Board Exam Compilation Book 1 Sample

NP1 PAGE 1 NP2 PAGE 30 NP3 PAGE 60 NP4 PAGE 88 NP5 PAGE 112

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NURSING PRACTICE I 1. A nurse calls calls the physician physician of a client schedul scheduled ed for a cardiac cathet catheteriza erization tion because because the client client has numerous questions regarding the procedure and has requested to speak to the physician. The physician is very upset and arrives a rrives at the unit to visit the client after p rompting by the nurse. The nurse is outside of  the client’s room and hears the physician tell the client in a derogatory manner that the nurse” doesn’t know anything.” Which legal tort has the physician violates? a. Libel b. Slander  c. Assault d. Negligence Answer: B Defama Def amatio tion n tak takes es pla place ce whe when n som someth ething ing unt untrue rue is sai said d (sl (slande ander) r) or wri writte tten n (l (libe ibel) l) abo about ut a per person son,, resulting in injury to that person’s good name and reputation. An assault occurs when a person puts anothe ano therr per person son in fea fearr of a har harmfu mfull or an off offens ensive ive con contac tact. t. Ne Negli gligen gence ce inv involv olves es the actions actions of  professionals that fall below the standard of care for a specific professional group. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 62. 2. A nur nurse se is ass assess essing ing a cli client ent who has just been mea measur sured ed and fitted fitted for crutche crutches. s. The nur nurse se determines that the client’s crutches are fitted correctly if: a. The elbow is at a 30 degrees angle when the hand is on the handgrip b. The elbow is straight when the hand is on the handgrip c. The client’s axilla is resting on the crutches pad during ambulation d. The top of the crutch is even with the axilla Answer: A For optional upper extremity leverage, the elbow should be at approximately 30 degrees of flexion when the hand is resting on the handgrip. The top of the crutch need to be two to three fingerwidths lower than the axilla. When crutch walking, all weight needs to be on the hands to prevent nerve palsy from pressure on the axilla. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 73. 3. The first attempt to elevate nursing as a profession by enriching and broadening the preparation of  nurses and by educating them in University setting is an idea conceived by: a. b. c. d.

Rosari Rosa rio o De Delg lgad ado o Juli Ju lita ta V. So Sote tejo jo Flor Fl orenc ence e Ni Nigh ghti ting ngal ale e Fay aye e Abd bdel ella lah h

Answer: B Julita V. Sotejo is a nurse and lawyer who became the first dean of the University of the Philippines, College of Nursing Source: Fundamentals in Nursing by Tungpalan page 37-38

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4. A nurse is instructing a client how to safely use crutches for ambulating at home. Which measure would the nurse recommend to minimize the risk of falls while ambulating with the crutches? a. Use grab bars in the bathtub or shower  b. Remove scatter rugs in the home c. Keep all pets out of the house d. Use soft-soled slippers when walking with the crutches Answer: B To reduce the risk of falls, all obstacles should be removed from the home. Not all pets are trip hazards (fish, birds, guinea pigs). Grab bars in the bathtub or shower will not necessarily assist the client while walking with crutches. Shoes with non-slip soles should be worn. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 75. 5. A client is being discharged and will receive oxygen therapy at home. The nurse is teaching the client and family about oxygen safety measures. Which of the following statements by the client indicates the need for further teaching? a. b. c. d.

“I realize realize that that I should should check the the oxygen level level of the the portable portable tank tank on a consistent consistent basis. basis.”” “I will will keep my scented scented candles candles withi within n 5 feet of my oxygen oxygen tank.” tank.” “I will will not sit sit in front front of of my wood-bur wood-burning ning firepl fireplace ace with with my oxygen oxygen on.” on.” “I will will call call the physici physician an if I experi experience ence any any shortness shortness of breat breath.” h.”

Answer: B Oxygen is a highly combustible gas, although it will not spontaneously burn or cause an explosion. It can easily cause fire to ignite in a client’s room if it contacts a spark from a cigarette, burning candle or  electrical equipment. Options A, C, and D are appropriate oxygen safety measures. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 110. 6.

a. b. c. d.

