RENR REVIEW RAS PRACTICE TEST 10 AMM

1. Which of the following is reflective of the signs of Cushing’s Triad?

A. Slow pulse, irregular respirations, increased blood pressure
B. Rapid pulse, regular respirations, decreased blood pressure
C. Slow pulse, regular respirations, decreased blood pressure
D. Rapid pulse, irregular respirations, increased blood pressure

2. The nurse holds the gauze swab against an IM injection site while removing the
needle from the muscle. This technique helps to
A. Seal off the track left by the needle in the tissue
B. Avoid the discomfort of the needle pulling on the skin
C. Prevent the entrance of organisms into the body
D. Speed the spread of the medication in the tissue

3. The nurse manager using the nominal group process, made a list of ways to handle
conflicts on the ward. The next step is to decide who should be involved in decision-
making and who would be responsible for implementing that decision. This is
known as
A. A negotiating session
B. Implementation charting
C. A round-robin session
D. Decision charting

4. Because of an increased risk of workplace violence, an urban medical centre

instituted a workplace violence prevention training program. All of the following
are topics that need to be included except
A. Risk factors that contribute to assault
B. Information on multicultural diversity
C. Ways of dealing with hostile persons
D. Approaches to dealing with individuals who have a stressful life

5. Because of low morale and a high level of territorialism, the ward personnel
decided that they wanted the administration to remove the new nurse manager.
The ward personnel were exhibiting what type of behaviour?
A. Bullying behaviour
B. Reasonable behaviour
C. Performance problems
D. Expected behaviour

1
 Diabetes Mellitus is a growing concern in Caribbean communities. The epidemiological
approach has been used to determine the causative factors of this phenomenon.
6. Which of the following aims of epidemiology are relevant to disease surveillance of
Diabetes Mellitus?
i. Seeking causes of health and disease
ii. Diagnosing the health of a community
iii. Determining factors of susceptibility
iv. Establishing modes of transmission
A. I, ii, iii
B. I, ii, iv
C. I, iii, iv
D. Ii, iii, iv

7. An eighty (80) year old female client has been taking prescribed medication to help
her sleep at nights. When the nurse brought the medication, the patient refused.
What is the best action by the nurse in this situation?
A. Call the doctor and inform him
B. Reason with the client and encourage her to take it
C. Encourage the family to make her take the medication
D. Comply with the client’s wishes and document the incident

A 28-year-old male is admitted for suspected brain tumour. His symptoms have
progressed rapidly. The doctor is concerned about increased intracranial pressure.
8. What will be the character of the client’s pulse during a period of increased intra
cranial pressure?
A. Rapid and thread
B. Rapid and bounding
C. Slow and bounding
D. Slow and irregular

9. A client is admitted to the neurosurgical ward with a diagnosis of closed head

injury. Which of the following nursing intervention would be priority?
A. Assess the neurological status q1h
B. Initiate an intravenous access
C. Maintain an adequate airway
D. Monitor pulse, respirations, and blood pressure q1h

2
10. A client sustained a severe closed head injury and the neurosurgeon is determining
if the client is “brain dead.” Which of the following data support that the client is
brain dead?
A. A positive oculocephalic (doll’s eyes) test
B. A vestibulo-ocular (cold caloric) test produces no eye activity
C. The client’s head is turned to the right, and the eyes turn to the right
D. The client assumes decorticate posturing when painful stimuli are applied

11. Lumbar puncture (LP) is a common diagnostic procedure for patients with
neurological problems. Which of the following is true about lumbar puncture?
A. Normal CSF pressure is 20-35 mm Hg
B. There are no contraindications for doing a LP
C. A lumbar puncture is generally performed between 1st and 2nd lumbar
vertebrae
D. A lumbar puncture is generally performed between 3rd and 4th lumbar
vertebrae

12. Which of the following defines the term “Paraplegia?”

A. Spinal cord damage below level of T1
B. Spinal cord damage at level of C5
C. Spinal cord damage at level of L3
D. Spinal cord damage below level of T12

13. A client with a spinal cord injury was fortunate because the level of his injury did
not interrupt his respiratory mechanism. What level of the spinal cord is important
for diaphragm function?
A. Thoracic level 2 and 3
B. Thoracic level 5 and 6
C. Cervical level 3 and 4
D. Cervical level 7 and 8

14. Brain herniation is a complication of increased intracranial pressure. Through which

of the following structures does the brain commonly herniate if intracranial
pressure is not relieved?
A. Foramen magnum
B. Frontal sinus
C. Tentorial notch
D. The orbits

