National Council Licensure Examination: Physiological Integrity

1.Mr. Gallagher is unconscious after a seizure and needs mouth care. Which method is safest?

2.Ms. Ortiz's dentures are being cleaned at the sink. Which technique is correct?

3.The nurse is providing perineal care for Ms. Duarte, who has a urinary catheter. Which direction is correct?

4.Mr. Holt has a new nonblanchable red area on the coccyx. Which plan is correct?

5.A healing deep wound that once showed bone is now shallower. Which documentation is correct?

6.Ms. Levy's nasogastric tube was just inserted, and the surgeon ordered tube feeding to start. Which check is required first?

7.Mr. Santos is receiving a continuous tube feeding. Which position is safest?

8.Ms. Romano's new colostomy stoma is purple and dry. Which action is correct?

9.Mr. Ibrahim has a new ileostomy with liquid output. A coworker prepares a routine irrigation set. Which action is correct?

10.During a tap-water enema, Mr. Cole becomes dizzy and his pulse falls from 82 to 48. Which action is correct?

11.Ms. Wright has vomiting, a distended abdomen, and no flatus. An as-needed laxative is on the chart from a previous stay. Which action is correct?

12.The nurse is starting a 24-hour urine collection for Mr. Klein at 7 a.m. Which step is correct?

13.Ms. Grant has heart failure. This morning she weighs 4 pounds more than yesterday on the same scale, after voiding, in similar clothes. Which action is correct?

14.Mr. Costa is learning to walk with a cane after a right-leg injury. The right leg is weaker. Which teaching is correct?

15.Ms. Navarro is going down stairs with crutches and cannot bear full weight on the left leg. Which sequence is correct?

16.Mr. Young is using a walker for a weak right leg. Which pattern is correct?

17.Assistive personnel are helping Ms. Perry from bed to a chair. Which direction from the nurse is correct?

18.Mr. Bennett is ordered compression stockings, but both feet are pale, cold, and without pulses. Which action is correct?

19.Ms. Cho is a day after abdominal surgery and is taking shallow breaths. Which teaching is correct?

20.Mr. Diaz drank 200 mL of ice chips. How much intake does the nurse record?

21.Mr. Alvarez has cervical spine precautions and needs to be turned. Which method is correct?

22.Ms. Friedman is on bed rest and the nurse wants to prevent foot drop. Which device is correct?

23.While inserting Ms. Blake's urinary catheter, the nurse gets no urine return. The catheter may be in the vagina. Which action is correct?

24.The apical rate of Mr. Reed, an adult taking digoxin, is 52 beats per minute and regular. The order says to hold the dose if the rate is under 60. Which action is correct?

25.The order for 4-month-old Jonah's digoxin says to hold it if the apical rate is under 100. The rate is 92. Which action is correct?

26.Ms. Rahman, who takes digoxin, reports nausea and yellow halos around lights. Her potassium is 3.0 mEq/L. Which understanding is correct?

27.Mr. Petrova takes warfarin. His INR is above his target and his nosebleed has not stopped after 15 minutes of correct pressure. Which action is correct?

28.Ms. Abebe takes warfarin and asks if she must never eat greens again. Which teaching is correct?

29.The nurse is giving Mr. Solano a subcutaneous heparin injection. Which technique is correct?

30.Ms. Haddad's platelet count fell from 240,000 to 80,000 after a week of heparin. Which action is correct?

31.Enoxaparin is ordered to be given to Mr. Lange one hour before planned spinal anesthesia. Which action is correct?

32.Ms. Vogel is awake, shaky, and sweaty. Her capillary glucose is 48 mg/dL. She can swallow. Which treatment is correct?

33.Mr. Brooks is unconscious with a glucose of 32 mg/dL. Which action is correct?

34.The nurse is drawing up insulin glargine and regular insulin for Mr. Feldman. Which action is correct?

35.The nurse is mixing NPH and regular insulin for Ms. Khan, after confirming they may be mixed. Which sequence is correct?

36.Mr. Owens is NPO for a test. His glucose is 118 mg/dL. He has orders for bedtime glargine and for lispro with meals. Which action is correct?

37.Ms. Laurent is due for metformin, and her CT scan with intravenous contrast is this morning. Which action is correct?

38.Twenty minutes after morphine, Mr. Pike is hard to arouse and breathing 7 times a minute. Naloxone is ordered for this situation. Which plan is correct?

