Socrative Questions
1. A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What
manifestations should the nurse expect to find?
a. Decreased body weight
b. Decreased urinary output
c. Increased plasma osmolality
d. Increased serum sodium levels
2. During care of the patient with SIADH, what should the nurse do?
a. Monitor neurologic status at least every 2 hours
b. Teach the patient receiving treatment with diuretics to restrict sodium intake
c. Keep the head of the bed elevated to prevent antidiuretic hormone release.
d. Notify the HCP if the patient's blood pressure decreases more than 20 mmHg from
baseline
3. ???A patient with SIADH is treated with water restriction. What does the patient experience
with the nurse determines that treatment has been effective?
a. Increased urine output, decreased serum sodium, and increased urine specific gravity
b. Increased urine output, increased serum sodium, and decreased urine specific gravity
c. Decreased urine output, increased serum sodium, and decreased urine specific gravity
d. Decreased urine output, decreased serum sodium, and increased urine specific gravity
4. In a patient with central diabetes insipidus, the administration of desmopressin acetate during a
water deprivation test will result in what?
a. Decrease in body weight
b. Increase in urinary output
c. Decrease in blood pressure
d. Increase in urine osmolality
5. When caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect
the treatment to include?
a. Fluid restriction
b. Thiazide diuretics
c. A high sodium diet
d. Metformin (Glucophage)
6. A 38 yr old woman has newly diagnosed multiple sclerosis and asks the nurse what is going to
happen to her. What is the best response by the nurse?
a. "You will have either periods of attacks and remissions or progression of nerve
damage over time."
b. "You need to plan for a continuous loss of movement, sensory functions, and mental
capabilities."
c. "You will most likely have a steady course of chronic progressive nerve damage that will
change your personality."
d. "It is common for people with MS to have an acute attack of weakness and then not to
have any other symptoms for years."
7. During assessment of a patient admitted to the hospital with an acute exacerbation of MS, what
should the nurse most likely expect to find?
a. Tremors, dysphasia, and ptosis
b. Bowel and bladder incontinence and loss of memory
c. Motor impairment, visual disturbances, and paresthesias
d. Excessive involuntary movements hearing loss, and ataxia
8. The classic manifestations associated with Parkinson's disease is tremor, rigidity, akinesia, and
postural instability. What is a consequence related to rigidity?
a. Shuffling gait
b. Impaired handwriting
c. Inability to stop forward movement
d. Muscle soreness and pain
9. A patient with a tremor is being evaluated for Parkinson's disease. The nurse explains to the
patient that Parkinson's disease can be confirmed by:
a. CT and MRI scans
b. relief of symptoms with administration of dopaminergic agents
c. the presence of tremors that increase during voluntary movement
d. cerebral angiogram that reveals the presence of cerebral atherosclerosis
10. Which laboratory results would indicate that the patient has prediabetes?
a. Glucose tolerance result of 132 mg/dL
b. Glucose tolerance result of 240 mg/dL
c. Fasting blood glucose result of 80 mg/dL
d. Fasting blood glucose result of 120 mg/dL
11. The nurse is teaching the patient with prediabetes ways to prevent or delay the development of
type 2 diabetes. What information should be included? SELECT ALL THAT APPLY
a. Maintain a healthy weight
b. Exercise for 60 minutes each day
c. Have blood pressure checked regularly
d. Assess for visual changes on a monthly basis
e. Monitor for polyuria, polyphagia, and polydipsia
12. Lispro insulin with NPH insulin is ordered for a patient with newly diagnosed type 1 diabetes.
The nurse know that when lispro insulin is used, when should it be administered?
a. Only once a day
b. 1 hour before meals
c. 30 minutes before meals
d. At mealtime or within 15 minutes of meal
13. The nurse is assessing a newly admitted patient with diabetes. Which observation should be
addressed as the priority by the nurse?
a. Bilateral numbness of both hands
b. Stage II pressure ulcer on the right heel
c. Rapid respirations with deep inspiration
d. Areas of lumps and dents on the abdomen
14. To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the
patient using glucose-lowering agents about the best time for exercise?
a. Plan activity and food intake related to blood glucose levels
b. When blood glucose is greater than 25o mg/dL and ketones are present
c. When morning glucose monitoring reveals that the blood glucose is in the normal range
d. When blood glucose levels are high, because exercise always has a hypoglycemic effect
15. What are manifestations of diabetic ketoacidosis (DKA)? SELECT ALL THAT APPLY
a. Thirst
b. Ketonuria
c. Dehydration
d. Metabolic acidosis
e. Kussmaul respirations
f. Sweet, fruity breath ordor
16. Following the teaching of foot care to a patient with diabetes, the nurse determines that
additional instruction is needed when the patient makes which statement?
a. "I should wash my feet daily with soap and warm water."
b. "I should always wear shoes to protect my feet from injury."
c. "if my feet are cold, I should wear socks instead of using a heating pad."
d. "I'll know if I have sores or cuts on my feet because they will be painful."
17. A nurse in a community health clinic is administering seasonal inactive influenza vaccine. Before
administering it, the nurse must confirm that the client is not allergic to which of the following?
a. Shellfish
b. Eggs
c. Gelatin
d. Yeast
18. A nurse is assessing a client prior to administering a seasonal influenza vaccine. The client says
he read about an influenza vaccine that is given as a nasal spray and wants to receive it. The
nurse should recognize that which of the following findings is a contraindication for the client
receiving the live attenuated influenza vaccine (LAIV)?
a. The clients age is 62
b. The client smokes one pack of cigarettes a day
c. The client has a history of myocardial infarction.
d. The client has recently traveled to Europe.
19. A nurse is admitting a client who requires droplet precautions due to influenza. Which of the
following actions should the nurse take?
a. Place the client in a room with negative airflow.
b. Wear a gown when providing care to the client.
c. Wear a mask when providing care to the client.
d. Ensure the client's room has HEPA filtration.
20. A nurse in the emergency department is assessing an older adult client who has communityacquired pneumonia. Which of the following findings should the nurse expect?
a. Unequal pupils
b. Hypertension
c. Tympany upon chest percussion
d. Confusion
21. A nurse in a provider's office is assessing an older adult client whose son reports that the client
has been sick with a respiratory illness for the past 6 days. Which of the following assessment
findings is a manifestation of pneumonia in the older adult client?
a. Bradycardia
b. Night sweats
c. Anorexia
d. Narrowed pulse pressure
22. The nurse is caring for a client with a diagnosis of influenza who first began to experience
symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the
client about the therapy. Which statement by the client indicates an understanding of the
instructions?
a. "I will not get any colds or infections while taking this medication."
b. "Once I start the medication, I will no longer be contagious."
c. "I must take the medication exactly as prescribed."
d. "This medication has minimal side effects and I can return to normal activities."
23. While assisting a client with intermittent asthma to identify specific trigger of asthma, what
should the nurse explain?
a. Food and drug allergies do not manifest as respiratory symptoms.
b. Exercise-induced asthma is seen only in individuals with sensitivity to cold air.
c. Asthma attacks are psychogenic in origin and can be controlled with relaxation
techniques.
d. Viral upper respiratory infections are a common precipitating factor in acute asthma
attacks.
24. When teaching the client about going from a metered-dose inhaler (MDI) to a dry powder
inhaler (DPI), which statement by the client shows the nurse that the client needs more
teaching?
a. “I do no need to use the spacer like I used to.”
b. “I will hold my breath for 10 seconds or longer if I can.”
c. “I will not shake this inhaler like I did with my old inhaler.”
d. “I will store it in the bathroom so I will be able to clean it when I need to.”
