- (Topic 3)
A newborn has been delivered with a meningomyelocele. The nursery nurse should position the newborn:

1. A. Prone
2. B. Supine
3. C. Side lying
4. D. Semi-Fowler

Correct Answer: A
(A) The prone position reduces pressure and tension on the sac. Primary nursing goals are to prevent trauma and infection of the sac. (B) The supine position exerts pressure on the sac. (C) Newborns usually cannot maintain side-lying position. (D) The semi- Fowler position exerts pressure on the sac.

- (Topic 1)
A psychotic client who believes that he is God and rules all the universe is experiencing which type of delusion?

1. A. Somatic
2. B. Grandiose
3. C. Persecutory
4. D. Nihilistic

Correct Answer: B
(A) These delusions are related to the belief that an individual has an incurable illness. (B) These delusions are related to feelings of self-importance and uniqueness. (C) These delusions are related to feelings of being conspired against. (D) These delusions are related to denial of self-existence.

- (Topic 7)
A client states to his nurse that ??I was told by the doctor not to take one of my drugs because it seems to have caused decreasing blood cells.?? Based on this information, which drug might the nurse expect to be discontinued?

1. A. Prednisone
2. B. Timolol maleate (Blocadren)
3. C. Garamycin (Gentamicin)
4. D. Phenytoin (Dilantin)

Correct Answer: D
(A) Prednisone is not linked with hematological side effects. (B) Timolol, a -adrenergic blocker is metabolized by the liver. It has not been linked to blood dyscrasia. (C) Gentamicin is ototoxic and nephrotoxic. (D) Phenytoin usage has been linked to blood dyscrasias such as aplastic anemia. The drug most commonly linked to aplastic anemia is chloramphenicol (Chlormycetin).

- (Topic 7)
Which of the following nursing orders has the highest priority for a child with epiglottitis?

1. A. Vital signs every shift
2. B. Tracheostomy set at bedside
3. C. Intake and output
4. D. Specific gravity every shift

Correct Answer: B
(A) Because of the possibility of fever or respiratory failure, vital signs should be done more often than every eight hours. (B) If the epiglottitis worsens, the edema and laryngospasm may close the airway and an emergency tracheostomy may be necessary. (C) Although intake and output are a part of the nursing care of a child with epiglottitis, it is not as important as the safety measure of keeping the tracheostomy set at the bedside. (D) Specific gravity will indicate hydration status, but it is not as important as keeping the tracheostomy set at the bedside.

- (Topic 4)
A client has been diagnosed with congestive heart failure. His fluid intake and output are strictly regulated. For lunch, he drank 8 oz of milk, 4 oz of tea, and 6 oz of coffee. His intake would be recorded as:

1. A. 500 mL
2. B. 540 mL
3. C. 600 mL
4. D. 655 mL

Correct Answer: B
(A, C, D) This answer is a miscalculation. (B) 1 oz = 30 mL; therefore, 18 oz x.