RN COMPETENCY EXAM
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1. You have been visiting a 65-year old patient, Mrs. Garcia, to monitor her cardiac status and teach her diet and medications. When you arrive, her B/P is 160/90. An appropriate nursing action would be to:
a. Ask her how long she has been hypertensive
b. Wait 15 minutes and recheck her B/P
c. Notify her physician immediately
d. Tell her that her B/P is within normal for a 65 year-old woman
2. When instructing Mrs.Garcia on a low sodium diet, you would explain that:
a. Sodium occurs naturally in most foods
b. One tsp of salt equals 1500 mg of sodium
c. She should limit her intake of bread, pasta, and rice
d. Cheese is low in sodium and is a good choice for a snack
3. Mr. Jones, who just turned 80, is experiencing signs of dementia. You would instruct his wife to:
a. Supervise his daily activities
b. Give him several instructions at one time to keep him from becoming frustrated
c. Tell her to restrain him at night to prevent falls
d. Be prepared to eventually put him in a nursing home
4. When examining his skin, you are aware that skin of the geriatric patient may exhibit:
a. Increased elasticity
b. A well-hydrated dermis
c. Increased subcutaneous fat
d. Decreased sweat secretion and dryness
5 . Mrs. Jones becomes tearful when discussing her husband’s dementia. An effective response would be to
a. Tell her she needs to join a support group
b. Ask her if she if she has seen a doctor for depression
c. Tell her that things will be OK soon
Choice2
6. Mr. Smith is a newly diagnosed Type 2 diabetic on insulin. Which of the following would be within the ADA goal range?
a. 60-70 before breakfast
b. Less than 180 two hours after a meal
c. 200-240 after a meal
d. 140-180 before breakfast
7. Symptoms of hypoglycemia include:ons, and dry skin d.Sores that are slow to heal, frequent infections, feeling tired
a. Hunger, nervousness, sweating, and confusion
b. Frequent urination, dry skin, blurred vision, and thirst
c. Unexplained weight loss, pain in the feet, palpitations, and dry skin
d. Sores that are slow to heal, frequent infections, feeling tired
8. Which of the following is a true statement?:
a. Humulin 70/30 insulin contains 70% Humulin R and 30% Humulin N
b. Humalog is a short acting insulin
c. Novolin R insulin peaks in 2 hours
d. Insulin left out of the refrigerator for more than 48 hours should be disposed of
9. You notice Mr. Smith’s feet are very dry. You inform him that it is important for diabetics to:
a. Examine his feet weekly
b. Wash his feet every day using mild soap and water and use lotion
c. Go barefoot to keep his feet from getting fungus
d. Soak his feet for 20 minutes every morning to remove the dry skin
10. A common problem resulting from uncontrolled diabetes is:
a. Diabetic retinopathy
b. Cardiovascular disease
c. Kidney disease
d. All of the above:
11. You are caring for Mrs. Powell, who was hospitalized for CHF exacerbation. You instruct her that s/sx of CHF exacerbation that she should report immediately to the nurse or physician include:
a. A two pound weight gain in one week
b. A weight gain of greater than 2 lbs in 24 hours and increased SOB
c. Difficulty performing ADLs
d. A decreased appetite
12. Which of the following is an inaccurate statement regarding congestive heart failure?
a. Common causes include MI, HTN, valve disease, obesity, smoking, alcohol abuse, and illegal drug use
b. Patients with CHF should limit fluid intake to 1000-1200 cc per day
c. Nausea and abdominal pain may be a sign of an exacerbation of CHF
d. Left-sided heart failure causes different symptoms than right-sided heart failure
13. A sign of digitalis toxicity is:
a. Heart rate less than 60 and nausea
b. Rash and decreased muscle tone
c. Hypertension
d. Edema
14. Mrs. Collins is on Lasix 40 mg and K-Dur 10 meq for CHF. Her physician has added Zaroxolyn 2.5 mg QAM. What is animportant adverse side effect you should instruct her to report?
a. Increased urinary frequency
b. Muscle cramps and weakness
c. Nausea
d. Rash
14. Mrs. Collins is on Lasix 40 mg and K-Dur 10 meq for CHF. Her physician has added Zaroxolyn 2.5 mg QAM. What is animportant adverse side effect you should instruct her to report?
