1.The client with a major burn injury

receives total parenteral nutrition (TPN).

The primary reason for this therapy is to

help:

a. Correct water and electrolyte imbalance.

b.Allow the gastrointestinal tract to rest.

c. Provide supplemental vitamins and minerals.

d.Ensure adequate caloric and protein intake.

2. The client asks the nurse what the word

eschar means. Which of the following

descriptions by the nurse best defines eschar?

a. Eschar is scar tissue in a developmental stage.

b. Eschar is crust formation without a blood

supply.

c. Eschar is burned tissue that has become

infected.

d. Eschar is visible living tissue with a rich blood

supply.

3. The nurse is administering fluids

intravenously as prescribed to a client who

sustained superficial partial-thickness burn

injuries of the back and legs. In evaluating the

adequacy of fluid resuscitation, the nurse

understands that which of the following would

provide the most reliable indicator for

determining the adequacy?

a. Vital signs

b. Urine output

c. Mental status

d. Peripheral pulses

4. The client asks the nurse what causes a

peptic ulcer to develop. The nurse responds

that recent research indicates that many

peptic ulcers are the result of which of the

following?

a. Work-related stress

b.Helicobacter pylori infection

c. Diets high in fat

d.A genetic defect in the gastric mucosa

5. The nurse instructs the client who has had

a hemorrhoidectomy not to use sitz baths

until at least 12 hours postoperatively to

avoid inducing which of the following

complications?

a. Haemorrhage

b.Rectal spasm

c. Urine retention

d.Constipation

6. When the clients common bile duct is

obstructed, the nurse should evaluate the

client for signs and symptoms of which of

the following complications?

a. Respiratory distress

b.Circulatory overload

c. Urinary tract infection

d.Prolonged bleeding time

7. A 40-year-old client is admitted to the hospital

with a diagnosis of abdominal pain. Following

numerous diagnostic tests, it is concluded that the

client has acute cholecystitis. The nurse should

contact the physician to question which of the

following orders?

a. I.V. fluid therapy of normal saline solution to be

infused at 100 mL/hr until further orders

b. Administer morphine sulphate 10 mg I.M. every 4

hours as needed for severe abdominal pain

c. Nothing by mouth (NPO) until further orders

d. Insert a nasogastric tube and connect to low

intermittent suction

8. A client undergoes a traditional cholecystectomy

and choledocholithotomy and returns from

surgery with a T-tube. To evaluate the effectiveness

of the T-tube, the nurse should understand that the

primary reason for the T-tube is to accomplish

which of the following?

a. Promote wound drainage

b. Provide a way to irrigate the biliary tract

c. Minimize the passage of bile into the duodenum

d. Prevent bile from entering the peritoneal cavity

9. The nurse evaluates the clients most recent

laboratory data. Which laboratory finding would

be consistent with a diagnosis of acute

pancreatitis?

a. Hyperglycemia

b. Leukopenia

c. Thrombocytopenia

d. Hyperkalemia

10. The nurse carefully monitors the client with

acute pancreatitis for which of the following

complications?

a. Heart failure

b. Duodenal ulcer

c. Cirrhosis

d. Pneumonia

11. Pancreatic enzyme replacements are ordered

for a client with chronic pancreatitis. What should

the nurse instruct the client to take them to obtain

the most therapeutic effect?

a. Three times daily between meals

b. With each meal and snack

c. In the morning and at bedtime

d. Every four hours at specified times

12. The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide (Cytoxan, Neosar). The nurse tells the client to:a. Take the medication with food.b. Increase fluid intake to 2000 to 3000 mL daily.c. Decrease sodium intake while taking the medication.d. Increase potassium intake while taking the

medication.

13. The client with nonHodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?a. Feverb. Diarrheac. Complaints of nausea and vomitingd. Crackles on auscultation of the lungs

14. The client with squamous cell carcinoma of the larynx is receiving bleomycin (Blenoxane) intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?a. Echocardiographyb. Electrocardiographyc. Cervical radiographyd. Pulmonary function studies

15. The client with lung cancer is receiving a high dose of methotrexate (Rheumatrex, Trexall). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse caring for the client understands that the purpose of administering the leucovorin is to:a. Preserve normal cells.b. Promote DNA synthesis.c. Promote medication excretion.d. Promote the synthesis of nucleic acids.

16. Which goal for the clients care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis?a. Promoting self-care and independenceb. Managing diarrheac. Maintaining adequate nutritiond. Promoting rest and comfort

17. The client with ovarian cancer is being treated with vincristine (Oncovin, Vincasar PFS). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?a. Diarrheab. Hair lossc. Chest paind. Numbness and tingling in the fingers and toes

18. Tamoxifen (Nolvadex) is prescribed for the client with metastatic breast carcinoma. The nurse administering the medication understands that the primary action of this medication is to:a. Increase DNA and RNA synthesis.b. Promote the biosynthesis of nucleic acids.c. Increase estrogen concentration and estrogen

response.d. Compete with estradiol for binding to estrogen

in tissues containing high concentrations of receptors.

19. A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenously administered doxorubicin (Adriamycin). The client tells the nurse that she has been told by her friends that she is going to lose all her hair. The appropriate nursing response is which of the following?a. Your friends are correct.b. You will not lose your hair.c. Hair loss may occur, but it will grow back just

as it is now.d. Hair loss may occur, and it will grow back, but

it may have a different color or texture.

20. The clinic nurse prepares instructions for a client who developed stomatitis following the administration of a course of antineoplastic medications. The nurse tells the client to:a. Rinse the mouth with baking soda or saline.b. Avoid foods and fluids for the next 24 hours.c. Swab the mouth daily with lemon and glycerin

pads.d. Brush the teeth and use waxed dental floss

three times a day.

21. A patient comes to the hospital complaining of sudden onset of sharp, severe pain originating in the lumbar region and radiating around the side and toward the bladder. The patient also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The doctor tentatively diagnoses renal calculi and orders flat plate abdominal x-rays. Renal calculi can form anywhere in the urinary tract. What is there most common formation site?a. Kidneyb. Ureterc. Bladderd. Urethra

22. Which of the following reasons explains why meperidine (Demerol) is not recommended for chronic cancer-related pain?a. It has a high potential for abuseb. It has agonist-antagonist property.c. It must be given intramuscularly to be

effective.d. It contains a metabolite that causes seizure.

23. The initial diagnosis of pancreatitis is

confirmed if the clients blood work shows a

significant elevation in which of the

following serum values?

a. Amylase

b.Glucose

c. Potassium

d.Trypsin

24. The nurse should teach the client with

chronic pancreatitis to monitor the

effectiveness of pancreatic enzyme

replacement therapy by doing which of the

following?

a. Monitoring fluid intake.

b.Observing regular glucose fingerstick tests.

c. Observing stools for steatorrhea.

d.Testing urine for ketones.

25. The client with chronic pancreatitis

should be monitored closely for the

development of which of the following

disorders?

a. Cholelithiasis

b.Hepatitis

c. Irritable bowel syndrome

d.Diabetes mellitus

26. The physician orders oral neomycin as

well as neomycin enema for a client with

cirrhosis. The nurse understands that the

purpose of this therapy is to:

a. Reduce abdominal pressure

b.Preventing straining during defecation

c. Block ammonia formation

d.Reduce bleeding within the intestine

27. If a gallstone becomes dislodged in the

common bile duct, the nurse should

anticipate that the clients stools would most

likely become what color?

a. Green

b.Gray

c. Black

d.Brown

28. A nurse is preparing to hang the first bag

of total parenteral nutrition (TPN) solution

via the central line of an assigned client. The

nurse obtains which most essential piece of

equipment before hanging the solution?

a. Urine test strips

b.Blood glucose meter

c. Electronic infusion pump

d.Noninvasive blood pressure monitor

29. A client is to take one daily dose of

ranitidine (Zantac) at home to treat her

peptic ulcer. The nurse knows that the client

understands proper drug administration of

ranitidine when she says that she will take

the drug at which of the following times?

a. Before meals

b.With meals

c. At bedtime

d.When pain occurs

30. When caring the client who is receiving

an aminoglycoside antibiotic, the nurse

monitors which of the following laboratory

values?

a. Serum sodium

b.Serum potassium

c. Serum creatinine

d.Serum calcium