39.Mr. Doyle has chest pain and a prescription for nitroglycerin, but he took sildenafil last night. His blood pressure is 158/90. Which action is correct?

40.Ms. Farooq takes lisinopril. Her lips and tongue are swelling and her voice is becoming hoarse. Which action is the priority?

41.Mr. Bernard takes metoprolol. His apical rate is 46, and the order says to hold it if the rate is under 50. He feels dizzy. Which action is correct?

42.Ms. Adebayo takes spironolactone, and a new order adds a daily potassium tablet. Her potassium is 5.3 mEq/L. Which action is correct?

43.Mr. Mensah is due for an intravenous dose of furosemide. His last potassium was 3.1 mEq/L. Which action is correct?

44.During a vancomycin infusion, Ms. Johnson's face and chest become flushed and itchy. Her blood pressure is stable. Which action is correct?

45.Mr. Costa is on gentamicin and reports new ringing in the ears. His creatinine has risen. Which action is correct?

46.Ms. Cho has pneumonia, is stable enough for a brief delay, and has orders for blood cultures and an intravenous antibiotic. Which sequence is correct?

47.Mr. Silva has taken prednisone for months and wants to stop it today because his joints feel better. Which teaching is correct?

48.Ms. Nowak takes levothyroxine and also takes calcium with breakfast. Which teaching is correct?

49.An order says to mix intravenous phenytoin for Mr. Adler in a bag of dextrose. Which action is correct?

50.Ms. Kapoor uses an albuterol inhaler and an inhaled corticosteroid. Which teaching is correct?

51.Mr. Gallagher is ordered intravenous potassium. His urine output is 15 mL in the past hour. Which action is correct?

52.Ms. Ellison is receiving magnesium sulfate. Respirations are 10 per minute and deep-tendon reflexes are absent. Which action is correct?

53.Mr. Klein has a history of a bleeding gastric ulcer. A new order prescribes ibuprofen for a sprain. Which action is correct?

54.Ms. Wright takes hydrocodone with acetaminophen and also takes extra acetaminophen for a headache. Which teaching is correct?

55.The nurse is teaching Mr. Bauer about oral iron. Which instruction is correct?

56.Ms. Friedman has a macrocytic anemia. Folic acid is ordered before the vitamin B12 result is known. Which action is correct?

57.Mr. Okonkwo is in a sickle cell pain crisis. Which plan is correct?

58.A provider orders alteplase for Mr. Novak's new stroke symptoms. The CT scan has not been done. Which action is correct?

59.Two days after hip surgery, Ms. Grant has a warm, swollen left calf. Which action is correct?

60.Mr. Sato, a day after a femur fracture, becomes confused and short of breath, with a petechial rash on his chest. Which action is the priority?

61.Ms. Blake's forearm cast was applied this morning. She has pain that worsens when her fingers are gently extended, and the fingers are pale. Which action is correct?

62.Mr. Dalal had a posterior hip replacement. Which finding and instruction pair is correct?

63.Mr. Young's skeletal traction weights are resting on the floor. Which action is correct?

64.Mr. Holt has a T4 spinal injury, a sudden pounding headache, and blood pressure of 200/110. Which action is first?

65.Ms. Reyes has rising intracranial pressure. Which plan is correct?

66.Clear fluid is dripping from Mr. Cohen's nose after pituitary surgery. A drop on gauze shows a halo. Which action is correct?

67.Ms. Vogel has myasthenia gravis. Right after her pyridostigmine she has severe diarrhea, heavy saliva, and new weakness. Which action is correct?

68.Mr. Ibrahim has Guillain-Barré syndrome. Weakness has reached his chest and his cough is weak. Which assessment is the priority?

69.Ms. Carter has glaucoma and a new order for atropine eye drops from a different clinic visit. Which action is correct?

70.On the day after cataract surgery, Mr. Lange reports sudden severe eye pain and a drop in vision. Which action is correct?

71.Ms. Ortiz sees a curtain coming down over one eye, with new flashes of light. Which instruction is correct?

72.Mr. Santos has chronic obstructive pulmonary disease. His family turned his oxygen from the ordered 2 liters to 10 liters. He is now drowsy, and his saturation is 99 percent. Which action is correct?

73.Ms. Haddad is having an asthma attack. Wheezing has stopped, she is exhausted, and she can say only one word at a time. Which understanding is correct?