a. Increased urinary frequency
b. Muscle cramps and weakness
c. Nausea
d. Rash
15. Which of the following is a good source of potassium?
a. Applesauce
b. Cauliflower
c. Orange juice
d. Peas
16. Which of the following is a true statement regarding HTN?
a. A pressure reading of 140/90 is considered normal
b. Patients with blood pressures between 120/80 and 139/89 are considered pre-hypertensive
c. Smoking can raise the blood pressure because it dilates the arteries
d. Increased physical activity can make HTN worse
17. Mr. Puffer, a patient with end-stage COPD, complains of increased SOB with activity. You should:
a. Call 911
b. Instruct him on pursed lip breathing and s/sx warranting immediate attention
c. Increase his O2 to 6 L/min
d. All of the above
18. Prednisone 20 mg daily is ordered for Mr. Puffer. You know to instruct him that:
a. He should take it on an empty stomach to maximize absorption
b. It should always be taken with food to prevent ulcersc.
c. It should be abruptly discontinued if bruising of the skin is noticed
d. It will help reduce his risk of infection
19. Mr. Puffer becomes anxious, his lips and nailbeds are blue, and his pulse ox level is 79%. Your first action would be to:
a. Call his doctor
b. Try to contact his daughter
c. Call 911
d. Place him a supine position in preparation to perform CPR
20. Patients on Coumadin should be instructed to:
a. Avoid drinking alcohol
b. Eat a diet high in green leafy vegetables
c. Keep their legs elevated higher than their heart to help prevent blood clots
c. Keep their legs elevated higher than their heart to help prevent blood clots
21. Besides having difficulty with walking, a patient with Multiple Sclerosis may have difficulty with:
a. Visual focusing
b. Bowel and bladder continence
c. Mental and emotional changes
d. All of the above
22. Arthroplasty involves:
a. Surgical replacement of a joint
b. Placing hot packs over a joint
c. Inserting a scope into a joint for diagnostic purposes
c. Inserting a scope into a joint for diagnostic purposes
23. The most common effects of a stroke are:
a. Confusion and mental retardation
b. Paralysis of both lower extremities
c. Disturbance of speech and unilateral paralysis
d. Permanent paralysis of the upper extremities and blindness
24. Which is correct when instructing a patient with hemiplegia?
a. Use the cane on the stronger side of the body
b. Use the cane on the weaker side of the body
c. Move the cane forward at the same time as the stronger extremity
d. When walking up stairs advance the weak leg first while holding onto the railing
25. Good body mechanics involves:
a. Bending forward when lifting heavy objects
b. Keeping feet close together while making a bed
c. Using large muscle groups of arms, legs, and shoulders
d. Keeping objects at arms length when carrying
26. You see Mr. Powers for an initial visit after his hospitalization for a hip replacement. Important post-operative care includes:
a. Increasing gluteal strength by bending and touching the toes three times a day
b. Keeping the legs 6 inches apart
c. Strengthening the abdominal muscles by standing in a fixed position and rotating the torso 180 degrees
d. Sitting on a soft couch or chair to decrease pain and irritation to the incision
27. Mr. Powers is complaining that his pain is not being adequately relieved. Pain management for Mr. Powers includes:
a. Taking his Vicodin only when he is having difficulty tolerating the pain to avoid addiction
b. Taking aspirin round the clock and Vicodin for breakthrough pain
c. Taking his Vicodin around the clock
d. Doubling up on his Vicodin if the pain is severe
28. Mrs. Ahmed is referred to home health for management of a decubitus ulcer to her sacrum. Your assessment reveals a 4x4x3 cm wound with a yellow, stringy base and a moderate to large amount of serosanguinous drainage. You would stage this decubitus as a:
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
29. Due to the depth and amount of drainage, the best choice of dressing would be:
a. Calcium alginate
b. Wet to dry
c. Duoderm
d. Tegaderm
30. How would you stage a decubitus ulcer covering the entire heel with 100% soft black eschar?
a. Stage II
b. Stage III
c. Stage IV
d. The ulcer is not stageable
31. A nurse’s role in managing wound care includes:
a. Maintaining good nutrition and hydration
b. Position changes every 4 hours
c. Sharps debridement of necrotic tissue
d. All of the above
32. Characteristics of a venous ulcer are:
a. Severe pain and pale, thin skin to the extremity
b. Location above the ankle and edema to the extremity
c. Minimal drainage and mild pain
d. Location on the bottom of the foot and weak or absent pedal pulses
33. The most effective way to prevent the spread of infectious disease is:
a. Covering your mouth when coughing
b. Avoiding crowds
c. Getting a TB test every year
d. Handwashing
34. You find your patient on the floor beside his bed. The first thing you do is:
a. Call the doctor
b. Call for help, then lift him into bed
c. Give him small sips of water
d. Establish level of consciousness and take his vital signs
35. Your patient has a new prescription for a beta blocker. An important side effect to watch for is:
a. Bradycardia
b. Tachycardia
c. An elevated blood pressure
d. Muscle cramping
36. The physician has ordered Ampicillin 0.5 gm for your patient on tube feedings. The drug comes from the pharmacy in liquid form as Ampicillin 250 mg per 5 ml. How many ml would you administer?
