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NMC GENERAL PAPER QUESTIONS AND ANSWERS-SOLUTION 3

NMC GENERAL PAPER QUESTIONS AND ANSWERS

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NMC PAST QUESTIONS AND ANSWERS-SOLUTIONS

NMC GENERAL PAPER QUESTIONS AND ANSWERS-SOLUTION 3

Situation 1: A nurse who is assigned in a medical ward took time to be prepared with her task and give quality nursing care.
1. If a client with increased pressure (ICP) demonstrates decorticate posturing, the nurse will observe:
A. Flexion of both upper and lower extremities
B. Extension of elbows and knees, plantar flexion of feet, and flexion of the wrists
C. Flexion of elbows, extension of the knees, and plantar flexion of the feet
D. Extension of upper extremities, flexion of lower extremities

2. The physician orders propranolol (Inderal) for a client’s angina. The effect of this drug is to:
A. Act as a vasoconstrictor
B. Act as a vasodilator
C. Block beta stimulation in the heart
D. Increase the heart rate

3. A client with alcoholic cirrhosis with ascites and portal hypertension is to receive neomycin. The desired effect of this drug is to:
A. Sterilize the bowel
B. Reduce abdominal distention
C. Decrease the serum ammonia
D. Prevent infection

4. A retention catheter for a male client is correctly taped if it is:
A. On the lower abdomen
B. On the umbilicus
C. Under the thigh
D. On the inner thigh

5. When assessing a client for Coumadin therapy, the condition that will exclude this client from Coumadin therapy is:

A Diabetes

B. Arthritis

C. Pregnancy

D. Peptic ulcer disease

6. Preparing for an intravenous pyelogram (IVP), the nurse instructs a 25

year-old male client to restrict her:

A. Fluid intake

B. Physical activity

C Use of stimulants such as tobacco

D. Use of any medications

7. Immediately following a thoracentesis, which clinical manifestations indicate that a complication has occurred and the physician should be notified?

A. Serosanguineous drainage from the puncture site

B. increased temperature and blood pressure

C. increased pulse and pallor

D. Hypotension and hypothermia

8. The nurse is collecting a urine specimen from a client who has been catheterized. When the urine begins to flow through the catheter, the next action is to:

A. Inflate the catheter balloon with sterile water

B. Place the catheter tip into the specimen container

C. Connect the catheter into the drainage tubing

D. Place the catheter tip into the urine collection receptacle

9. During a retention catheter insertion or bladder irrigation, the nurse must use:

A. Sterile equipment and wear sterile gloves

B. Clean equipment and maintain surgical asepsis

C. Sterile equipment and maintain medical asepsis

D. Clean equipment and technique

10. If a client continues to hypoventilate, the nurse will continually assess for a complication of this condition:

A. Respiratory acidosis

B. Respiratory alkalosis

C. Metabolic acidosis

D. Metabolic alkalosis

Situation 2: Diabetes Mellitus is a common disease among Filipinos. Caring for these patients require meticulous assessment and follow-up.

11. The nurse will know a diabetic client understands exercise and its relation to glucose when he says that he eats bread and milk before, or juice or fruit during exercise activity because

A. Exercise enhances the passage of glucose into muscle cells

B. Exercise stimulates pancreatic insulin production

C. A diabetic’s muscle requires more glucose during exercise

D. The pancreas utilizes more glucose during exercise

12. The ADA exchange diet is compiled of lists of foods. The statement that indicates the diabetic has an understanding of the purpose of these food lists is:

A. Exchanges are allowed within groups

B. Exchanges are allowed between groups

C. Only meat and fat exchanges can be interchanged

D. Vegetables and fruit exchanges can be Interchanged

13. The non-insulin-dependent diabetic who is obese is best controlled by weight loss because obesity

A. Reduces the number of insulin receptors

B. Cause pancreatic islet cell exhaustion

C. Reduces insulin binding at receptor sites

D. Reduces pancreatic insulin production

14. A person with a diagnosis of adult diabetes (NIDDM) should understand the symptoms of a hyperglycemic reaction. The nurse will know the client understands if she says these symptoms are:

A. Thirst, polyuria and decreased appetite

B. Flushed cheeks, acetone breath, and increased thirst

C. Nausea, vomiting and diarrhea

D. Weight gain, normal breath, and thirst

15. The diabetic client the nurse is counseling is a young man who occasionally goes drinking with his buddies. The nurse will know the client understands the diet when he says that when he consumes alcohol, he includes it as part of:

