Matrix Personnel Service, Inc.
Medical/Surgical Competency Test

 

1.  A client is placed on seizure precautions. The nurse knows that an appropriate intervention for a grand mal seizure is:
A.  Insert a tongue blade between the teeth to prevent biting the tongue.
B.  Apply restraints to prevent injury to the self.
C.  Place the client in a supine position.
D.  Place the head in a lateral position.
 
2.  A 15-year-old client fractured his tibia and several metatarsal bones. A cast has been applied; it extends from the knee to the toes. The      nurse makes frequent assessments of which of the following:
A.  Quality of the popliteal and femoral pulses.
B.  Color, temperature and sensation in the toes.
C.  Movement of the toes on both feet.
D.  The pedal pulses in both lower extremities.
 
3.  A client is on intravenous heparin therapy. The nurse would keep which of the following drugs available as an antidote?
A.  Vitamin K
B.  Protamine sulfate
C.  Epinephrine
D.  Norepinephrine
 
4.  A client is on chemotherapy for acute myelogenous leukemia. The nurse assesses the following laboratory test daily:
A.  Complete blood count
B.  Electrolyte panel
C.  Prothrombin time
D.  Blood urea nitrogen and creatinine
 
5.  A 44-year-old client is in acute congestive heart failure. The nurse and client establish a goal of highest priority as:
A.  Rest mentally as well as physically.
B.  Learn stress management
C.  Train for a less demanding job
D.  Prevent complications of immobility
 
6.  A client diagnosed with insulin-dependent diabetes mellitus becomes irritable and confused; the skin is cool and clammy, and the pulse      rate is 110. The first action of the nurse would be to:
A.  Give a half-cup of orange juice
B.  Check the serum glucose
C.  Administer regular insulin
D.  Call the physician
 
7.  A 29-year-old client has been taking prednisone 60 mg daily for an inflammatory condition for the past 6 months. The physician just      wrote an order to discontinue the medication. The nurse should:
A.  Stop the medication as ordered.
B.  Continue the medication until the physician is available.
C.  Call the physician and question the order.
D.  Hold the medication until the physician is available.
 
8.  A client is to have a nasogastric tube removed. To prevent aspiration as the tube is pulled past the epiglottis, the nurse asks the client     to:
A.  Use a cascade cough.
B.  Take a deep breath.
C.  Exhale and hold it.
D.  Use the valsalva maneuver.
 
9.  A 16-year-old client has nasal congestion, a temperature of 103 degrees F, malaise and aching muscles. A nurse recommends that the      following medication be taken to lower the temperature:
A.  Aspirin
B.  Enteric-coated aspirin
C.  Tylenol
D.  Anacin
 
10.  A client started on amoxicillin (Amoxil) at 9 a.m. At 9:30 a.m. the blood pressure drops and the client is dyspneic. The nurse       anticipates the need for:
A.  Epinephrine
B.  Glucagon
C.  Cortisol
D.  Aminophyllin
 
11.  A client’s blood pressure drops and he is gasping for air following an injection of penicillin. The nurse establishes her first priority as:
A.  Effective heart beat
B.  Effective tissue perfusion
C.  Normal acid-base balance
D.  Open airway
 
12.  A client is taking levathyroxine (Synthroid) for hypothyroidism. The nurse teaches the client to:
A.  Monitor the pulse regularly.
B.  Restrict sodium in the diet.
C.  Take the drug with meals.
D.  Measure urinary output.
 
13.  A client with NIDDM is admitted to the hospital. The client is confused and has dry mucous membranes and poor skin turgor. The       serum sodium is 149; the blood pressure 88/58; the pulse 118; and the serum glucose 465 mg/dl. The nurse anticipates that insulin and       the following will be needed:
A.  A potassium drip
B.  Sodium bicarbonate
C.  Intravenous fluids
D.  Calcium gluconate
 
14.  A hospitalized client is found in a coma. The skin is dry and flushed; Kussmaul respirations are noted and the smell of acetone is on       the breath. The nurse prepares for the emergency treatment of:
A.  Hyperosmolar hyperglycemic nonketotic syndrome.
B.  Diabetic ketoacidosis
C.  Hypoglycemia
D.  Dawn phenomenon
 
