PROFESSIONAL SERVICES
CLINICAL DIVISION
RN/LPN MEDSURG TEST
1. Rank the following routes of drug administration according to the usual rate of absorption from the most rapid to the slowest.
1. Intramuscular
2. Intravenous
3. Subcutaneous
a) 1-2-3
b) 2-3-1
c) 3-2-1
d) 2-1-3
2. Hypoglycemic reactions may occur in which of the following cases:
a) Too little insulin, too little food, or too much exercise
b) Too much exercise, too much insulin, or too little food
c) Too little food, too little exercise, or too little insulin
d) Too little exercise, too much insulin, or too little food
3. The insulin used for a random blood sugar (glucometer) coverage is which of the following?
a) NPH
b) Regular
c) Ultralente
d) Protamine Zinc
4. The drug of choice for anaphylactic shock is which of the following?
a) Atropine
b) Benadryl
c) Aramine
d) Epinephrine
5. Nitroglycerin is which of the following types of drugs?
a) Antiarrhythmic
b) Vasoconstrictor
c) Vasodilator
d) Ganglionic blocking agent
6. Opiate over-dosage is best treated with which of the following?
a) Narcan
b) Amphetamines
c) Phenobarb
d) Epinephrine
7. Patients taking any of the minor tranquilizers are cautioned against activities such as driving automobiles, operating dangerous machinery, or performing tasks requiring precision because of the common occurrence of which of the following side effects?
a) Drowsiness, ataxia, dizziness, headache
b) Rash, fever, dry mouth, chills
c) Nausea, vomiting, confusion
d) Jaundice, increased which blood count, diarrhea
8. Which of the following drugs is least likely to lead to dependence?
a) Morphine
b) Codeine
c) Demerol
d) Heroin
9. Culture and sensitivity tests are done prior to prescribing certain antibiotics because:
a) Many people are allergic to certain medications
b) The correct dosage must be determined
c) Microorganisms vary greatly in their resistance to drugs
d) Other drugs being taken by the patient may be incompatible
10. Then reconstituting drugs for injection, it is important for the nurse to use the type of diluent that the pharmaceutical company suggests for which of these reasons?
a) To insure the solubility of the drug
b) To minimize side effects from the drug
c) To render the solution sterile
d) To insure appropriate dosage of the drug
11. A patient with Bell’s palsy does not blink the affected eye. The nurse should:
a) Apply an eye patch to the affected eye at all times
b) Ask the patient to keep both eyes closed
c) Assess pupil reaction to light and accommodation
d) Obtain medical orders for eye lubrication
12. A patient with right hemiplegia is awake and alert. The patient is given exercise to do during the day. One afternoon the patient seems very discouraged, so the nurse plans to motivate her by:
a) Reassuring her that there is no need for her to feel discouraged
b) Reinforcing the small gains she has made
c) Suggesting that she could rest today and exercise again tomorrow
d) Explaining that exercise is necessary to get better
13. Pupil checks every hour are ordered for a patient with CVA. This is an important assessment because:
a) Blurred vision is a sign of increasing ICP
b) Cranial nerve III exits from the brain stem
c) Dilated and fixed pupils indicate cardiac arrest
d) Pinpoint pupils result from CNS depressant drugs
14. If a cerebrovascular injury involves the pyramidal tract the nurse expects to observe:
a) Intention tremors
b) Loss of pain and temperature sensation
c) Loss of equilibrium
d) Paralysis of voluntary movement
15. A female patient with CVA sometimes has difficulty “finding” the words she wants to say. The nurse will encourage the patient’s visitors to:
a) Be patient with her while she thinks of a word
b) End the visit if she becomes frustrated and angry
c) Finish her sentence for her if they know what she wants to say
d) Tactfully change the subject when she cannot find the word she wants to use
16. A patient has had a CVA with expressive aphasia. When assisting the patient to communicate during the early period after the CVA, it is most important for the nurse to:
a) Create signals for the patient to use
b) Speak loudly and clearly
c) Stand directly in front of the client
d) Write directions in large letters
17. In a patient with left hemiplegia, the nurse is applying pain by pressing on the base of the patient’s fingernail to access level of consciousness. The patient’s best response is:
a) Flexion of both arms
b) Flexion of the unaffected arm and unaffected leg
c) Grimacing (making a face)
d) Pulling the hand away
18. After a head injury, a client’s vital signs are stabilized and he is posted for a CT scan. To prepare him for this test, the nurse needs to understand that a CT scan:
a) Involves injection of a radiopaque contrast medium into an artery, which causes a burning sensation
b) Is a measure of electrical energy flowing away from the brain
c) Lasts only a few minutes, but he will have to remain flat for 12 hours after the test.
