1. A nurse is caring for a burn client who has sustained
aspirin with oxycodone (percodan) via nasogastric
thoracic burns and smoke inhalation and is risk for
impaired gas exchange. The nurse avoids which action in
caring for this client?
1. repositioning the client from side to side every 2
hours
2. maintaining the client in a supine position with the
head of the bed elevated
3. suctioning the airway as needed
4. providing humidified oxygen as prescribed
2. A client sustains a burn injury to the entire right arm,
entire right leg, and anterior thorax. According to the
rule of nine’s the nurse determines that what body
percent was injured?
3. A nurse assesses a burn injury and determines that
the client sustained a full-thickness fourth-degree burn
if which of the following is noted at the site of injury?
1. a wet shiny weeping wound surface
2. a dry wound surface
3. charring at the wound site
4. blisters In a full-thickness fourth-degree burn injury,
charring is visible.
4. A nurse reviews the record of a client scheduled for
removal of a skin lesion. The record indicates that the
lesion is an irregularly shaped, pigmented papule with a
blue-toned color. The nurse determines that this
description of the lesion is characteristic of:
1. melanoma
2. basal cell carcinoma
3. squamous cell carcinoma
4. actinic keratosis
5. A client is seen in the health care clinic and a biopsy is
performed on a skin lesion that the physician suspects
malignant melanoma. The nurse prepares a plan of care
for the client based on which characteristics of this type
of skin cancer?
1. it is an aggressive cancer that requires aggressive
therapy to control its rapid spread
2. it is a slow-growing cancer and seldom metastasizes
3. it can grow so large that an entire area, such as the
nose, the lip, or the ear must be removed and
reconstructed if it occurs on the face
4. it is the most common form of skin cancer
6. A nurse is caring for a client brought to the
emergency room following a burn injury that occurred
in the basement of the home. Which initial finding
would indicate the presence of inhalation injury?
a. expectoration of sputum tinged with blood
b. the presence of singed nasal hair
c. absent breath sounds in the lower lobes bilaterally
d. tachycardia
7. A nurse is caring for a client who arrives at the
emergency room with the emergency medical services
team following a severe burn injury from an explosion.
Once the initial assessment has been performed by the
physician and life-threatening dysfunctions have been
addressed, the nurse reviews the physician’s orders
anticipating that which pain medication will be
prescribed?
a. intravenous (IV) morphine sulfate
b.
tube
c. acetaminophen (tylenol) with codeine sulfate
d. morphine sulfate by the subcutaneous route
8. The nurse is admitting a client diagnosed with acute
renal failure (ARF). Which question would be most
important for the nurse to ask during the admission
interview?
1. “Have you recently traveled outside the United
States?”
2. “Did you recently begin a vigorous exercise
program?”
3. “Is there a chance you have been exposed to a virus?”
4. “What over-the-counter medications do you take
regularly?”
9. The client is diagnosed with rule out ARF. Which
condition would predispose the client to developing pre-
renal failure?
1. Diabetes mellitus.
2. Hypotension.
3. Aminoglycosides.
4. Benign prostatic hypertrophy.
10. The client diagnosed with ARF is admitted to the
intensive care department and placed on a therapeutic
diet. Which diet would be not appropriate for the
client?
1. A high-potassium and low-calcium diet.
2. A low-fat and low-cholesterol diet.
3. A high carbohydrate and restricted-protein diet.
4. A regular diet with six (6) small feedings a day.
11. The client is admitted to the emergency department
after a gunshot wound to the abdomen. Which nursing
intervention would the nurse implement first to prevent
ARF?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry.
4. Assess abdominal dressing.
12. The client diagnosed with ARF is experiencing
hyperkalemia. Which medication should the nurse
prepare to administer to help decrease the potassium
level?
1. Erythropoietin.
2. Calcium gluconate.
3. Regular insulin.
4. Osmotic diuretic.
13. The nurse and unlicensed nursing assistant are
caring for clients on a medical floor.
Which nursing task would be most appropriate for the
nurse to delegate?
1. Collect a clean voided midstream urine specimen.
2. Evaluate the client’s 8 hour intake and output.
3. Assist in checking a unit of blood prior to hanging.
4. Administer a cation-exchange resin enema.
14. The unlicensed nursing assistant tells the nurse that
the client with ARF has a white layer on top of the skin
that looks like crystals. Which intervention should the
nurse implement?
1. Have the assistant apply a moisture barrier cream to
the skin.
2. Instruct the nursing assistant to bathe the client in
cool water.
3. Tell the nursing assistant not to turn the client in this
condition.
4. Explain that this is normal and do not do anything to
the client.
