Fundamentals of Nursing Practice Test Set 1

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PT-Fundamentals of Nursing Set I Test yourself! This is a simulated interactive test for Foundations of Professional Nursing Practice or Test I of the Nursing Licensure Examinations.

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This test contains 25 items covering fundamentals of nursing, research, medication and many more.
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Foundations of Nursing Practice

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This is a simulated test for the Philippine Nursing Licensure Examination part I, entitled: Foundations of Nursing Practice. Start

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Question 1

A newly admitted female client was diagnosed with deep vein thrombosis. Which nursing diagnosis should receive the highest priority?

	Risk for injury related to edema.
	Ineffective peripheral tissue perfusion related to venous congestion.
	Excess fluid volume related to peripheral vascular disease.
	Impaired gas exchange related to increased blood flow.

Question 1 Explanation:Ineffective peripheral tissue perfusion related to venous congestion takes the highest priority because venous inflammation and clot formation impede blood flow in a client with deep vein thrombosis.

Question 2

Which dietary guidelines are important for nurse Oliver to implement in caring for the client with burns?

	Monitor intake to prevent weight gain.
	Provide high-protein, high-carbohydrate diet.
	Provide ice chips or water intake.
	Provide high-fiber, high-fat diet

Question 2 Explanation:A positive nitrogen balance is important for meeting metabolic needs, tissue repair, and resistance to infection. Caloric goals may be as high as 5000 calories per day.

Question 3

Dr. G writes the following order for the client who has been recently admitted “Digoxin .125 mg P.O. once daily.” To prevent a dosage error, how should the nurse document this order onto the medication administration record?

	“Digoxin .1250 mg P.O. once daily”
	“Digoxin 0.1250 mg P.O. once daily”
	“Digoxin .125 mg P.O. once daily”
	“Digoxin 0.125 mg P.O. once daily”

Question 3 Explanation:The nurse should always place a zero before a decimal point so that no one misreads the figure, which could result in a dosage error. The nurse should never insert a zero at the end of a dosage that includes a decimal point because this could be misread, possibly leading to a tenfold increase in the dosage.

Question 4

Which type of medication order might read "Vitamin K 10 mg I.M. daily × 3 days?"

	Standard written order
	Single order
	Standing order
	Stat order

Question 4 Explanation:This is a standard written order. Prescribers write a single order for medications given only once. A stat order is written for medications given immediately for an urgent client problem. A standing order, also known as a protocol, establishes guidelines for treating a particular disease or set of symptoms in special care areas such as the coronary care unit. Facilities also may institute medication protocols that specifically designate drugs that a nurse may not give.

Question 5

Nurse Nam attends an educational conference on leadership styles. The nurse is sitting with a nurse employed at a large trauma center who states that the leadership style at the trauma center is task-oriented and directive. The nurse determines that the leadership style used at the trauma center is:

	Laissez-faire.
	Autocratic.
	Democratic.
	Situational

Question 5 Explanation:The autocratic style of leadership is a task-oriented and directive.

Question 6

Which instruction should nurse Tom give to a male client who is having external radiation therapy:

	Wash the skin over regularly.
	Protect the irritated skin from sunlight.
	Apply lotion or oil to the radiated area when it is red or sore.
	Eat 3 to 4 hours before treatment.

Question 6 Explanation:Irradiated skin is very sensitive and must be protected with clothing or sunblock. The priority approach is the avoidance of strong sunlight.

Question 7

Nurse Michelle witnesses a female client sustain a fall and suspects that the leg may be broken. The nurse takes which priority action?

	Immobilize the leg before moving the client.
	Reassure the client that everything will be alright.
	Call the radiology department for X-ray.
	Takes a set of vital signs.

Question 7 Explanation:If the nurse suspects a fracture, splinting the area before moving the client is imperative. The nurse should call for emergency help if the client is not hospitalized and call for a physician for the hospitalized client.

Question 8

She finds out that some managers have benevolent-authoritative style of management. Which of the following behaviors will she exhibit most likely?

	Allows decision making among subordinates.
	Gives economic and ego awards.
	Communicates downward to staffs.
	Have condescending trust and confidence in their subordinates.

Question 8 Explanation:Benevolent-authoritative managers pretentiously show their trust and confidence to their followers.