74.There is continuous bubbling in the water-seal chamber of Mr. Brooks's chest drainage system. Which interpretation is correct?

75.Ms. Duarte's chest tube drained 50 mL of dark red fluid in 4 hours, then 250 mL of bright red fluid in the next hour. Which action is correct?

76.Mr. Feldman, with heart failure, is suddenly gasping, coughing pink frothy sputum, and has crackles. Which action is the priority?

77.Mr. Costa has calf pain when walking that stops with rest. His feet are pale when elevated and dusky red when dependent. Which teaching is correct?

78.Ms. Perry has brown discoloration of the lower legs, edema, and aching that improves when she elevates them. Pedal pulses are strong. Which teaching is correct?

79.Mr. Alvarez is cool, clammy, and confused. His blood pressure is 78/46 and his heart rate is 128. Which action is correct?

80.Ms. Khan is in diabetic ketoacidosis. Her glucose is 460 mg/dL and her potassium is 2.8 mEq/L. Insulin is ordered. Which action is correct?

81.82-year-old Mr. Holt has type 2 diabetes, a glucose of 880 mg/dL, no significant ketones, and profound dehydration. Which priority is correct?

82.Six hours after a thyroidectomy, Ms. Cho has tingling around her mouth and a facial twitch when the nurse taps her cheek. Which action is correct?

83.Mr. Rossi has Addison's disease, has been vomiting, and stopped his steroid yesterday. His blood pressure is 80/50. Which action is correct?

84.Ms. Grant has syndrome of inappropriate antidiuretic hormone. Her sodium is 118 mEq/L, she is confused, and her urine is concentrated. Which plan is correct?

85.Mr. Diaz has diabetes insipidus after pituitary surgery. Urine output is 900 mL in one hour and the urine specific gravity is 1.002. Which plan is correct?

86.Ms. Navarro's arteriovenous fistula has no thrill and no bruit this morning. Which action is correct?

87.During peritoneal dialysis, Mr. Klein's outflow is cloudy and his abdomen is tender. Which action is correct?

88.Mr. Young's continuous bladder irrigation after prostate surgery is running. In one hour, 2000 mL went in and 2600 mL came out. How much is urine output?

89.A pregnant nurse is asked to crush finasteride tablets for Mr. Bennett. Which action is correct?

90.Mr. Santos has a kidney stone, fever, chills, and little urine output. Which understanding is correct?

91.4-year-old Felix has a new abdominal mass. Wilms tumor is suspected. Which action is correct?

92.During labor, Ms. Abebe's fetal monitor shows late decelerations with every contraction. Oxytocin is running. Which action is the priority?

93.One hour after birth, Ms. Laurent's fundus is boggy and shifted to the right, and bleeding is heavy. Which action is correct?

94.Ms. Farooq's fundus is firm and midline, but a steady trickle of bright blood continues. Which understanding is correct?

95.The umbilical cord is visible at the vaginal opening, and the fetal heart rate has fallen. Which action is correct?

96.Newborn Jonah is jittery at 2 hours of life. His glucose is 30 mg/dL. Which action is correct?

97.Baby Leila is 10 hours old and her skin is yellow. Which teaching is correct?

98.The nurse compares pulses in a 2-day-old. Arm pulses are strong and femoral pulses are weak. Which action is correct?

99.An infant with tetralogy of Fallot is crying and turning deeply blue. Which action is the priority?

100.4-week-old Owen vomits breast milk in a forceful arc and then wants to eat again. A small olive-shaped mass is felt in the abdomen. Which plan is correct?

101.7-month-old Sofia screams and pulls her knees up, then quiets, and now has red, jelly-like stool. Which action is correct?

102.10-year-old Diego has right lower abdominal pain, a fever, and rebound tenderness. The pain suddenly stops, then his abdomen becomes rigid. Which action is correct?

103.A 6-week-old has a rectal temperature of 100.8 Fahrenheit and is feeding poorly. Which teaching is correct?

104.Ms. Rahman is teaching her child with cystic fibrosis about enzymes. Which instruction is correct?

105.3-year-old Maya has a barking cough and stridor while resting. Which action is correct?

106.Toddler Luis is moderately dehydrated after vomiting. Which oral fluid is best while he is still able to drink?

107.The nurse is giving ear drops to 2-year-old Theo. Which technique is correct?

108.Mr. Solano's abdominal incision has opened and bowel is protruding. Which action is correct?