The four four main concepts concepts common common to nursing nursing that that appear in in each of the current current concept conceptual ual models models are:

Person,, Nursin Person Nursing g , Environ Environmen ment, t, Medic Medicine ine Person Per son,, Health Health,, Nursin Nursing, g, Suppo Support rt Syste System m Person Per son,, Healt Health, h, Psyc Psychol hology ogy,, Nursi Nursing ng Person Per son,, Enviro Environme nment, nt, Heal Health, th, Nurs Nursing ing

Answer: D The four concepts that have been accepted by all theorists as the focus of nursing practice from the time of Flor Florence ence Nightingale Nightingale incl include ude the PER PERSON, SON, receiving receiving the nursing care, his ENVI ENVIRONM RONMENT ENT,, his HEALTH on the health-illness continuum, and the NURSING, actions necessary to meet his needs. Source: Nurse Test Review Series (Fundamentals) page 51 7. A nurse is taking care of a client on contact isolation. After the nursing care has been performed, on leaving the room, which protective item during client care, would the nurse remove first? Gloves Mask Eye wear(goggles) Gown Answer: C The nurse removes the goggles first. The nurse unties the gown at the waist and then removes the goggles and discards them. The nurse then removes and discards the mask, unties the neck strings of  the gown and allows the gown to fall from the shoulders. The gown is removed without touching the outside of the gown and discarded. The hands are then washed. For more nursing reviewers, contact [email protected]

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Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 93. 8. An older adult woman client with a fractured left tibia has a long leg cast and is using crutches to ambulate. In caring for the client, the nurse assesses for which of the following signs and symptoms that indicate a complication associated with crutch walking? a. Forearm muscle weakness b. Left leg discomfort. c. Triceps muscle spasm d. Weak biceps brachii Answer: A Forearm muscle weakness is a sign of radial nerve injury caused by crutch pressure on the axillae. When clients lack upper body strength, especially in the extensor and flexor muscle o f the arms, they frequently allow their weight to rest on their axillae instead of their arms while ambulating with crutches. Leg discomfort is expected as a result of the injury. Triceps muscle spasm may occur as a result of increase muscle use but is not a complication of crutch walking. Weak biceps brachii is a common physical assessment finding in older adults and is not a complication of crutch walking. Source: Potter, P., & Perry, A. (2001). Fundamentals of nursing (5th ed.). St. Louis: Mosby, p.1008. 9. A client requests pain medication and the nurse administers an intramuscular (IM) injection. After  administration of the injection, the nurse does which of the following first? a. Recaps the needle b. Removes the gloves c. Washes the hands d. Places the syringe in the puncture-resistant needle box container  Answer: D Following administration of an IM injection, the nurse would massage the site to assist in medication absorption. Then the nurse assists the client to a comfortable position. The uncapped needle is discarded in a puncture-resistant container, gloves are removed, and the hands are washed. A needle is never  recapped. Of the options provided, the nurse would perform option D first. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 93. 10. A nursing manager is reviewing the purpose for applying restraints with the nursing staff. The nurse manager tells the staff that which of the following is not an indication for the use of a restraint? a. To prevent falls b. To restrict movement of a limb c. To prevent the client from pulling out IV lines and catheters d. To prevent the violent client from injuring self and others Answer: A Restraints do not necessarily prevent falls. Restraints are d evices used to restrict the client’s movement in situations when it is necessary to immobilize a limb or other body part. They are applied to prevent selfinflicted injury or from injuring other’s; from pulling out intravenous lines, catheters, or tubes; or from removing dressings. Restraints also may be used to keep children still and from injuring themselves during treatments and diagnostic procedures. Restraints should not be used as a form of punishment. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 94. 11. A client who is scheduled for gallbladder surgery is mentally impaired and is unable to communicate. In regard to obtaining permission for the surgical procedure, which nursing intervention would be most appropriate? a. Ensure that the family has signed the informed consent b. Ensure that the client has signed the informed consent For more nursing reviewers, contact [email protected]

