1. A patient is admitted to the medical-surgical nursing following a total hip replacement procedure. The nurse applies an abduction pillow as ordered by the doctor. The nurse knows that abduction of a joint is described as:
A. Bending the joint to form an acute angle
B. Moving the limb away from a normal position
C. Moving the limb toward a normal resting position
D. Straightening a bent joint

Correct answer is B:
Abduction is when an arm leg, or finger is moved away from the normal resting position.

2. The nurse is preparing a powdered medication for administration. Upon reconstituting a powdered medication for injection, it’s necessary to use which type of solution?
A. Sterile saline
B. Sterile water
C. Spring water
D. Tap water

Correct answer is B:
The best solution for reconstituting a powdered medicine is sterile water. Medications for administration must remain sterile. Tap water and spring water are considered nonsterile. Sterile sodium chloride (saline) isn’t considered the best solution for mixing medication.

3. The nurse is caring for a patient with a nasogastric tube. The doctor orders a 100-ml flush through the tube every 4 hours .When it’s necessary to flush a nasogastric juice, the solution to use is:
A. Distilled water
B. Sterile saline
C. Sterile water
D. Tap water

Correct answer is D:
The stomach isn’t considered sterile, so using tap water is acceptable, unless some underlying condition exist that prohibits its use. Flushing the tube with sterile saline may cause GI or electrolyte problems.

4. A child is admitted to the emergency department with a laceration to the scalp. The doctor has requested assistance while he sutures the laceration. The nurse places the patient on a papoose board with the understanding that this restraint is used with a child during a procedure:
A. That requires the patient to be motionless.
B. That causes the patient a lot of pain.
C. That causes the patient to vomit.
D. That requires sterile technique.

Correct answer A:
A papoose board is used with a child for a procedure requiring the child to be motionless, such as venipuncture or suturing. The papoose board restrains the child in a supine position. It’s contraindicated for vomiting patients to minimize the risk of aspiration. Papoose boards may be utilized in painful procedures or in procedures that require sterile technique, but they aren’t necessary for those procedures.

5. Palpation of a joint reveals crepitation. The nurse knows that crepitation found in a joint is due to:
A. Bone fragments in the joint
B. Fluid in the joint
C. Infection in the joint
D. Normal functioning

Correct is answer is A:
The presence of crepitation in a joint means that there are loose bodies in the joint, typically bone fragments from the friction of the opposing bones rubbing one another. Fluid in the joint may result in painful or difficult movement, but it doesn’t cause a crepitation. Infection in the joint may result in swelling and painful or difficult movement, but it doesn’t result in a crepitation. Crepitation in a joint is an abnormal finding and requires further evaluation.

6. Chvostek’s sign is associated with which electrolyte imbalance?
A. Hypocalcemia
B. Hypokalemia
C. Hyponatremia
D. Hypophosphatemia

Correct answer is A:
Chvostek’s sign is a spasm of facial muscle elicited by tapping the facial nerve and is associated with hypocalcemia. Clinical signs of hypokalemia are muscle weakness, leg cramps, fatigue, nausea, and vomiting. Muscles cramps, anorexia, nausea and vomiting are clinical signs of hyponatremia. Clinical manifestations associated with hypophosphatemia include muscle pain, confusion, seizures and coma.

7. When caring for a patient who is at risk for falling, it’s important to perform which of the following tasks?
A. Keep all objects away from the patient so he doesn’t fall on them.
B. Keep the bed in the high position so the patient won’t want to get out of it.
C. Raise the side rails on beds and stretches when appropriate
D. Use throw rugs on the area around the bed so the patient’s feet will be warm when standing.

Correct answer is C:
The use of side rails on beds and stretches will help remind the patient that he should not get out of bed without assistance. Items the patient may want to use should be kept close to him so he can reach them. It’s also important to keep the bed in the low position; in the event the patient does try to get out of bed, he wont fall as far. Throw rugs should be avoided because they tend to slip out from under the patient upon standing.

8. The use of isolation in the hospital is intended to:
A. Discourage a patient with an infection from ambulating.
B. Keep an infection from becoming endemic.
C. Maintain a sterile environment.
D. Prevent the further spread of an infection to others.

Correct is answer is D:
Isolation protocols are used in the hospital setting to contain an organism to one area and reduce the spread of infection to others. Isolation protocols may not prevent an infection from becoming endemic, nor will they maintain a sterile environment. Patients may ambulate while on isolation protocols, but they may be required to follow the precautions specified by the specific type of isolation in effect.

9. The nurse is caring for a patient who develops sudden weakness on one side of his body and facial droop. This would most likely be associated with the patient having a:
A. Cerebrovascular accident
B. Muscle spasm
C. Myocardial infarction
D. Pulmonary embolism

Correct answer is A:
A patient experiencing a cerebrovascular accident typically exhibits weakness on one side of the body as well as facial droop. Depending on the area of the brain involved, there may be other symptoms. Muscle spasms usually will result in temporary pain in the affected site. A patient experiencing a myocardial infarction will usually exhibit chest pain and shortness of breath, but he shouldn’t be affected with weakness on one side of the body. A patient diagnosed with a pulmonary embolism will usually complain of chest pain and shortness of breath; one-sided weakness and facial droop are usually not concerns for these patients.

10. A patient is admitted to the emergency department with complaints of chest pain and shortness of breath. The nurse’s assessment reveals jugular venous distention. The nurse knows that when a patient has jugular venous distention it’s typically due to:
A. A neck tumor
B. An electrolyte imbalance
C. Dehydration
D. Fluid overload

Correct answer is D:
Fluid overload causes the volume of the blood within the vascular system to increase. The increase causes the veins to distended and can be seen most obviously in the veins. An electrolyte imbalance may result in fluid overload, but it doesn’t directly contribute to jugular venous distention. Dehydration doesn’t cause jugular venous distention. A neck tumor may result in swelling to the neck, but it wont cause jugular venous distention.