1. Mr. Epstein, 58 years old, is recovering from a suprapubic prostatectomy. His urinary output in the past 2 days has been satisfactory; however the nurse now notices that it is becoming increasingly bloody. The initial action of the nurse should be to:
A. Irrigate the Foley catheter
B. Notify the physician
C. Take vital signs
D. Empty the drainage bag

2. Dianne, a 28-year old female, is admitted to the hospital with a diagnosis of anorexia nervosa. She is 5'6" tall and weighs 90 pounds.. She appears weak and lethargic, with very poor skin color. Dianne is placed on a high-protein, high-carbohydrate diet. The primary function of carbohydrates in the body is to:
A. Develop a cushion around vital organs
B. Break down and transport proteins
C. Supply energy to the body
D. Maintain fluid balances

3. Jean Thomas is a 25-year-old secretary admitted to the emergency room with diaphoresis, hyperventillation, palpitations, and trembling. Jean tells the nurse that she has been "very upset and nervous" over a poor employment evaluation. A tentative diagnosis or acute anxiety episode is made. Which of the following acid-base imbalances would likely occur as a result of Jean's hyperventillation?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis

4. Amy Stevens is a 17-year-old student admitted for evaluation of lower abdominal pain. She tells the nurse, "I wish my friends would come to visit me. I don't like being alone." Which of the following would be the most appropriate response of the nurse?
A. "You sound very lonely. Shall I stay with you for awhile?"
B. "I'm sure your friends will come to see you soon."
C. "It's a little too early for visiting hours. You'll have to wait until this afternoon."
D. "It's hard to be alone. Would you like me to stay with you?"

5.  Samuel Davidson is a 68-year-old being treated for metastatic prostate carcinoma. He says "you may as well give up on me, nurse. I'll never get better." The nurse would appropriately respond:
A. "But you really are improving. Try to keep a positive attitude."
B. "I won't give up on you Mr. Davidson. I know you'll get better."
C. "I'm not sure what you are saying. You feel you're not improving?"
D. "Recovering from cancer takes a while. Be patient."

6. Joyce Lisle is a patient on a medical-surgical unit who has undergone biopsy for abnormal uterine bleeding. Joyce questions the nurse about the procedure and then says, "Do you think I have cancer?" The nurse should respond to Joyce's question with which of the following statements?
A. "It's impossible to know for sure until your biopsy report is complete."
B. "Often biopsies are negative."
C. "I can understand how you must feel. I'd be frightened, too."
D. "I really can't say. Are you concerned about what the biopsy will show?"

7. Mrs. Durham is recovering from a colon resection for removal of a malignant mass in the large bowel. Following breakfast one morning she told the nurse, "I'm tired of waiting, I want my bath now. You're never here when I need you." Which of the following responses by the nurse is most appropriate?
A. "What do you mean, I'm never here? I spent 3 hours with you yesterday, Mrs. Durham."
B. "I'm sorry you've been waiting Mrs. Durham. Let's get you comfortable now, and I'll be back in 20 minutes to give you a bath."
C. "I'm doing my best, Mrs. Durham. You know I have three other patients to take care of today, besides you."
D. "I must see Mrs. Jones right now Mrs. Durham. She's really sick today. I'll be back soon as I can."

8. Jerry is a 32-year-old white male. He has been married for 10 months, and he and his wife, Sue, are expecting their first child in 6 months. Prior to marrying Sue, Jerry was sexually active and nonmonogamous. He has been sexually active since the age of 18. Recently Jerry has complained of persistent dry cough, night sweats, and a temperature over 100ْF. Although Jerry is concerned about his weight and watches his diet, he has lost 15 pounds without even trying. Upon assessing Jerry, he admits to have had sexual intercourse with prostitutes, both male and female, during the last 10 years. Jerry's symptoms of elevated temperature, chills, and dry cough are probably related to which undiagnosed condition?
A. Alteration in tissue perfusion
B. An infection, etiology unknown
C. Indigestion from too frequent traveling
D. Lack of knowledge related to frequent travel

9. Mr. Smith is a 44-year-old iron worker, who is admitted through the emergency room with a flushed face, irritability, and the following vital signs:
Temp: 99.1°F
Resp: 20
Pulse: 108
BP: 280/114
A diagnosis of hypertensive crisis is made. Signs and symptoms of hypernatremia would include all of the following, except:
A. Restlessness
B. Muscular weakness
C. Tachycardia
D. Thirst

10. Molly Flannery is a 67-year-old female chronic congestive heart failure and hypertension. She is being evaluated for complaints of muscular weakness and general fatigue. Molly's serum electrolyte studies reveal a K+ level of 2.9. Which of the following medications taken by the patient at home contributed most of her hypokalemic state?
A. Digoxin, 0.125mg, PO, daily
B. Lasix, 80mg, PO, daily
C. Aldomet, 250mg, PO, did
D. Aspirin, 10 grains, bid

11. Margaret O'Hara, a 30-year-old known diabetic, is brought to the emergency department by ambulance. The paramedic team reports symptoms of apparent hyperglycemia. Stat blood glucose is 640. The nurse is aware that excess serum glucose acts to draw fluids osmotically with resultant polyuria. In addition to increased urinary output, the nurse should expect to observe which of the following sets of symptoms in Margaret?
A. Polydipsia, diaphoresis, bradycardia
B. Thirst, dry mucous membranes, hot dry skin
C. Hypotension, bounding pulse, headache
D. Nervousness, rapid respirations, diarrhea

12. Loberta Jackson, a 21-year-old college student, is admitted to a medical unit with with diagnosis of uncontrolled diabetes, acute hypoglycemic reaction. Loberta explains to the admitting nurse that she had been feeling "sick to my stomach, like I was coming down with the flu" for the past 48 hours. She has continued to take her usual daily dosage of insulin. Noting that Loberta has been admitted with a blood-glucose value of 53, which of the following assessment questions would provide the most valuable information about Loberta's status?
A. "Have you been under a great deal of stress lately, Loberta?"
B. "Were you having difficulty sleeping after this illness started?"
C. "Have you eaten anything in the past 48 hours?"
D. "Did you take any medications for this illness other than your insulin?"