A. Protein

B. Simple carbohydrates

C. Complex carbohydrates

D. Fats

16. The nurse is teaching a Type 1 diabetic client about her diet, which is based on the exchange system. The nurse will know the client has learned correctly when she says that she can have as much as she wants of:

A. Lettuce

B. Tomato

C. Grapefruit juice

D. Skim milk

17. The nurse should explain to a client with diabetes mellitus that self-monitoring of blood glucose is preferred to urine glucose testing because it is:

A. More accurate

B. Easier to perform

C. Done by the client

D. Not influenced by drugs

18. A client is diagnosed as having non-insulin-dependent diabetes mellitus how to provide self-care to prevent infections of the feet. The nurse recognizes that the teaching was effective when the client says, should: ban

A. “Massage my feet and feet with oil or lotion.”

B. “Apply heat intermittently to my feet and legs.”

C. “Eat foods high in kilocalories of protein and carbohydrates.”

D. “Control my diabetes through diet, exercise, and medication.”

19. A client is admitted to the hospital with diabetic ketoacidosis. The nurse understands that the elevated ketone level present with this disorder is caused by the incomplete oxidation of:

A. Fats

B. Protein

C. Potassium

D. Carbohydrates

20. A client with insulin-dependent diabetes is placed on an insulin pump. The most appropriate short-term goal in teaching this client to control the diabetes: “The client will:

A. adhere to the medical regimen.”

B. remains normoglycemic for 3 weeks.”

C. demonstrates the correct use of the insulin pump.”

D. list three self-care activities necessary to control the diabetes.”

NMC GENERAL PAPER QUESTIONS AND ANSWERS-SOLUTION 3

Situation 3: In the CCU, the nurse has a patient who needs to be watched out.

21. To determine the status of a client’s carotid pulse, the nurse should palpate:

A. In the lateral neck region

B. Immediately below the mandible

C. At the anterior neck, lateral to the trachea

D. At the base of the neck”, along the clavicle

22. To help reduce a client’s risk factors for a heart disease, the nurse, in discussing dietary guidelines, should teach the client to:

A. Avoid eating between meals

B. Decrease the amount of unsaturated fat

C. Decrease the amount of fat-binding fiber

D. Increase the ratio of complex carbohydrates

23. The nurse would expect a client diagnosed as having hypertension to report experiencing the most common symptom associated with this disorder, which is:

A. Fatigue

B. Headache

C. Nosebleeds

D. Flushed face

24. A client with a history of hypertension develops pedal edema and demonstrates dyspnea on exertion. The nurse recognizes that the client’s dyspnea on exertion is probably:

A. Caused by cor pulmonale

B. A result of left ventricular failure

C. A result of right ventricular failure

D. Associated with wheezing and coughing

25. A client who has been admitted to the cardiac care unit with myocardial infarction complains of chest pain. The nursing intervention that would be effective in relieving the client’s pain would be to administer the ordered:

A. Morphine sulfate 2 mg IV

B. Oxygen per nasal cannula

C. Nitroglycerin sublingually

D. Lidocaine hydrochloride 50 mg IV bolus

26. The nurse admitting a client with a myocardial Infarction to ICU understands that the pain the client is experiencing is a result of:

A. Compression of the heart muscle

B. Release of myocardial isoenzymes

C. Inadequate perfusion of the myocardium

D. Rapid vasodilation of the coronary arteries

27. A male client who is hospitalized following a myocardial infarction asks the nurse why he is receiving morphine. The nurse replies that morphine:

A. Dilates coronary blood vessels

B. Relieve pain and prevents shock

C. Helps prevent fibrillation of the heart

D. Decreases anxiety and restlessness

28. Several days following surgery a client develops pyrexia. The nurse should monitor the client for other adaptations related to the pyrexia including:

A. Dyspnea

B. Chest pain

D. Increased pulse rate

D. Elevated blood pressure

29. The nurse recognizes that a pacemaker is indicated when a client is experiencing:

A. Angina

B. Chest pain

C. Heart block

D. Tachycardia

30. When assessing a client with a diagnosis of left ventricular failure (congestive heart failure), the nurse should expect to find:

A. Crushing chest pain

B. Dyspnea on exertion

C. Jugular vein distention

D. Extensive peripheral edema

Situation 4: In the recall of the fluids and electrolytes, the nurse should be able to understand the calculations and other conditions related to loss or retention.