a. 1 ml
b. 2.5 ml
c. 5 ml
d. 10 ml
37. You have an order to administer Lasix 20 mg IVP. You have on hand a 10 cc vial containing 100 mg. How many mls will you give?
a. 1 ml
b. 2 ml
c. 5 ml
d. 10 ml
38. Mr. Whitney comes home after two weeks of inpatient rehabilitation for a stroke with facial droop on the right. He comes home with an order for thickened liquids. Which one of the following actions indicates Mrs. Whitney has a correct understanding of aspiration precautions?
a. She makes sure to give him a straw when offering fluids while Mr. Whitney is laying down.
b. She sprinkles the thickener over his meatloaf to increase the fiber in his diet.
c. She adds enough thickener to his water until it is the consistency of nectar.
d. She has him chew his food on the right side of his mouth.
39. Mr. Whitney becomes angry when his dinner is delayed. Which one of the following courses of action would be the most appropriate initial response?
a. Ignore his behavior until his anger subsides
b. Listen quietly to him as he expresses his anger
c. Explain to him that his anger is interfering with his recovery
d. Tell him he should try to be more patient
40. Dilantin is prescribed for Mr. Whitney. Which of the following is an accurate statement regarding Dilantin?
a. Dilantin can help control his mood swings.
b. Dilantin will help him sleep better at night.
c. Mr. Whitney is taking Dilantin to help prevent seizures
d. The drug Dilantin is used to prevent nausea by stimulating the digestive tract which can become slowed after astroke
41. Mrs. Carter has osteoarthritis. Which one of the following joints is least likely to be effected?
a. Hip
b. Spine
c. Fingers
d. Shoulders
42. Which of the following is a HIPAA violation?
a. Faxing lab results to the pharmacy providing IV infusion therapy
b. Providing details about the patient’s physical assessment to the insurance company
c. Faxing lab results to the patient’s cardiologist when he/she is not the physician signing the 485
d. None of the above
43. Which of the following is a correct statement regarding obtaining a blood sample through a venipuncture?
a. If possible, a hand vein should be chosen, however if no vein is visible, the arm should be assessed, followed bythe antecubital area
b. The tourniquet should be released after withdrawing the needle.
c. A serum separator tube should be vigorously shaken 5 or 6 times after the blood is drawn.
d. The thumb and index finger should be used to stabilize the vein and keep the skin taught
44. Universal precautions involve:
a. Disposing of sharps in a hard plastic container with a secure lid
b. Handwashing
c. Using a mask when caring for a patient with Tuberculosis
d. All of the above
45. Which of the following is a true statement regarding medication dosing in the elderly patient?
a. The elderly usually need a larger dose due to a decreased ability to absorb drugs.
b. The elderly usually need a larger dose due to a decreased ability to maintain adequate blood levels of mostdrugs.
c. A smaller than average dose may be needed, because the elderly tend to have an increased sensitivity to manydrugs
d. A smaller than average dose may be needed because the elderly tend to develop allergies to manymedications
46. The correct way to administer eye drops is:
a. Apply the drops directly onto the surface of the eyeball.
b. Instill the drops into a pocket made by pulling down on the lower lid.
c. Gently touch the inner corner of the eye with the tip of the dropper and squeeze out one drop
d. Hold the bottle 6 inches above the eye and lift the upper lid with the thumb
47. Mrs. Jones comes home from the hospital with a transverse colostomy. She complains that she has been unable to have a formed stool. You inform her that:
a. She should follow a clear liquid diet and advance as tolerated until her stool thickens
b. She needs to avoid eating fruit
c. Loose bowels are common with a transverse colostomy
d. The stools will become firm within a few weeks
48. When teaching her colostomy care, you explain that:
a. Her stoma may shrink for several weeks following surgery
b. Skin prep products should be used sparingly as they tend to decrease adherence of the barrier
c. The barrier should be cut ½ to ¾ inches bigger than the size of the stoma
d. Once a bag is removed, it should not be reused
49. Mrs. Jones still has a vertical incision with staples to her abdomen. You instruct her to report symptoms of infection such as:
a. An oral temperature of 99.1 degrees
b. Itching and irritation around the staples
c. Redness, warmth, and increased pain to the incision
d. All of the above
50. Which of the following statements about foley catheter care is incorrect?
a. The catheter should be cleaned starting from the urethral meatus and moving downward.
b. When sitting in a chair, the bag may be kept on your lap to prevent anyone from stepping on it.
c. If you notice that no urine has flowed into the bag for one hour, you should first check to see if the tubing iskinked.
d. Sediment in the urine does not necessarily indicate infection
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