3
15. Which of the following assessments of the eyes are critical when determining
increased intracranial pressure?
i. Size of pupils
ii. Visual acuity
iii. Pupillary reaction to light
iv. Corneal reflex
A. I, ii, iii
B. I, ii, iv
C. I, iii, iv
D. I, ii, iii, iv

16. The client diagnosed with a closed head injury is admitted to the rehabilitation unit.
Which of the following medication order would the nurse question?
A. An oral anticonvulsant
B. An oral proton pump inhibitor
C. A subcutaneous anticoagulant
D. An intravenous osmotic diuretic

17. Clear fluid is draining from the nose of a client who sustains a head injury. Which of
the following differentiates it as rhinorrhoea as opposed to mucus?
i. Specific gravity
ii. Presence of glucose
iii. Presence of lymphocytes
iv. Presence of fibrinogen
A. I, ii
B. I, iii
C. Ii, iii
D. Ii, iv

4
 During the course of practice, nurses are expected to abide by the guidelines of the
Code of Ethics. The following are elements of the Code of Ethics for nurses
A. Nurses and People
B. Nurses and Practice
C. Nurses and the Profession
D. Nurses and Co-Workers
Match the statements in items (18-23) with the appropriate element of the Code
above. Each element can be used once or more than once.
18. The nurse maintains a standard of personal health, such that the ability to provide
care is not compromised

19. The nurse is active in developing a core of research-based professional knowledge

20. The nurse shares responsibility to sustain and protect the natural environment from
depletion, pollution, degradation and destruction

21. The nurse at all times maintain standards of personal conduct which reflect well on
the profession and enhance public confidence

22. The nurse takes appropriate action to safeguard individuals, families and
communities when their health is endangered by a co-worker or any other person

23. The nurse assumes the major role in determining and implementing acceptable
standards of clinical nursing practice, management, research and education

24. There are several cases of malaria on the ward. When the charge nurse speaks of
the need to break the chain of infection “at the second link” she is referring to
A. The susceptible host
B. An area for the storage and filtering of water
C. A place where the microorganism enters the body
D. A place where the microorganism naturally lives

25. A nurse is reviewing the burned client’s white blood cell count with differential. All
of the following results are listed. Which laboratory finding indicates the possibility
of sepsis?
A. The “bands” outnumber the “segs”
B. The “segs” outnumber the “bands”
C. The basophils outnumber the monocytes
D. The monocytes outnumber the basophils

5
 26. During the acute phase, the nurse applied gentamycin sulphate (topical antibiotic)
to the burn before dressing the wound. The client has all the following
manifestations. Which manifestation indicates that the client is having an adverse
reaction to this topical agent?
A. Increased serum creatinine level
B. Decreased white blood cell count
C. Increased wound pain 30 to 40 minutes after drug application
D. Presence of small, pale-pink bumps in the wound bed
RAS
27. The nurse is participating in a study and is collecting data identifying the number of
obese adults whose parents were also obese or overweight. Which research
method is being used in this study?
A. Control
B. Description
C. Explanation
D. Prediction

28. The nurse reviews a study in which adherence to an asthma action plan is compared
among groups of adolescents who received different asthma education. Which
research method does this represent?
A. Control
B. Description
C. Explanation
D. Prediction

29. Which of the following management theorists established a work standard based
on the effects of fatigue on work performance?
A. Henry Gantt
B. Frederick Taylor
C. Abraham Maslow
D. Frank Gilbreth

30. Which is the most important result of Florence Nightingale’s data collection and
statistical analysis during the Crimean war?
A. Bringing awareness of the rigors of the war to the general public
B. Using clinical research to evaluate the importance of sanitation and adequate
nutrition
C. Developing a process for statistical analysis and nursing documentation
D. Identifying and defining the role of nurses in modern health care

6
31. The development of nursing theories and conceptual models in the late 1960s and
1970s served to
A. Provide direction for nursing research
B. Provide funding for nursing research
C. Establish the concept of evidence-based practice
D. Determine the effectiveness of nursing interventions

32. What might one find in Likert’s consultative system that would be less likely in
participative management systems?
A. Sometimes an informal organization resists the formal goals
B. Staff members feel free to discuss their jobs with the manager
C. Decision-making is integrated throughout the organization
D. Staff members’ ideas are sought

33. An adult female client is using the rhythm method of family planning. In this
method, the unsafe period for sexual intercourse is indicated by
A. Return of preovulatory basal body temperature
B. Breast tenderness and mittelschmerz
C. 3 full days of elevated basal body temperature and clear, thin cervical mucus
D. Basal body temperature increase of 0.1-0.2 degrees on the 2 nd or 3rd day of the
cycle