15.  A client has no bowel sounds and has been vomiting for the last hour. The nurse places a nasogastric tube (as ordered by the       physician). In order to estimate the distance to the beginning of the esophagus, this nurse will measure the distance from the tip of the       nose to the:
A.  Cough
B.  Breathe deeply
C.  Turn her head to the side
D.  Perform the Valsalva maneuver
 
16.  A client with amyotrophic lateral sclerosis (ALS) is receiving tube feedings and medications through a gastrotomy tube. The nurse       initiates a feeding by aspirating gastric contents (for placement of the tube and for residual). Sixty milliliters are obtained. The nurse       should handle the aspirate as follows:
A.  Discard it
B.  Return it to the stomach
C.  Send it to the laboratory
D.  Add it to the feeding
 
17.  Morphine 10 mg and promethazine (Phenergan) 25 mg IM have been ordered for postoperative pain. On hand is morphine 12 mg/cc and        promethazine 50 mg/2 cc. How many total cutic centimeters will the nurse administer:
A.  0.8 cc
B.  1.0 cc
C.  1.8 cc
D.  2.2 cc
 
18.  A 50-year-old client admitted with an onset of seizures. As the nurse observes the seizure, which is the most important nursing action?
A.  Have the side rails padded.
B.  Place a padded tongue blade in the mouth.
C.  Document the client’s level of consciousness.
D.  Position client to maintain an open airway.
 
19.  A 40-year-old female has been admitted in end-stage renal failure. She is scheduled for a kidney transplant. Which of the following is        the most critical preoperative nursing intervention for this client?
A.  Monitor for urinary retention.
B.  Monitor for signs and symptoms of infection.
C.  Monitor emotional response to impending surgery.
D.  Monitor nutritional status and encourage fluids.
 
20.  A 26-year-old female is 2 days’ postoperative for a right wrist repair following a motor vehicle accident. She has a history of NKDA. Her       doctor orders IVPB piperacillin 500 mg tid. During infusion of her antibiotic, the client becomes anxious, expresses feelings of doom, is       diaphoretic, and has dyspnea and nasal pruritus. Which of the following actions should the nurse perform with this client?
A.  Call the doctor.
B.  Take the client’s vital signs.
C.  Administer epinephrine IM, SQ or IV.
D.  Stop the infusion.
 
21.  A 76-year-old female with a history of right-sided cerebral vascular accident 7 years ago has been transferred to the unit from a nursing        home. During the assessment, the nurse finds a 4 cm hole in the left heel that oozes a foul-smelling yellow fluid. The sore extends into        the muscle and has developed a black crust around the edges. The ulcer is not painful to the client. The nurse would place this ulcer        into which of the following stages of skin breakdown?
A.  I
B.  II
C.  III
D.  IV
 
22.  A 26-year-old female is admitted in status epilepticus. The nurse anticipates the physician will order which of the following as the drug       of choice for this condition?
A.  Thiamine
B.  50% dextrose
C.  Diazepam
D.  Digoxin
 
23.  A client with premature ventricular contractions has been receiving procainamide hydrochloride (Pronestyl) 500 mg four times per day        for the past 8 months. Which sympton if experienced by the client would the nurse recognize as needing immediate investigation?
A.  Constipation
B.  Dizziness
C.  Shivering
D.  Diarrhea
 
24.  A nurse working in the cardiovascular unit is observing the EKG strips of newly admitted clients. The nurse observes one client who has       a high pointed P wave. The best action of the nurse based on this observation is to:
A.  Call the physician immediately for atrial fibrillation medication.
B.  Call the nursing supervisor and order a cardiac arrest cart nearby.
C.  Carefully assess and monitor the client for pulmonary disease.
D.  Carefully assess and monitor the renal status and urinary output.
 
25.  The client with a permanent pacemaker has returned home and is being seen by the home health nurse. The nurse notes an apical        pulse rate of 50 and the rhythm is irregular. The client pacemaker code is set on 60. The client has no other symptoms and is not short        of breath. The most appropriate action by the nurse is to:
A.  Inform the hospital.
B.  Inform his physician.
C.  Obtain a 12-lead electrocardiogram.
D.  Do nothing because pulse rate is within normal limits.
 
26.  A 71-year-old client is diagnosed with right-sided congestive heart failure (CHF). Which assessment by the nurse is most reflective of       right-sided CHF?
A.  Tachypnea
B.  Pink, frothy sputum
C.  Korotkoff’s sounds
D.  Distended jugular veins

 

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