31. After a Whipple procedure for cancer of the pancreas, a client is to receive the following intravenous (IV) fluids over 24 hours: 1000 ml D5W; 0.5-liter normal saline; 1500 ml D5NS. In addition, an antibiotic piggyback in 50 ml D5W is ordered every 8 hours. The nurse calculates that the clients IV fluid intake for 24 hours will be:

A. 3150 ml

B. 3200 ml

C. 3650 ml

D. 3750ml

32. The dietary practice that will help a client reduce the dietary intake of sodium is

A. Increasing the use of dairy products

B. Using an artificial sweetener in coffee

C. Avoiding the use of carbonated beverages

D. Using catsup for cooking and flavoring foods

33. When evaluating a client’s response to fluid replacement therapy, the observation that indicates adequate tissue perfusion to vital organ is:

A. Urinary output of 30 ml in an hour

B. Central venous pressure reading of 2 cm H20

C. Pulse rates of 120 and 110 in a 15-minute period

D. Blood pressure readings of 50/30 and 70/40 mmHg within 30 minutes

34. When monitoring for hypernatremia, the nurse should assess the client for:

A. Dry skin

B. Confusion

C. Tachycardia

D. Pale coloring

35. Serum albumin is to be administered intravenously to client with ascites, the expected outcome of this treatment will be a decrease in:

A. Urinary output

B. Abdominal girth

C. Serum ammonia level

D. Hepatic encephalopathy

36. A client with a history of cardiac dysrhythmias is admitted to the hospital with the diagnosis of dehydration. The nurse should anticipate that the physician will order:

A. A glass of water every hour until hydrated

B. Small frequent intake of juices, broth, or milk

C. Short-term NG replacement of fluids and nutrients

D. A rapid IV infusion of an electrolyte and glucose solution

37. The nurse, in assessing the adequacy of a client’s fluid replacement during the first 2 to 3 days following full-thickness burns to the trunk and right thigh, would be aware that the most significant data would be obtained from recording

A. Weights every day

B. Urinary output every hour

C. Blood pressure every 15 minutes

D. Extent of peripheral edema every 4 hours

38. A client with ascites has a paracentesis, and 1500 ml of fluid is removed. Immediately following the procedure, it is most important for the nurse to observe for:

A. A rapid, thready pulse

B. Decreased peristalsis

C. Respiratory congestion

D. An increased in temperature

39. The nurse is aware that the shift of body fluids associated with the intravenous administration of albumin occurs by the process of:

A. Filtration

B. Diffusion

C. Osmosis

D. Active Transport

NMC GENERAL PAPER QUESTIONS AND ANSWERS-SOLUTION 3

NMC PAST QUESTIONS AND ANSWERS — **CLICK HERE AND TAKE A QUIZ**

40. A client’s IV fluid orders for 24 hours are 1500 ml D5W followed by 1250 ml of NSS. The IV tubing has a drop factor of 15 gtt/ml. To administer the required fluids the nurse should set the drip rate at:

A. 13 gtt/min

B. 16 gtt/min

C. 29 gtt/min

D. 32 gtt/min

Situation 5: Protection of self and patient can be done by supporting the body’s immunity.

41. Halfway through the administration of a unit of blood, a client complains of lumbar pain. The nurse should:

A. Obtain vital signs

B. Stop the transfusion

C. Assess the pain further

D. Increase the flow of normal saline

42. A client comes to the clinic complaining of weight loss, fatigue, and a low-grade fever. Physical examination reveals a slight enlargement of the cervical lymph nodes. To assess possible causes for the fever, it would be most appropriate for the nurse to initially ask:

A. “Have you been sexually active lately?”

B. “Do you have a sore throat at the present time?”

C. “Have you been exposed recently to anyone with an infection?”

D. “When did you first notice that your temperature had gone up?”

43. The nursing staff has a team conference on AIDS and discusses the routes of transmission of the human immunodeficiency virus (HSV). The discussion reveals that an individual has no risk of exposure to HIV when that individual:

A. Has intercourse with just the spouse

B. Makes a donation of a pint of whole blood

C. Limits sexual contact to those without HIV antibodies

D. Uses a condom each time there is a sexual intercourse

44. The knows that a positive diagnosis for HIV infection is made based on:

A. A history of high-risk sexual behaviors

B. Positive ELISA and Western blot tests

C. Evidence of extreme weight loss and high fever

D. Identification of an associated opportunistic infection

45. When taking the blood pressure of a client who has AIDS the nurse must:

A. Wear dean gloves

B. Use barrier technique

C. Wear a mask and gown

D. Wash the hands thoroughly

46. The nurse should plan to teach the client with pancytopenia caused by a chemotherapy to:

A. Begin a program of aggressive, strict mouth care

B. Avoid traumatic injuries and exposure to any infection

C. increase oral fluid intake to a minimum of 3000 ml daily

D. Report any unusual muscle cramps or tingling sensations in the extremities

47. An elderly client develops severe bone marrow depression from chemotherapy for cancer of the prostate. The nurse should:

A. Monitor for signs of alopecia

B. Increase daily intake of fluids

C. Monitor Intake and output of fluids

D. Use a soft toothbrush for oral hygiene

48. A tuberculin skin test with purified protein derivative (PPD) tuberculin is performed as part of a routine physical examination. The nurse should instruct the client to make an appointment so the test can be read in:

A. 3 days

B. 5 days

C. 7 days

D. 10 days

49. A client is admitted with cellulitis of the left leg with a temperature of 103°F. The physician orders IV antibiotics. Before instituting this therapy, the nurse should:

A. Determine whether the client has allergies

B. Apply a warm, moist dressing over the area

C. Measure the amount of swelling in the client’s leg

D. Obtain the results of the culture and sensitivity tests

50. Following multiple bee stings, a client has an anaphylactic reaction. The nurse is aware that the symptoms the client is experiencing are caused by:

A. Respiratory depression and cardiac standstill

B. bronchial constriction and decreased peripheral resistance

C. Decreased cardiac out and dilation of major blood vessels

D. Constriction of capillaries and decreased peripheral circulation

Situation 6: Following these diagnostic tests, Mr. Maguire’s physician discussed possible therapies with him. It was decided that a partial gastrectomy, vagotomy, and gastrojejunostomy would be performed.

51. Mr. Maguire asks why the vagotomy is being done. You explain that a vagotomy is done in conjunction with a subtotal gastrectomy because the vagus nerve:

A. Stimulates increased gastric motility

B. Decreases gastric motility, thereby preventing the movement of HCI out of the stomach

C. Stimulates both increased gastric secretion and gastric motility.

D. Stimulates decreased gastric secretion, thereby increasing nausea and vomiting.

52. Which of the following nursing interventions would be included in the preoperative period for Mr. Maguire?

A. Insertion of a nasogastric tube on the morning of surgery.

B. Administration of Valium 4 mg with 4 oz water 1 hour before surgery.

C. Detailed description of the possible complications that could happen postoperatively.

D. Instructions to avoid taking pain medication too frequently in the first 2 postoperative days to avoid drug dependency.

53. Which of the following complications, would you primarily anticipate in Mr. Maguire’s postoperative period?

A. Thrombophlebitis from decreased mobility.

B. Abdominal distention due to air swallowing.

C. Atelectasis due to shallow breathing.

D. Urinary retention due to prolonged use of anticholinergic medications.

54. The nurse would recognize drainage from the nasogastric tube after surgery

A. It continues after 6 hours.

B. It continues for a period greater than 12 hours.

C. If it turned greenish-yellow in less than 24 hours.

D. It was dark red in the immediate postoperative period.

55. Which of the following statements would the nurse include in teaching regarding nasogastric tubes?

A. Nasogastric tubes should be irrigated with sterile water.

B. Client should be in sitting position with head slightly flexed for tube insertion.

C. When resistance is met while irrigating a nasogastric tube, pressure should be increased to complete that irrigation, and the physician should be notified at the completion.

D. Ice chips can be taken as often as desired to promote comfort in the throat.

56. The nurse must observe for which of the following imbalances to occur with prolonged nasogastric suctioning?

A. Hypernatremia

B. Hyperkalemia

C. Metabolic alkalosis

D. Hypoproteinemia

57. Of the following mouth care measures by the nurse, which one should be used with caution when a client has a nasogastric tube?

A. Regularly brushing teeth and tongue with soft brush.

B. Sucking on ice chips to relieve dryness.

C. Occasionally rinsing mouth with a nonastringent substance and massaging gums.

D. Application of lemon juice and glycerine swabs to the lips.

58. The nurse tells Mr. Mangoni that the nasogastric tube will be removed: