Dosage Calculation & I&O (6 Questions)
1) A patient is prescribed 1.5 g of amoxicillin per day, divided into three doses. The available stock is 500 mg per tablet. How many tablets should the patient take per dose?
Rationale: 1.5 g = 1500 mg. Divided into 3 doses = 500 mg per dose. Each tablet is 500 mg, so 1 tablet per dose.
2) A nurse is recording a patient's intake and output (I&O). The patient drank 480 mL of water, received 250 mL of IV fluids, and had a 120 mL juice. The urine output recorded is 750 mL. What is the patient’s net fluid balance?
Rationale: Total intake = 480 + 250 + 120 = 850 mL; output = 750 mL. Net = +100 mL.
3) The physician orders 75 mg of a drug IV push. The available vial contains 100 mg/2 mL. How many mL will the nurse administer?
Rationale: 100 mg per 2 mL = 50 mg/mL. 75 mg ÷ 50 mg/mL = 1.5 mL.
4) A patient requires 40 mg of furosemide IV push. The vial contains 10 mg/mL. How many mL will you administer?
Rationale: 40 mg ÷ 10 mg/mL = 4 mL.
5) A nurse is documenting I&O for a patient. The patient had: 1 cup of coffee, 240 mL IV fluids, 500 mL of soup, 800 mL urine output. What is the total intake in mL?
Rationale: 1 cup coffee = 240 mL, plus 240 mL IV, plus 500 mL soup = 980 mL total intake.
6) The physician prescribes 0.5 g of a medication. The available stock is 250 mg per tablet. How many tablets will you administer?
Rationale: 0.5 g = 500 mg. Each tablet is 250 mg, so 2 tablets are needed.
Gastrointestinal (GI) (8 Questions)
7) Which of the following assessment findings is most concerning in a patient with a peptic ulcer?
Rationale: Dark, tarry stools indicate possible GI bleeding, which is most concerning.
8) A patient with GERD is prescribed omeprazole (Prilosec). What should the nurse include in patient education?
Rationale: Limiting caffeine and spicy foods helps reduce GERD symptoms.
9) A patient has severe vomiting and diarrhea. Which laboratory value would the nurse expect?
Rationale: Excessive GI losses commonly cause hypokalemia.
10) A nurse is caring for a patient with a nasogastric (NG) tube to low intermittent suction. The patient reports nausea. What is the nurse’s first action?
Rationale: Checking if the NG tube is patent is the first step to relieve possible blockage causing nausea.
11) A patient with ulcerative colitis is experiencing frequent bloody stools. Which assessment finding is most concerning?
Rationale: A low hemoglobin level (8.0 g/dL) indicates significant blood loss and is most concerning.
12) A patient with cirrhosis develops ascites. What is the primary cause of this condition?
Rationale: Portal hypertension and hypoalbuminemia are the primary contributors to ascites.
13) Which diet is best for a patient with diverticulitis during an acute flare-up?
Rationale: A low-fiber (or low-residue) diet is recommended during an acute diverticulitis flare to reduce bowel irritation.
14) What is a priority assessment for a patient with chronic pancreatitis?
Rationale: Monitoring for jaundice is crucial due to possible bile duct involvement and liver dysfunction in chronic pancreatitis.
Genitourinary (GU) (8 Questions)
15) A patient with a urinary tract infection (UTI) reports flank pain and fever. What complication is the nurse most concerned about?
Rationale: Flank pain and fever are classic signs that a lower UTI may have progressed to pyelonephritis.
16) A patient with benign prostatic hyperplasia (BPH) reports difficulty urinating. Which medication is typically prescribed?
Rationale: Tamsulosin (an alpha-1 blocker) helps relax smooth muscle in the prostate and bladder neck, improving urine flow.
17) A patient with acute kidney injury (AKI) has high serum creatinine and low urine output. What is the priority nursing intervention?
Rationale: With low urine output, fluid can accumulate quickly, so monitoring for fluid overload is a priority.
18) Which of the following findings is expected in a patient with nephrotic syndrome?
Rationale: Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema.
19) A nurse is caring for a patient with a new ileal conduit (urostomy). What is an appropriate nursing intervention?
Rationale: To prevent leakage or weight pulling on the stoma, empty the pouch when it is about 1/3 full.
20) A patient is scheduled for hemodialysis. Which finding should the nurse report before initiating treatment?
Rationale: A low blood pressure (88/50) can worsen with dialysis; the physician must be notified.
21) A nurse is instructing a female patient on UTI prevention. Which statement indicates further teaching is needed?
Rationale: Cranberry juice may help reduce risk but does not cure a UTI. This statement indicates misunderstanding.
22) What is the primary function of erythropoietin, which is affected in chronic kidney disease (CKD)?
Rationale: Erythropoietin is responsible for stimulating RBC production; deficiency causes anemia in CKD.
Integumentary (11 Questions)
23) A patient with a Stage III pressure ulcer on the sacrum has exposed subcutaneous fat but no visible bone or muscle. What is the best initial nursing intervention?
Rationale: A hydrocolloid dressing helps maintain a moist environment and protect the wound in Stage III ulcers.
24) Which of the following is a priority assessment in a patient with severe burns covering 40% of the body?
Rationale: Urine output is a key indicator of fluid status and organ perfusion in burn management.
25) A patient with contact dermatitis asks how to relieve symptoms. What is the best response?
Rationale: Cool compresses can help soothe irritated skin and reduce inflammation for contact dermatitis.
26) A nurse notes eschar on a patient's wound. What is the priority nursing intervention?
Rationale: Eschar often must be debrided to promote healing and prevent infection.
27) A patient with herpes zoster (shingles) is prescribed acyclovir. What should the nurse include in teaching?
Rationale: Acyclovir is most effective when started promptly at the onset of symptoms.
28) Which type of skin cancer is the most aggressive and can metastasize quickly?
Rationale: Melanoma is known for its rapid metastasis and high mortality if not treated early.
29) A patient with psoriasis is prescribed a topical corticosteroid. What is an important teaching point?
Rationale: Topical steroids can cause skin thinning and other effects; limiting application to affected areas is key.
30) A nurse is assessing a burn wound and notes leathery, dry, and white areas with no pain. How should this burn be classified?
Rationale: A full-thickness burn often appears white or leathery and is typically painless due to nerve ending destruction.
31) A patient with eczema (atopic dermatitis) is prescribed a moisturizing regimen. What advice should the nurse give?
Rationale: Applying moisturizer right after bathing helps lock in moisture and reduce dryness/irritation.
32) A nurse is caring for a post-operative patient with dehiscence of a surgical wound. What is the priority nursing action?
Rationale: Covering the open wound with a sterile saline dressing keeps the tissue moist and helps prevent infection.
33) Which patient is at highest risk for delayed wound healing?
Rationale: Poor glycemic control in diabetes significantly impairs wound healing.
CPE Skills Related to UAP Role (8 Questions)
34) Which task can a UAP (unlicensed assistive personnel) perform?
Rationale: UAPs can assist with activities of daily living such as ambulation, but not invasive procedures or assessments.
35) A nurse delegates feeding assistance to a UAP for a patient at risk of aspiration. What instruction is most important?
Rationale: Keeping the patient upright (high Fowler’s) reduces the risk of aspiration during feeding.
36) A UAP reports that a patient’s vital signs are abnormal. What is the nurse’s best response?
Rationale: Abnormal vitals require nursing assessment; the nurse should check the patient personally.
37) Which of the following tasks can a UAP perform?
Rationale: UAPs may measure and record I&O, but cannot assess wounds or provide teaching.
38) A UAP tells the nurse, "I think the patient’s blood sugar is low." What should the nurse do first?
Rationale: The nurse must assess and verify the actual blood glucose before taking further steps.
39) A nurse is delegating tasks to a UAP. Which task is not appropriate?
Rationale: Pain assessment is a nursing responsibility and cannot be delegated to UAP.
40) A UAP reports to the nurse that a patient refused a bed bath. What is the nurse’s best response?
Rationale: The nurse should explore the patient's reasons and respect patient autonomy, then address concerns.
41) A UAP is caring for a post-operative patient. Which action by the UAP requires immediate intervention by the nurse?
Rationale: Assessing (checking) the incision site is outside the UAP scope and requires the nurse.