25. Which dietary modification helps to meet the nutritional needs of clients with COPD?
a. Eating a high-carbohydrate, low-fat diet
b. Avoiding foods that require a lot of chewing
c. Preparing most foods of the diet to be eaten hot
d. Drinking fluids with meals to promote digestion
26. During an acute exacerbation of mild COPD, the client is severely short of breath, and the nurse
identifies a nursing problem of ineffective breathing pattern related to alveolar hypoventilation
and anxiety. What is the best nursing action?
a. Prepare and administer routine bronchodilator medications.
b. Perform chest physiotherapy to promote removal of secretions.
c. Administer oxygen at 5L/minute until the shortness of breath is relieved.
d. Position the client upright with the elbows resting on the over-the-bed table.
27. The nurse is caring for a client hospitalized with acute exacerbation of COPD. Which findings
would the nurse expect to note on assessment of this client? SELECT ALL THAT APPLY
a. A low arterial PCO2 level
b. A hyperinflated chest noted on the chest x-ray
c. Decreased oxygen saturation with mild exercise
d. A widened diaphragm noted on the chest x-ray
e. Pulmonary function tests that demonstrate increased vital capacity
28. Two days after undergoing pelvic surgery, a client develops marked dyspnea and anxiety. What
is the first action the nurse should take?
a. Raise the head of the bed.
b. Notify the health care provider.
c. Take the client’s pulse and blood pressure.
d. Determine the clients SpO2 with an oximeter.
29. A pulmonary embolus is suspected in a client with a deep vein thrombosis who develops
dyspnea, tachycardia, and chest pain. Diagnostic testing is scheduled. Which test should the
nurse plan to teach the client about?
a. D-dimer
b. Chest x-ray
c. Spiral CT scan
d. Ventilation-perfusion lung scan
30. A client diagnosed with TB 1 week ago is admitted to the hospital with symptoms of chest pain
and coughing. What nursing action has the highest priority?
a. Administering the client’s antitubercular drugs
b. Admitting the client to an airborne infection isolation room.
c. Preparing the client’s room with suction equipment and extra linens
d. Placing the client in an intensive care unit, where he can be closely monitored.
31. Which medication would be used in four-drug treatment for the initial p hase of TB? Select all
that apply.
a. Isoniazid
b. Pyrazinamide
c. Rifampin (Rifadin)
d. Rifabutin (Mycobutin)
e. Levofloxacin (Levaquin)
f. Ethambutol (Myambutol)
32. Patient teaching for management of gastritis should include? Select all that apply.
a. Decrease anxiety/stress
b. No caffeinated beverages
c. No smoking
d. No alcohol
e. Finish antibiotics for complete treatment of viral gastritis
33. A patient with a history of chronic gastritis has been admitted to the hospital. The nurse should
monitor for which potential vitamin deficiency?
a. Vitamin A
b. Vitamin B12
c. Vitamin C
d. Vitamin D
34. A nurse is completing discharge teaching for a client who has an infection due to H. pylori.
Which of the following statements by the client understanding of the teaching?
a. "I will continue my prescription of corticosteroids"
b. "I will schedule a CT to monitor for improvement"
c. "I will take a combination of medications for treatment"
d. "I will have my throat swabbed to recheck for this bacteria"
35. A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following
findings should the nurse expect? Select all that apply.
a. Client reports pain relieved by eating
b. Client states that pain often occurs at night
c. Client reports a sensation of bloating
d. Client states that pain occurs 30 mins to 1 hour after a meal
e. Client experiences pain upon palpation of the epigastric region
36. Patient teaching for managing GERD symptoms should include?
a. Follow a high fat diet
b. No intake of carbonated beverages, beer, caffeine, peppermint, spearmint or milk
c. Eat within 1 hour of bedtime
d. Keep the head of the bed lower than 30 degrees
37. True or False: The mechanism of action of a proton pump inhibitor is to block acid production
and heal the esophagus.
38. Fill in the blank: What medication classification is famotidine (Pepcid)? _histamine-2 blockers_
39. The patient diagnosed with secondary hypertension asks why it is called secondary and not
primary. What is the best explanation for the nurse to provide?
a. Has a more gradual onset than primary hypertension
b. Does not cause the target organ damage that occurs with primary hypertension
c. Has a specific cause, such as renal disease, that often can be treated
d. Is caused by age-related changes in BP regulatory mechanisms
40. Most organ damage in hypertension is related to what?
a. Increased fluid pressure exerted against organ tissue
b. Atherosclerotic changes in vessels that supply the organs
c. Erosion and thinning of blood vessels in organs from constant pressure
d. Increased hydrostatic pressure causing leakage of plasma into organ interstitial spaces
41. What is the primary BP effect of Beta-adrenergic blockers such as atenolol?
a. Vasodilation of arterioles by blocking movement of calcium into cells
b. Decrease Na and water re-absorption by blocking the effect of aldosterone
c. Decrease cardiac output by decreasing rate and strength of the heart and renin
secretion by the kidneys
d. Vasodilation caused by inhibiting sympathetic outflow from the CNS
42. Dietary teaching that includes eating dietary sources of potassium is indicated for the
hypertensive patient taking which drug?
a. Enalapril
b. Labetalol
c. Spironolactone
d. Hydrochlorothiazide
43. A patient’s blood pressure has not responded to the prescribed drugs for hypertension. Which
of the following should the nurse assess first?
a. Potential for drug interactions
b. Progressive target organ damage
c. Possible use of recreational drugs
d. Patient’s adherence to drug therapy
44. A patient is seen at the outpatient clinic for a sudden onset of inflammation and severe pain in
the great toe. A diagnosis of gouty arthritis is made on the basis of what?
a. A family history of gout
b. Elevated urine uric acid levels
c. Elevated serum uric acid levels
d. Inflammation of the bursa of the knee
45. During a home health visit, a client asks you what of their food choices they should avoid due
reduce flare ups of gout. The nurse would instruct the client to avoid:
a. Strawberries
b. Sardines
c. Whole wheat bread
d. Crackers
46. Which client is most at risk for developing gout?
a. A 56-year-old male who reports consuming foods low in purines
b. A 45-year-old male with a BMI of 40 who reports taking hydrochlorothiazide and
aspirin
c. A 39-year-old female hospitalized with bulimia that has a BMI of 24
d. A 27-year-old female with ulcerative colitis
47. While performing a head-to-toe assessment on a client with a history of gout, you the nurse
recognize that gout tends to start at what site?
a. Elbow
b. Great toe
c. Thumb or index finger
d. Knees
48. Which clinical manifestation would cause the nurse to suspect that the client is diagnosed with
systemic lupus erythematosus?
a. Joint edema and tenderness
b. Red, burning, tearing eyes
c. Chest tightness with wheezing on expiration
d. Fever and night sweats
49. A client is diagnosed with systemic lupus erythematosus. Which instruction would be included in
the teaching plan for the client?
a. "Wear large-brimmed hats when exposed to the sun."
b. "Use tanning beds instead of sunbathing outside."
c. "remove all rugs, curtains, and dust-collecting items in home."
d. "Carry injectable epinephrine at all times in case of an exacerbation."
50. A female client asks the nurse if there are any conditions that can exacerbate systemic lupus
erythematosus. Which is the nurse's best response?
a. "Conditions that cause hypotension can often exacerbate SLE"
b. "GI upset is often associated with SLE exacerbation"
c. "Pregnancy is often associated with an SLE exacerbation"
d. "Fever is a known trigger for an SLE exacerbation"
51. A nurse is caring for a client with systemic lupus erythematous (SLE) who is taking
hydrochloroquine (Plaquenil). The nurse understands the primary concern with this drug is:
a. Pulmonary fibrosis
b. Cushing's-like effects
c. Retinal toxicity
d. Renal toxicity
52. What is a disadvantage of open reduction and internal fixation (ORIF) of a fracture compared to
closed reduction?
a. Skin irritation
b. Infection
c. Nerve impairment
d. Complications of immobility
53. A patient is admitted with an open fracture of the tibia following a bicycle accident. During
assessment of the patient, about what specifically should the nurse question the patient?
a. Any previous injuries to the leg
b. The status of tetanus immunization
c. The use of antibiotics in the last month
d. Whether the injury was exposed to dirt or gravel
54. A patient is discharged from the outpatient clinic following application of a synthetic fiberglass
long arm cast for a fractured ulna. Before discharge, the nurse instructs the patient to do what?
a. Never get the cast wet
b. Move the shoulder and fingers frequently
c. Utilize a tongue depressor or Popsicle stick to reach itches under the cast
d. Use a sling to support the arm at waist level for the first 48 hours
55. A patient with a fractured tibia accompanied by extensive soft tissue damage initially has a split
applied and held in place with an elastic bandage. What early sign should alert the nurse that
the patient is developing compartment syndrome?
a. Paralysis of the toes
b. Absence of peripheral pulses
c. Distal pain unrelieved by opioid analgesics
d. Skin over the injury site is blanched when the bandage is removed
56. What should the nurse include in discharge instructions for the patient following a hip
prosthesis with a posterior approach?
a. Restrict walking for 2-3 months
b. Take a bath rather than a shower to prevent falling
c. Keep the leg internally rotated while sitting and standing
d. Have a family member put on the patient's shoes and socks
57. Twenty-four hours after a BKA a patient uses the call system to tell the nurse that his
compression bandage has fallen off. What is the first action that the nurse should take?
a. Apply ice to the site
b. Cover the incision with dry gauze
c. Reapply the compression dressing
d. Elevate the extremity on a couple of pillows
58. Following a total knee arthroplasty, a patient has a continuous passive motion (CPM) machine
for the affected joint. The nurse explains to the patient that this device is used for what
purpose?
a. To relieve edema and pain at the incision site
b. To promote early joint mobility and increase knee flexion
c. To prevent DVT
d. To improve arterial circulation to the affected extremity to promote healing
59. Which female patients are at risk for developing osteoporosis? SELECT ALL THAT APPLY
a. 60 yr old white aerobics instructor
b. 55 yr old Asian American cigarette smoker
c. 62 yr old African American on estrogen therapy
d. 68 yr old white who is underweight and inactive
e. 58 yr old Native American who started menopause prematurely
60. Which statement accurately describes Graves' disease?
a. Exophthalmos occurs in Graves' disease
b. It is an uncommon form of hyperthyroidism
c. Manifestations of hyperthyroidism occur from tissue desensitization to the sympathetic
nervous system.
d. Diagnostic testing in the patient with Graves' disease will reveal an increased thyroidstimulating hormone (TSH) level.
61. A patient with Graves' disease asks the nurse what caused the disorder. What is the best
response by the nurse?
a. "The cause of Graves' disease is completely unknown"
b. "It is usually associated with goiter formation from an iodine deficiency over a long
period of time."
c. "Antibodies develop against thyroid tissue and destroy it, causing a deficiency of
thyroid hormones."
d. "In genetically susceptible persons, antibodies are formed that cause excessive thyroid
hormone secretion."
62. A patient is admitted to the hospital with acute thyrotoxicosis (Thyroid Storm). On physical
assessment of the patient, what should the nurse expect to find?
a. Hoarseness and laryngeal stridor
b. bulging eyeballs and dysrhythmias
c. Elevated temperature and signs of heart failure
d. Lethargy progressing suddenly to impairment of consciousness
63. What medication is used with thyrotoxicosis (Thyroid Storm) to block the effects of the
sympathetic nervous stimulation of the thyroid hormone?
a. Potassium iodine
b. Propylthiouracil
c. Propranolol (Inderal)
d. Radioactive iodine (RAI)
64. Which characteristics most accurately describe the use of RAI (Select all that apply).
a. decreases release of thyroid hormones
b. often causes hypothyroidism over time
c. blocks peripheral conversion of T4 to T3
d. Treatment of choice in non-pregnant adults
e. Often used with iodine to produce euthyroid before surgery
f. Decreases thyroid hormone secretion by damaging thyroid gland
65. When replacement therapy is started for a patient with long-standing hypothyroidism, what is
most important for the nurse to monitor for in the patient?
a. Insomnia
b. Weight loss
c. Nervousness
d. Dysrhythmias
66. A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical
assessment of the patient, what should the nurse expect to find?
a. Hypertension, peripheral edema, and petechiae
b. Weight loss, buffalo hump, and moon face with acne
c. Abdominal and buttock striae, truncal obesity, and hypotension
d. Anorexia, signs of dehydration, and hyperpigmentation of the skin
67. An IV hydrocortisone infusion is started before a patient is taken to surgery for a bilateral
adrenalectomy. Which explanation, if given by the nurse, is most appropriate?
a. “The medication prevents sodium and water retention after surgery.”
b. “The drug prevent clots from forming in the legs during your recovery from surgery.”
c. “This medicine is given to help your body respond to stress after removal of the
adrenal glands.”
d. “This drug stimulates your immune system and promotes wound healing.”
68. At the beginning of a shift, a nurse is assessing a client who has Cushing's disease. Which of the
following findings is a priority?
a. Weight gain
b. Fatigue
c. Fragile skin
d. Joint pain
69. A nurse is reviewing the lab findings of a client who has Cushing's disease. Which of the
following findings should the nurse expect for this client? (Select all that apply)
a. Sodium 150 mEq/L
b. Potassium 3.3 mEq/L
c. Calcium 8.0 mg/dL
d. Lymphocyte count 35%
e. Fasting glucose 145 mg/dL
70. You are called to the patient’s room by the patient’s spouse when the patient experiences a
seizure. Upon finding the patient in a postictal state, what do you think you should do first?
a. Turn the patient to the side.
b. Start oxygen by mask at 6 L/min.
c. Restrain the patient’s arms and legs to prevent injury.
d. Record the time sequence of the patient’s movements and responses as they occur.
71. When teaching a patient with a seizure disorder about the medication regimen, what is it most
important for the nurse to emphasize?
a. The patient should increase the dosage of the medication if stress is increased.
b. Most over-the-counter and prescription drugs are safe to take with antiseizure drugs.
c. Stopping the medication abruptly may increase the intensity and frequency of
seizures.
d. If gingival hypertrophy occurs, the HCP should be notified and the drug may be changed.
72. A patient is admitted to the hospital with possible bacterial meningitis. During the initial
assessment, the nurse questions the patient about a recent history of what?
a. Mosquito or tick bites
b. Chickenpox or measles
c. Cold sores or fever blisters
d. An upper respiratory infection
73. What are the key manifestations of bacterial meningitis?
a. Papilledema and psychomotor seizures
b. High fever, nuchal rigidity, and severe headache
c. Behavioral changes with memory loss and lethargy
d. Jerky eye movements, loss of corneal reflex and hemiparesis
Answers:
1. B
2. A
3. B
4. D
5. B
6. A
7. C
8. D
9. B
10. D
11. A, E
12. D
13. C
14. A
15. A, B, C, D, E, F
16. D
17. B
18. A
19. C
20. D
21. C
22. C
23. D
24. D
25. B
26. D
27. B, C
28. A
29. C
30. B
31. A, B, C, F
32. A, B, C, D
33. B
34. C
35. C, D, E
36. B
37. True
38. Histamine 2 Blocker (H2 blocker)
39. C
40. B
41. C
42. D
43. D
44. C
45. B
46. B
47. B
48. A
49. A
50. C
51. C
52. B
53. B
54. B
55. C
56. D
57. C
58. B
59. B, D, E
60. A
61. D
62. C
63. C
64. B, D, F
65. D
66. A
67. C
68. A
69. A, B, C, E
70. A
71. C
72. D
73. B