June 2008 Nursing Licensure Examination (NLE)
June 2008 NP4 Nursing Board Exam Answer Key
Nursing Board Exams Questions 21-40
Situation - You are assigned to take care of four patients with different conditions.
21. KJ, who is to have a kidney transplant asks you how long will he take azathioprime (Imuran), cyclosporine and prednisone? You recognized that KJ understood the teaching when he states, “I must take these medications:
A. until the anastomosis heals
B. during the preoperative period
C. until the supply is over
D. for the rest of my life
22. After the kidney transplant, you must observe KJ for signs of rejection which includes:
A. fever and weight gain
B. hematuria and seizure
C. polyuria and jaundice
D. moon face and muscle atrophy
23. FB, 28 years old with chronic renal disease plans to receive a kidney transplant. Recently, FB was told by his physician that he was a poor candidate for transplant because of his hypertension and diabetes mellitus. Now, FB tells you “I want to go off dialysis, I’d rather not live than to be in this treatment the rest of my life”. How would you respond to him?
A. leave the room and allow him to collect his thoughts
B. tell FB that “ We all have days when we don’t feel like going on”
C. tell FB that “ Treatments are only three times a week, you can live with that”
D. take a sit next to him and sit quietly
24. DS signed a consent form for participation in a clinical trial for implantable cardioverter defibrillators. Which statement by DS indicates the need for further teaching before true informed consent can be obtained?
A. “a wire from the generator will be attached to my heart”
B. “the physician will make a small incision in my chest wall and place the generator there”
C. “I wonder if there is another way to protect these bad rhythms”
D. “this implanted defibrillator will protect me from those bad rhythms my heart goes into”
25. KP is participating in a cardiac study in which his physician is directly involved. Which statement by KP indicates a lack of understanding about his rights as a research study participant?
A. “My confidentiality will not be compromised in this study”
B. “ I understand the risk associated in this study”
C. “I can withdraw from the study anytime”
D. “ I’ll have to find a new physician if I don’t complete this study”
Situation - Foot care among patients with peripheral vascular problems is very important.
26. When teaching a client with peripheral vascular disease about foot care, you should include which instructions:
A. avoid wearing canvas shoes
B. avoid using a nail clipper to cut toe nails
C. avoid use of cornstarch on the foot
D. avoid wearing cotton socks
27. FT, who has no known history of peripheral vascular disease, comes to the emergency room complaining of sudden onset of lower leg pain. Inspection and palpation reveal absent pulses, paresthesia and a mottled, cyanotic, cold, cadaverous left calf. While the physician determines the appropriate management, you should:
A. shave the affected leg in anticipation of surgery
B. place a healing pad around the calf
C. keep the affected leg level or slightly dependent
D. elevate the affected calf as high as possible
28. Peripheral neuropathies primarily affect:
A. sensory functions
B. vascular functions
C. optic functions
D. motor functions
29. Peripheral neuropathy can BEST be controlled by:
A. good glucose control
B. steroid therapy
C. vitamin supplement
D. nothing, there is no slowing the process
30. In addition to clients with diabetes mellitus you must be aware that acute hypoglycemia can also develop in a client with:
A. hypertension
B. hyperthyroidism
C. liver disease
D. diabetes insipidus
Situation - The physician has ordered 3 units of whole blood to be transfused to WQ following a repair of a dissecting aneurysm of the aorta.
31. You are preparing the first unit of whole blood for transfusion. From the time you obtain it from the blood bank, how long should you infuse it?
A. 6 hours
B. 1 hour
C. 4 hours
D. 2 hours
32. What should you do FIRST before you administer blood transfusion?
A. verify client identity and blood product, serial number, blood type, cross matching results, expiration date
B. verify client identity and blood product serial number, blood type, cross matching results, expiration date with another nurse
C. check IV site and use appropriate BT set and needle
D. verify physician’s order
33. As WQ’s nurse, what will you do AFTER the transfusion has started?
A. add the total amount of blood to be transfused to the intake and output
B. discontinue the primary IV of Dextrose 5% Water
C. check the vital signs every 15 minutes
D. stay with WQ for 15 minutes to note for any possible BT reactions
34. WQ is undergoing blood transfusions of the first unit. The EARLIEST signs of transfusion reactions are:
A. oliguria and jaundice
B. urticaria and wheezing
C. hypertension and flushing
D. headache, chills, fever
35. In case WQ will experience an acute hemolytic reaction, what will be your PRIORITY intervention?
A. immediately stop the blood transfusion, infuse Dextrose 5% in Water and call the physician
B. stop the blood transfusion and monitor the patient closely
C. immediately stop the BT, infuse NSS, call the physician, notify the blood bank
D. immediately stop the BT, notify the blood bank and administer antihistamines
Situation - The kidneys have very important excretory, metabolic, erythropoietic functions. Any disruptions in the kidney’s functions can cause disease. As a nurse it is important that you understand the rationale behind the treatment regimen used.
36. PL, who is in acute renal failure, is admitted to the Nephrology Unit. The period of oliguria usually lasts for about 10 days. Which assessment parameter for kidney function will you use during the oliguric phase?
A. urine output directly related to the amount of IV fluid infused
B. urine output is less than 400 ml/24 hours
C. urine output of 30-60 ml/hour
D. no urine output, kidneys in a state of suspension
37. During the shock phase, what is the effect of the rennin-aldosterone-angiotensin system on renal function?
A. increased urine output, increased absorption of sodium and water
B. decreased urine output, decreased absorption of sodium and water
C. increased urine output, decreased absorption of sodium and water
D. decreased urine output, increased absorption of sodium and water
38. As you are caring for PL who has acute renal failure, one of the collaborative interventions you are expected to do is to start hypertonic glucose with insulin infusion and sodium bicarbonate to treat:
A. hyperkalemia
B. hypercalcemia
C. hypokalemia
D. hypernatremia
39. BN, 40 year old with chronic renal failure. An arteriovenous fistula was created for hemodialysis in his left arm. What diet instructions will you need to reinforce prior to his discharge?
A. drink plenty of water
B. restrict your salt intake
C. monitor your fruit intake and eat plenty of bananas
D. be sure to eat meat every meal
40. BN, is also advised not to use salt substitute in the diet because:
A. salt substitute contain potassium which must be limited to prevent arrhythmias
B. limiting salt substitutes in the diet prevents a buildup of waste products in the blood
C. fluid retention is enhanced when salt substitutes are included in the diet
D. a substance in the salt substitute interferes with fluid transfer across the capillary membrane
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