. Decreased calcium and phosphate levels in the urine