Question 9

The doctor orders hourly urine output measurement for a postoperative male client. The nurse Trish records the following amounts of output for 2 consecutive hours: 8 a.m.: 50 ml; 9 a.m.: 60 ml. Based on these amounts, which action should the nurse take?

	Continue to monitor and record hourly urine output
	Irrigate the indwelling urinary catheter
	Notify the physician
	Increase the I.V. fluid infusion rate

Question 9 Explanation:Normal urine output for an adult is approximately 1 ml/minute (60 ml/hour). Therefore, this client's output is normal. Beyond continued evaluation, no nursing action is warranted.

Question 10

The physician prescribes a loop diuretic for a client. When administering this drug, the nurse anticipates that the client may develop which electrolyte imbalance?

	Hypervolemia
	Hypokalemia
	Hyperkalemia
	Hypernatremia

Question 10 Explanation:A loop diuretic removes water and, along with it, sodium and potassium. This may result in hypokalemia, hypovolemia, and hyponatremia.

Question 11

A newly admitted female client was diagnosed with agranulocytosis. The nurse formulates which priority nursing diagnosis?

	Deficient knowledge
	Constipation
	Risk for infection
	Diarrhea

Question 11 Explanation:Agranulocytosis is characterized by a reduced number of leukocytes (leucopenia) and neutrophils (neutropenia) in the blood. The client is at high risk for infection because of the decreased body defenses against microorganisms. Deficient knowledge related to the nature of the disorder may be appropriate diagnosis but is not the priority.

Question 12

Nurse Amileen is aware that the following is true about functional nursing

	Concentrates on tasks and activities.
	Provides continuous, coordinated and comprehensive nursing services.
	Emphasize the use of group collaboration.
	One-to-one nurse patient ratio.

Question 12 Explanation:Functional nursing is focused on tasks and activities and not on the care of the patients.

Question 13

A male client is being transferred to the nursing unit for admission after receiving a radium implant for bladder cancer. The nurse in-charge would take which priority action in the care of this client?

	Admit the client into a private room.
	Encourage family and friends to visit.
	Encourage the client to take frequent rest periods.
	Place client on reverse isolation.

Question 13 Explanation:The client who has a radiation implant is placed in a private room and has a limited number of visitors. This reduces the exposure of others to the radiation.

Question 14

Nurse Labs is assigned to the following clients. The client that the nurse would see first after endorsement?

	A 34 year-old post operative appendectomy client of five hours who is complaining of pain.
	A 63 year-old post operative’s abdominal hysterectomy client of three days whose incisional dressing is saturated with serosanguinous fluid.
	A 26 year-old client admitted for dehydration whose intravenous (IV) has infiltrated.
	A 44 year-old myocardial infarction (MI) client who is complaining of nausea.

Question 14 Explanation:Nausea is a symptom of impending myocardial infarction (MI) and should be assessed immediately so that treatment can be instituted and further damage to the heart is avoided.

Question 15

Nurse Gray places a client in a four-point restraint following orders from the physician. The client care plan should include:

	Socialize with other patients once a shift.
	Provide diversional activities.
	Assess temperature frequently.
	Check circulation every 15-30 minutes.

Question 15 Explanation:Restraints encircle the limbs, which place the client at risk for circulation being restricted to the distal areas of the extremities. Checking the client’s circulation every 15-30 minutes will allow the nurse to adjust the restraints before injury from decreased blood flow occurs.

Question 16

A male client who has severe burns is receiving H2 receptor antagonist therapy. The nurse In-charge knows the purpose of this therapy is to:

	Facilitate protein synthesis.
	Prevent stress ulcer
	Enhance gas exchange
	Block prostaglandin synthesis

Question 16 Explanation:Curling’s ulcer occurs as a generalized stress response in burn patients. This results in a decreased production of mucus and increased secretion of gastric acid. The best treatment for this prophylactic use of antacids and H2 receptor blockers.

Question 17

Nurse Hazel will administer a unit of whole blood, which priority information should the nurse have about the client?

	Calcium and potassium levels
	Blood pressure and pulse rate.
	Hgb and Hct levels.
	Height and weight.

Question 17 Explanation:The baseline must be established to recognize the signs of an anaphylactic or hemolytic reaction to the transfusion.

Question 18

A female client with a fecal impaction frequently exhibits which clinical manifestation?

	Hard, brown, formed stools
	Increased appetite
	Liquid or semi-liquid stools
	Loss of urge to defecate

Question 18 Explanation:Passage of liquid or semi-liquid stools results from seepage of unformed bowel contents around the impacted stool in the rectum. Clients with fecal impaction don't pass hard, brown, formed stools because the feces can't move past the impaction. These clients typically report the urge to defecate (although they can't pass stool) and a decreased appetite.

Question 19

A male client is receiving total parenteral nutrition suddenly demonstrates signs and symptoms of an air embolism. What is the priority action by the nurse?

	Notify the physician.
	Stop the total parenteral nutrition.
	Place the client on the left side in the Trendelenburg position.
	Place the client in high-Fowlers position.

Question 19 Explanation:Lying on the left side may prevent air from flowing into the pulmonary veins. The Trendelenburg position increases intrathoracic pressure, which decreases the amount of blood pulled into the vena cava during aspiration.

Question 20

In assisting a female client for immediate surgery, the nurse In-charge is aware that she should:

	Assist the client in removing dentures and nail polish.
	Encourage the client to drink water prior to surgery.
	Explore the client’s fears and anxieties about the surgery.
	Encourage the client to void following preoperative medication.

Question 20 Explanation:Dentures, hairpins, and combs must be removed. Nail polish must be removed so that cyanosis can be easily monitored by observing the nail beds.

Question 21

A male client is admitted and diagnosed with acute pancreatitis after a holiday celebration of excessive food and alcohol. Which assessment finding reflects this diagnosis?

	Hyperactive bowel sounds
	Sudden onset of continuous epigastric and back pain.
	Blood pressure above normal range.
	Presence of crackles in both lung fields.

Question 21 Explanation:The autodigestion of tissue by the pancreatic enzymes results in pain from inflammation, edema, and possible hemorrhage. Continuous, unrelieved epigastric or back pain reflects the inflammatory process in the pancreas.

Question 22

The nurse In-charge in labor and delivery unit administered a dose of terbutaline to a client without checking the client’s pulse. The standard that would be used to determine if the nurse was negligent is:

	The statement in the drug literature about administration of terbutaline.
	The physician’s orders.
	The actions of a reasonably prudent nurse with similar education and experience.
	The action of a clinical nurse specialist who is recognized expert in the field.

Question 22 Explanation:The standard of care is determined by the average degree of skill, care, and diligence by nurses in similar circumstances.

Question 23

Nurse Marlon prepares to perform an otoscopic examination on a female client. For proper visualization, the nurse should position the client's ear by:

	Pulling the lobule down and forward
	Pulling the helix up and back
	Pulling the helix up and forward
	Pulling the lobule down and back

Question 23 Explanation:To perform an otoscopic examination on an adult, the nurse grasps the helix of the ear and pulls it up and back to straighten the ear canal. For a child, the nurse grasps the helix and pulls it down to straighten the ear canal. Pulling the lobule in any direction wouldn't straighten the ear canal for visualization.

Question 24

Tommy, a basketball player twist his right ankle while playing on the court and seeks care for ankle pain and swelling. After the nurse applies ice to the ankle for 30 minutes, which statement by Tony suggests that ice application has been effective?

	“My ankle looks less swollen now”.
	“My ankle appears redder now”.
	“I need something stronger for pain relief”
	“My ankle feels warm”.

Question 24 Explanation:Ice application decreases pain and swelling. Continued or increased pain, redness, and increased warmth are signs of inflammation that shouldn't occur after ice application

Question 25

Nurse Trish is caring for a female client with a history of GI bleeding, sickle cell disease, and a platelet count of 22,000/μl. The female client is dehydrated and receiving dextrose 5% in half-normal saline solution at 150 ml/hr. The client complains of severe bone pain and is scheduled to receive a dose of morphine sulfate. In administering the medication, Nurse Trish should avoid which route?

	I.M
	I.V
	Oral
	S.C

Question 25 Explanation:With a platelet count of 22,000/μl, the clients tends to bleed easily. Therefore, the nurse should avoid using the I.M. route because the area is a highly vascular and can bleed readily when penetrated by a needle. The bleeding can be difficult to stop.

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