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c. Inform the family about the advance directive process d. Inform the family about the process of a living will Answer: A A client must be alert, able to communicate, and competent to sign the informed consent. If the client is unable to, then the family can sign the consent. A living will lists the medical treatment a person chooses to omi omitt or ref refuse use if the person person bec become omes s una unable ble to mak make e dec decisi isions ons and is ter termi minal nally ly ill ill.. Adv Advanc anced ed directives are forms of communication in which persons can give direction on how they would like to be treated when they cannot speak for themselves. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 92. 12. A client diagnosed with tuberculosis (TB) is scheduled to go to the radiology department for a chest xray evaluation. Which nursing intervention would be appropriate when preparing to transport the client? a. Apply a mask to the client b. Apply a mask and gown to the client c. Apply a mask, gown, and gloves to the client d. Notify the x-ray department that the personnel can be sure to wear a mask when the client arrives. Answer: A Clients known or suspected of having TB should wear a mask when out of the room to prevent the spread of the infection to others. A gown or gloves are not n ecessary. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 92. 13. A nurse is observing a client using a walker. The nurse determines that the client is using the walker  correctly if the client: a. Puts all four points of the walker flat on the floor, puts weight on the hand pieces, and then walks into it b. Puts weight on the hand pieces, moves the walker forward, and the walks into it. c. Puts weight on the hand pieces, slides the walker forward, and then walks into it. d. Walks into the walker, puts weight on the hand pieces, and then puts all four points of the walker flat on the floor. Answer: A When the client uses a walker, the nurse stands adjacent to the affected side. The client is instructed to put all four points of the walker two feet forward flat on the floor before putting weight on the hand pieces. This will ensure client safety and prevent stress cracks in the walker. The client is then instructed to move the walker forward and walk into it. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 77. 14. A nurse has an order to obtain a 24-hour urine collection of a client with renal disorder. The nurse avoids which of the following to ensure proper collection of the 24-hour specimen? a. b. c. d.

Have the the client void at the the start time time,, and place place this specime specimen n in the containe container. r. Discard Disc ard the first first voiding; voiding; save all subsequ subsequent ent voiding voiding during during the 24-hour 24-hour time period. period. Place Pla ce the the contai container ner on on ice, ice, or in a refr refrige igerat rator  or  Have the the client void at the the end time time and place place this specime specimen n in the containe container. r.

Answer: A The nurse asks the client to void at the beginning of the collection period and discards the urine sample. All subsequent voided urine is saved in a container, which is placed on ice or refrigerated. The client is asked to void at the finish time, and this sample is added to the collection. The container is labeled, placed on fresh ice, and sent to the laboratory immediately. Source: Potter, P., & Perry, A. (2001). Fundamentals of nursing (5th ed.). St. Louis: Mosby, p.1398. For more nursing reviewers, contact [email protected]

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15. A client is receiving total parenteral nutrition (TPN) via central intravenous (IV) line is scheduled to receive an antibiotic by the IV route. Which action by the nurse is appropriate before hanging the antibiotic solution? a. b. c. d.

Ensure a separ Ensure separate ate IV acces access s for for the the antibio antibiotic. tic. Turn off off the TPN TPN for 30 minute minutes s before before administeri administering ng the antibiot antibiotic. ic. Check with with the pharma pharmacy cy to be sure sure the antibiot antibiotic ic can be hung hung through through the TPN TPN line. line. Flush the the central central line with with 60 mL of normal normal saline saline solution solution before before hanging hanging the antibiotic. antibiotic.

Answer: A The TPN line is used only for the administration of the TPN solution. Any other intravenous medication must be administered through a separate IV site. Source: Potter, P., & Perry, A. (2001). Fundamentals of nursing (5th ed.). St. Louis: Mosby, p.1218 16. A nurse has inserted a nasogastric (NG) tube to the level of the oropharynx and has repositioned the client’s head in a flexed forward position. The client has been asked to begin swallowing. The client begins to cough, gag, and choke. Which of the following nursing actions would least likely result in proper  tube insertion and promote client relaxation? a. Continue to advance the tube to the desired distance. b. Pulling the tube back slightly. c. Checking the back of the pharynx using a tongue blade and flashlight. d. Instructing the client to breath slowly. Answer: A As the NG tube is passed through the oropharynx, the gag reflex is stimulated, which may cause coughing, gagging, and choking. Instead of passing through the esophagus, the NG tube may coil around itself in the oropharynx, or it may enter the larynx and obstruct the airway. Since the tube may enter the larynx, advancing the tube may position it in the trachea. Slow breathing help the client relax to reduce the gag response. The tube maybe advance after the client relaxes. Source: Potter, P., & Perry, A. (2001). Fundamentals of nursing (5th ed.). St. Louis: Mosby, p.1467. 17. A nurse has an order to obtain a urinalysis from a client with an indwelling urinary catheter. The nurse avoids which of the following, which could contaminate the specimen? a. Obtaining the specimen from the urinary drainage bag b. Clamping the tubing of the drainage bag c. Aspirating a sample from the port on the drainage bag d. Wiping the port with an alcohol swab before inserting the syringe Answer: A A urine specimen is not taken from the urinary drainage bag. Urine undergoes chemical changes while sitting in the bag and does not necessarily reflect the current client status. In addition, it may become contaminated with bacteria from opening the system. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 96 18. A nursing assistant is caring for an elderly client with cystitis who has an indwelling urinary catheter. The registered nurse provides directions regarding care and ensures that the nursing assistant: a. b. c. d.

Uses soap Uses soap and wate waterr to cleans cleanse e the perin perineal eal area area Keeps the drainag drainage e bag above the level level of the the bladder  bladder  Loops Loo ps the the tubi tubing ng under under the the clien client’s t’s leg Lets Let s the drai drainag nage e tubing tubing rest rest unde underr the the leg

Answer: A Proper care of an indwelling urinary catheter is especially important to prevent prolonged infection or  reinfection in the client with cystitis. The perineal area is cleansed thoroughly using mild soap and water  at least twice a day and following a bowel movement. The drainage bag is kept below the level of the For more nursing reviewers, contact [email protected]

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bladder to prevent urine from being trapped in the bladder, and for the same reason, the drainage tubing is not placed or looped under the client’s leg. The tubing must drain freely at all times. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 96. 19. A nurse is inserting an indwelling urinary catheter into a male client. As the catheter is inserted into the urethra, urine begins to flow into the tubing. At this point, the nurse: a. Immediately inflates the balloon b. Withdraws the catheter approximately 1 inch and inflates the balloon c. Inserts the catheter until resistance is met and inflates the balloon d. Inserts the catheter 2.5 to 5 cm and inflates the balloon Answer: D The catheter’s balloon is behind the opening at the insertion tip. The catheter is inserted 2.5 to 5 cm after  urine begins to flow in order to provide sufficient space to inflate the balloon. Inserting the catheter the extra distance will ensure that the balloon is inflated inside the bladder and not in the urethra. Inflating the balloon in the urethra could produce trauma. Source: Saunders Q&A Review for NCLEX-RN by Linda Anne Silvestri, 2 nd edition, page 82. 20. A nurse is caring for a client with cancer. The client tells the nurse that a lawyer will be arriving today to prepare a living will. The client asks the nurse to act as one of the witnesses for the will. The most appropriate nursing action is to: a. b. c. d.

Agree Agre e to to act act as a wit witnes ness. s. Refu Re fuse se to to help help the the cli client ent.. Inform Infor m the client client that that a nurse caring caring for for the client client cannot cannot serve serve as a witness witness to a living living will. will. Call Ca ll th the e phys physic icia ian. n.

Answer: C Living wills address the withdrawal or withholding of life sustaining interventions that unnaturally prolong life. It identifies the person who will make care decisions if the client is unable to take action. It is witnessed and signed by two people who unrelated to the client. Nurses or employees of a facility in which the client is receiving care, and beneficiaries of the client, must not serve as a witness. There is no reason to call the physician. Source: Potter, P., & Perry, A. (2001). Fundamentals of nursing (5th ed.). St. Louis: Mosby, p.436

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