34. The nurse instructs the nursing assistant on how to perform oral hygiene for a client
who cannot perform this task for himself. Which of the following techniques should
the nurse tell the nursing assistant to incorporate into the client’s daily care?
A. Rinse the client’s mouth with mouth wash several times a day
B. Use a soft toothbrush to brush the client’s teeth after each meal
C. Assess the oral cavity each time mouth care is given and record observations
D. Swab the client’s tongue, gums and lips with a soft foam applicator every 2
hours

35. The nurse is conducting a teaching session on the importance of condom use.
Which statement by the nurse is most accurate?
A. Condoms are impenetrable by viruses
B. Condoms contain spermicide and are reliable
C. Condoms are ninety percent safe
D. Condoms should be stored a little above room temperature

7
36. After a sub-total gastrectomy, the nurse should anticipate that nasogastric tube
drainage would be what colour for about 12 to 24 hours after surgery?
A. Dark brown
B. Bile green
C. Bright red
D. Dark yellow

37. Which of the following would be an expected nutritional outcome for a client who
has undergone a sub-total gastrectomy for cancer?
A. Regain weight lost within one month after surgery
B. Resume normal dietary intake of three meals a day
C. Control nausea and vomiting through regular use of antiemetic
D. Achieve optimal nutritional status through oral or parenteral feedings

38. In assessing a client with a T12 spinal cord injury, which clinical manifestation
would the nurse expect to find to support the diagnosis of spinal shock?
A. Hypotension and bradycardia
B. Inability to move upper extremities
C. No reflex activity below the waist
D. Complaints of a pounding headache

39. A client is admitted to the hospital after vomiting bright red blood and is diagnosed
with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the
mid-epigastric area along with a rigid board-like abdomen. Which of the following
do these clinical manifestations likely indicate?
A. An intestinal obstruction has developed
B. Rupture of another ulcer
C. The stomach has become inflamed
D. The ulcer has perforated

40. When obtaining a nursing history on a client with a suspected gastric ulcer, which
signs and symptoms would the nurse expect to see?
i. Epigastric pain at night
ii. Weight loss
iii. Rigid abdomen
iv. Vomiting
A. I, ii
B. I, iii
C. Ii, iii
D. Ii, iv

8
41. The nurse is preparing a discharge teaching plan for a male client who had umbilical
hernia repair. What should the nurse include in the plan?
A. Avoiding coughing
B. Irrigating the drain
C. Maintaining bed rest
D. Nurse in prone position

42. The nurse is instructing the male client who has an inguinal hernia repair how to
reduce postoperative swelling following the procedure. What should the nurse tell
the client?
A. Limit oral fluids
B. Elevate the scrotum
C. Apply heat to the abdomen
D. Remain on a low-fibre diet

43. The nurse is caring for a hospitalized female client with a diagnosis of ulcerative
colitis. Which finding, if noted on assessment of the client, would the nurse report
to the physician?
A. Hypotension
B. Bloody diarrhoea
C. Rebound tenderness
D. Haematocrit level of 40%

44. The focus of data analysis is to

A. Collect data from various sources
B. Transform data into a usable form
C. Evaluate data for efficiency
D. Identify data sources for later inclusion

9
45. The nurse is reviewing the record of a female client with Crohn’s disease. Which of
the following stool characteristics should the nurse expect to note documented in
the client’s record?
i. Yellow diarrhoea
ii. Fatty stools
iii. Bloody diarrhoea
iv. Bile salt diarrhoea

A. I, ii, iii
B. I, ii, iv
C. Ii, iii, iv
D. I, ii, iii, iv

46. The nurse is performing a colostomy irrigation on a male client. During the
irrigation the client begins to complain of abdominal cramps. What is the
appropriate nursing action?
A. Notify the physician
B. Stop the irrigation temporarily
C. Increase the height of the irrigation
D. Continue the irrigation slowly

47. A staff nurse began a graduate program focussing on health systems management.
To be prepared as an effective leader in a health care agency, the staff nurse would
probably benefit the most from instruction in which area?
A. Information systems
B. Computerized charting
C. Computerized medical records
D. Self-regulation of nursing practice

48. The primary difference between leadership and management is that leadership is
more outcomes oriented and management is more
A. Solutions oriented
B. Organization oriented
C. Process oriented
D. Conflict resolution oriented

10
49. Which of the following trends is most important for the twenty-first century leader
and manager?
A. Spread of Asian flu
B. Globalization
C. Shortage of medication
D. Shortage of health care facilities

50. A female client is undergoing tests for multiple myeloma. Diagnostic study findings
in multiple myeloma include
A. Hypocalcaemia
B. Decreased serum creatinine
C. Bence Jones protein in urine
D. Low serum protein level

RAS

11