[单项选择]A client is admitted with atrial fibrillation. The physician noted a pulse deficit. The pulse deficit measures which of the following（）
A. The difference between apical and radial pulse rates.
B. The difference between systolic and diastolic blood pressures.
C. The amount of blood ejected from the left ventricle per minute.
D. The percentage of blood emptied from the ventricle during contraction.

[单项选择]A client admitted for a hysterectomy has a secondary diagnosis of Ménière s disease. Which of the following nursing interventions should the nurse include in the client’s plan of care to decrease the effects of tinnitus（）
A. Reduce the amount of glucose and cholesterol in the diet.
B. Encourage the client to listen to the radio with earphones.
C. Encourage a weight-reduction diet.
D. Administer antihypertensive medications as ordered.

[单项选择]A client is admitted for a suspected eating disorder. Which of the following statements would indicate that the client may be suffering from anorexia nervosa（）
A. "I’ve gained 3 pounds in the last month. "
B. "I eat loads of spinach and yellow vegetables each day. "
C. "I’m a perfectionist, and I work hard to get A’s. "
D. "I binge frequently in the morning and feel fat. "

[单项选择]A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects the client has a belief that he is（）
A. highly important or famous.
B. being persecuted.
C. connected to events unrelated to himself.
D. responsible for the evil in the world.

[单项选择]A client is admitted to the psychiatric unit with a diagnosis of anorexia nervosa. Although she is 5’7" and weighs only 100 lb, she keeps on telling the nurse about how fat she is. What should the nurse do first（）
A. Discuss cultural stereotypes regarding thinness and attractiveness.
B. Explore the reasons why the client doesn’t eat.
C. Teach the client about nutrition, calories, and a balanced diet.
D. Establish a trusting relationship with the client.

[单项选择]A client is admitted with a suspected diagnosis of an acute myocardial infarction. When providing care for the client, the nurse should avoid which route when taking a temperature（）
A. Oral.
B. Rectal.
C. Axillary.
D. Tympanic.

[单项选择]A client is admitted for an overdose of amphetamines. When assessing this client, the nurse should expect to have which of the following findings（）
A. Tension and irritability.
B. Slow pulse.
C. Hypotension.
D. Constipation.

[单项选择]An elderly female client is admitted to a nursing home from the general hospital with a diagnosis of dementia of the Alzheimer’s type. One morning, after being in the nursing home for several days, the client is going to join a group of residents in recreational therapy. The nurse notes that the client has laid out several dresses on her bed but has not changed from her nightclothes. It would be most helpful for the nurse to（　）
A. Remind the client to dress more quickly to avoid delaying the other residents
B. Help the client select appropriate attire and offer her assistance in getting dressed
C. Help the client dress and tell her what time the residents are expected at the activity
D. Allow the client as much time as she needs but explain that she is too late to attend this activity

[单项选择]A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using（）
A. Withdrawal.
B. Logical thinking.
C. Repression.
D. Denial.

[单项选择]The client was admitted with severe head injury resulting from a motor vehicle accident. The client is presently unconscious. To facilitate rehabilitation when the client’s condition allows, the nurse should
A. maintain limbs in the position of function.
B. apply restraints to arms and legs to control spasms.
C. exercise just the arms as the legs maintain their tone longer.
D. notify physical therapy as soon as the physician orders passive range of motion.

[单项选择]A client is admitted to the emergency department with a suspected overdose of an unknown drug. The client’s arterial blood gas values indicate respiratory acidosis. What should the nurse do first（）
A. Prepare to assist with ventilation.
B. Monitor the client’s heart rhythm.
C. Prepare to begin gastric lavage.
D. Obtain urine for drug screening.

[单项选择]An unconscious client has been admitted with a head injury. Which of the following nursing diagnoses would receive the greatest priority in the plan of care（　）
A. Disturbed sensory perception related to decreased level of consciousness.
B. Ineffective airway clearance related to inability to remove respiratory secretions.
C. Impaired gas exchange related to shallow irregular breathing.
D. Risk for injury related to disorientation and decreased level of consciousness.

[单项选择]The nurse is caring for a client admitted to the emergency department after a motor vehicle accident. Under the law, the nurse must obtain informed consent before treatment unless（）
A. the client is mentally ill.
B. the client refuses to give informed consent.
C. the client is in an emergency situation.
D. the client asks the nurse to give substituted consent.

[单项选择]The nurse is caring for a client admitted to the hospital with a bowel obstruction. The nurse should wear sterile gloves when（）
A. inserting an indwelling urinary catheter.
B. giving a back rub on intact skin.
C. changing an oxygen system.
D. inserting an IV catheter.

[单项选择]A client is admitted to the labor and delivery unit in active labor. She has had no prenatal care but appears to be between 32 and 35 weeks’ gestation. History reveals that she’s gravida 5, para 1, abortus 3. She tells the nurse she thinks her friend gave her a cigarette containing crack cocaine. What should the nurse do next
A. Move the precipitant delivery cart to the labor room, and notify the neonatologist on call.
B. Teach the mother controlled breathing techniques.
C. Call a family member to come to the hospital.
D. Call the friend who gave the client the cigarette and find out exactly what the drug was.

[单项选择]A client is admitted to the hospital with an exacerbation of his chronic gastritis. When assessing his nutritional status, the nurse should expect a deficiency in（）
A. vitamin A.
B. vitamin B₆.
C. vitamin B₁₂.
D. D. vitamin

[单项选择]A client is admitted to the labor and delivery department in preterm labor. To help manage preterm labor the nurse would expect to administer which of the following medication（　）
A. Ritodrine (Yutopar).
B. Bromocriptine (Parlodel).
C. Betamethasone (Celestone).
D. Magnesium sulfate.

[单项选择]A client is admitted to the hospital with a productive cough, night sweats, and a fever. Which action is most important in the initial plan of care（）
A. Assessing the client’s temperature every 8 hours.
B. Placing the client in respiratory isolation.
C. Monitoring the client’s fluid intake and output.
D. Wearing gloves during all client contact.

[单项选择]A client in acute renal failure is admitted to the nephrology unit. The period of oliguria in these clients usually lasts about t0 days. Which of the following assessments of kidney function would the nurse make during the oliguric phase（）
A. No urine output; kidneys in a state of suppression.
B. Urine output of 30 to 60 mL/hr.
C. Urine output of less than 400 to 600 mL in 24 hours.
D. Urine output directly related to the amount of IV fluids infused.

[单项选择]A client is being admitted to the labor unit. Because she’s well advanced in labor, the nurse must prioritize the admission questions. Which information is most important to obtain when birth is imminent（）
A. Duration of previous labor.
B. Frequency of contractions.
C. Presence of bloody show.
D. Expected due date.