15. The client diagnosed with renal calculi is scheduled
for lithotripsy. Which post-procedure nursing task would
be most appropriate to delegate to the unlicensed
nursing assistant (NA)?
1. Monitor the amount, color, and consistency of urine
output.
2. Teach the client about care of the indwelling Foley
catheter.
3. Assist the client to the car when being discharged
home.
4. Take the client’s post-procedural signs.
16. In the oliguric phase of acute renal failure, the nurse
should anticipate the development of which of the
following complications?
1. Pulmonary edema.
2. Metabolic alkalosis.
3. Hypotension.
4. Hypokalemia.
17. The nurse initiates the client's first hemodialysis
treatment. The client develops a headache, confusion,
and nausea. These symptoms indicate which of the
following potential complications?
1. Disequilibrium syndrome.
2. Myocardial infarction.
3. Air embolism.
4. Peritonitis.
18. If disequilibrium syndrome occurs during dialysis,
which of the following would be the priority nursing
action?
1. Administer oxygen per nasal cannula.
2. Slow the rate of dialysis.
3. Reassure the client that the symptoms are normal.
4. Place the client in Trendelenburg's position.
19. Which of the following symptoms would most likely
indicate pyelonephritis?
1. Ascites.
2. Costovertebral angle (CVA) tenderness.
3. Polyuria.
4. Nausea and vomiting.
20. Which of the following groups of laboratory tests is
most important for assessing the client's renal status?
1. Serum sodium and potassium levels.
2. Arterial blood gases and hemoglobin.
3. Serum blood urea nitrogen (BUN) and creatinine
levels.
4. Urinalysis and urine culture.
21. The nurse is preparing a plan of care for the client
diagnosed with acute glomerulonephritis. Which would
be a long term goal?
1. The client will have a blood pressure within normal
limits.
2. The client will show no protein in the urine.
3. The client will maintain renal function.
4, The client will have clear lung sounds.
22. A client is admitted for treatment of
glomerulonephritis. On initial assessment, the nurse
detects one of the classic signs of acute
glomerulonephritis of sudden onset. Such signs include:
1. generalized edema, especially of the face and
periorbital area.
2. green-tinged urine.
3. moderate to severe hypotension.
4. polyuria.
23. The nurse helps the client with chronic renal failure
develop a home diet plan with the goal of helping the
client maintain adequate nutritional intake. Which of
the following diets would be most appropriate for a
client with chronic renal failure?
1. High carbohydrate, high protein.
2. High calcium, high potassium, high protein.
3. Low protein, low sodium, low potassium.
4. Low protein, high potassium.
24. The client is scheduled for an intravenous pyelogram
(IVP) to determine the location of the renal calculi.
Which of the following measures would be most
important for the nurse to include in pretest
preparation?
1. Ensuring adequate fluid intake on the day of the test.
2. Preparing the client for the possibility of bladder
spasms during the test.
3. Checking the client's history for allergy to iodine.
4. Determining when the client last had a bowel
movement.
25. . After an IVP, the nurse should anticipate incorpo-
rating which of the following measures into the
client's plan of care?
1. Maintaining bed rest.
2. Encouraging adequate fluid intake.
3. Assessing for hematuria.
4. Administering a laxative.
26. A client with end-stage renal failure receives
hemodialysis via an arteriovenous fistula (AV) placed in
the right arm. When caring for the client, the nurse
should:
1. Take the blood pressure in the right arm above the AV
fistula
2. Flush the AV fistula with IV normal saline to keep it
patent
3. Auscultate the AV fistula for the presence of a bruit
4. Perform needed venipunctures distal to the AV fistula
27. The client’s serum potassium is elevated in acute
renal failure, and the nurse administers sodium
polystyrene sulfonate (kayexalate). The drugs acts to
1. Increase potassium excretion from the colon.
2. Release of hydrogen ions for sodium ions.
3. Increase calcium absorption in the colon.
4. Exchange sodium for potassium ions in the colon.
28. In the diuretic phase of ARF, the nurse must be alert
for which of the following complications?
1. Respiratory acidosis
2. Hypertension
3. Hypokalemia
4. Hypernatremia
29. A client in ARF receives an IV infusion of 50 percent
dextrose in water with 20 units of regular insulin. The
nurse understands that the rational for this therapy is
to:
1. correct the hyperglycemia that occurs with acute
renal failure
2. facilitate the intracellular movement of potassium
3. provide calories to prevent tissue catabolism and
azotemia
4. force potassium into cells to prevent arrhythmias

30. The nurse is developing a nursing care plan for the

client diagnosed with ESRD. Which nursing problem
would have priority for the client?
1. Low self-esteem.
2. Knowledge deficit.
3. Activity Intolerance.
4. Excess fluid volume.