d) Requires him to lie very still during the examination
19. A male patient with herniated nucleus pulposis (HNP) had a myelogram this morning. To prevent headache, the nurse instructs him to remain flat in bed for 6 hours, and the nurse will:
a) Dim the lights in his room
b) Force fluids
c) Offer analgesic medication
d) Turn him every 2 hours from side to side
20. After a cerebral angiogram, the nurse will encourage the patient to:
a) Ask for assistance with ambulation
b) Drink fluids
c) Turn, cough, and deep breathe
d) Void
21. To prepare a female patient for an MRI, the nurse explains that the patient will:
a) Be asked to lie still during the entire procedure and will hear a humming noise
b) Have an injection of a radiopaque contrast medium into her vein
c) Have many small electrodes placed on her scalp
d) Need to stay in bed with the head of the bed elevated for 6-8 hours after the procedure
22. A patient with Guillaine-Barre syndrome is going to undergo plasmapheresis and is concerned about what it means. The nurse’s response is based on the understanding that plasmaphersis:
a) Alleviates symptoms by removing autoimmune autibodies from the blood
b) May cause mild allergic reaction with generalized itching
c) Prevents secondary bacterial infection to the nervous system
d) Reduces the need for Oxygen while the patient is on a respirator
23. To help prevent tonic-clonic type seizures due to epilepsy, the nurse will teach a patient to:
a) Avoid any situation that produces fatigue
b) Refrain from participating in competitive sports
c) Take extra medication if an infection is present
d) Try to determine factors that consistently precede a seizure
24. Which of the following assessments most likely indicates a complication of total hip replacement during the early postoperative period?
a) Both legs cool to touch
b) Calf tenderness when the foot is dorsiflexed
c) Tenderness at the surgical site
d) Lightheadedness when standing
25. The nurse expects a person with rheumatoid arthritis to have the most difficulty with pain and stiffness after:
a) ADL
b) Heat application
c) Meals
d) Sleep
26. Then counseling women about exercise to prevent osteoporosis, the nurse knows the best exercise is:
a) Isometric exercises of all major muscle groups
b) Leg raises with the knees bent
c) Swimming
d) Walking
27. The primary purpose of Buck’s traction for the immediate treatment of hip fracture is to:
a) Eliminate rotation of the femur
b) Immobilize the fracture
c) Maintain abduction
d) Reduce the fracture
28. When assessing a patient in Buck’s traction, the nurse observes the patient’s affected foot resting on the foot of the bed. The appropriate intervention is to:
a) Place a pillow between the affected foot and the foot of the bed
b) Pull the patient up in bed
c) Take no action
d) Turn the patient to the side
29. The nurse is assessing a 46-year old man with a fractured pelvis due to an automobile accident. Which of the following signs or symptoms alerts the nurse to a serious complication of pelvic fracture?
a) Eccymosis of the perineum
b) Edema over the symphysis pubis
c) Hematuria
d) Discomfort at the fracture site
30. Which of the following is an early sign of fat embolism and should alert the nurse to the need for medical intervention?
a) Irritability and confusion
b) Fat in the stool
c) Hyperglycemia
d) Pruritus
31. Following an injury, the nurse should access for fat embolism:
a) During the first 12 hours
b) During the first 48 hours
c) If the client has chronic respiratory disease
d) If the client is in skeletal traction
32. To best assess circulation to extremities, the nurse should check:
a) Capillary refill
b) Motion and sensation
c) Pain and pallor
d) Skin temperature
33. After and above-the-knee amputation, the nurse will encourage the client to lie prone periodically to:
a) Extend the client’s hip joint
b) Increase the client’s vital lung capacity
c) Prepare the client by lifting weights for crutch walking
d) Provide diversion
34. When accessing a client with obstructive cholelithiasis, the nurse might expect to find:
a) Abdominal distention
b) Dark urine
c) Diminished bowel sounds
d) Loose stools
35. In a client with a stone lodged in the cystic duct, the nurse would expect to observe:
a) Beginning jaundice, dark urine, and clay-colored stools
b) Burning and frequency in voiding, cloudy urine
c) Colicky pain after a fatty meal
d) Petechiae, melena, and possible hematemesis
36. After a cholecystectomy, a client asks why he has to have a nasogastric (NG) tube. The nurse states the purpose of the NG tube is to:
a) Administer high-caloric liquid feeding
b) Facilitate collection of gastric secretions
c) Prevent postoperative distention
d) Simplify administration of medications
37. A client with cholescystectomy and exploration of a the common bile duct has a T-tube and a Jackson-Pratt drain. Because of the location of the incision, an important nursing action is to encourage the client to:
a) Lie on the inoperative side
b) Remain in a semi-Fowler position
c) Splint the incision when moving
d) Turn, cough, and deep breathe
38. The nurse expects which of the following laboratory results for a client with jaundice?
a) Decreased PT
b) Elevated serum bilirubin
c) Elevated serum potassium
d) Metabolic acidosis
39. Which of the following is most likely to put a client with cirrhosis at risk for hepatic encephalopathy?
a) Anorexia and weight loss
b) Diarrhea and tenesmus
c) GI Bleeding
d) Nausea and vomiting
40. When caring for a client with advanced cirrhosis, the nurse is alret for changes in all of the following. Which change suggests hepatic encephalopathy?
a) Level of consciousness
b) Respiratory status
c) Urine output
d) Vital signs
41. Your order reads Penicillin 400,000 units. You have on hand a vial of 500,000 units in 10 cc’s. How many cc’s would you give?
a) 6
b) 9
c) 8
d) 5
42. To give Ganstrisin 1 GM, you would need to give how many 250mg tablets?
a) 4
b) 2
c) 8
d) 3
43. A patient is to receive 800ml of intravenous fluids in 6 hours. The infusion pump should be set to deliver how many milliliters per hour?
a) 125
b) 150
c) 133
d) 115
44. You have on hand a tubex syringe labeled Digoxin 0.5mg in 2 cc’s. How many cc (s) would you need to administer 0.125 mg?
a) 0.5
b) 2.5
c) 1
d) 0.25
45. IV fluids are ordered at the rate of 50 cc’s per hour. In 24 hours, your patient should receive how many cc’s?
a) 1000
b) 800
c) 1200
d) 1800
46. MOM ½ ounce is ordered. You would give how many cc’s?
a) 30
b) 10
c) 15
d) 60
47. The doctor orders lasix 40 mg by injection. Since the label on the ampule reads Lasix 20 mg per 2 ml, you would give how many milliliters?
a) 10
b) 4
c) 2
d) 6
48. Nitroglycerin 0.4 mg has been ordered. The drug label states gr 1/150 equals 1 tablet. How many tablets would the nurse give?
a) 1
b) ½
c) 2
d) 1 ½
49. Cephalexin monohydrate (Keflex) 0.5 g has been ordered. The drug comes in 250 mg per capsule. How many capsules would the nurse give?
a) 5
b) 4
c) 2
d) 1
50. Penicillin V potassium (Pen-Vee K) suspension 0.75 g has been ordered. The drug is available as 250 mg per 5 ml. How many milliliters would the nurse give?
a) 10
b) 15
c) 3
d) 20
51. Cyclophsphamide (Cytoxan) 4 mg/kg per day po has been ordered. The client weighs 154 lb. How much would the nurse give each day?
a) 100 mg
b) 120 mg
c) 240 mg
d) 280 mg
52. Vitamin K is available as 1 mg per 0.5 ml. Vitamin K 0.5 mg has been ordered. The amount of vitamin K to be administered is:
a) 2.5 ml
b) 0.5 ml
c) 0.25 ml
d) 1 ml
53. Digoxin is available as 0.125 mg per tablet. Digoxin 0.25 mg has been ordered. The number of tablets to be administered is:
a) 1
b) ½
c) 2
d) 1 ½
54. Meperidine (Demerol) is available as 75 mg/ml. Meperidine 50 mg has been ordered. The amount of drug to be administered is:
a) 0.5 ml
b) 0.6 ml
c) 0.7 ml
d) 1.5 ml
55. Hydroxyzine (Vistaril) is available as 25 mg/ml. The amount ordered is 100 mg po q 4-6 hours prn. How many milliliters would the nurse give for each prn dose?
a) 0.25 ml
b) 2.5 ml
c) 4 ml
d) 40 ml
56. The amount of solution and amount of aminophylline received by a client IV each hour when there is 500 mg of aminophylline in 250 m. given every 24 hours is: