NCLEX RN Practice Test 1 0% 3 NCLEX NCLEX RN Practice Test 1 This NCLEX RN Practice Test Set contains 100 Questions attempt them all and check your knowledge. 1 / 100 A client visiting a family planning clinic is suspected of having an STI. The best diagnostic test for treponema pallidum is: Fluorescent treponemal antibody (FTA) Rapid plasma reagin (RPR) Thayer-Martin culture (TMC) Venereal Disease Research Lab (VDRL) Fluorescent treponemal antibody (FTA) is the test for treponema pallidum. VDRL and RPR are screening tests done for syphilis so answers A and B are incorrect. The Thayer-Martin culture is done for gonorrhea so answer D is incorrect. 2 / 100 What additional laboratory test should be performed on any African American client who sustains a serious burn injury? Prostate specific antigen Hemoglobin S electrophoresis Tissue type antigens Total protein Sickle cell disease and sickle cell trait are more common among African Americans. Although clients with sickle cell disease usually know their status, the client with sickle cell trait may not. The fluid, circulatory, and respiratory alterations that occur in the emergent phase of a burn injury could result in decreased tissue perfusion that is sufficient to cause sickling of cells, even in a person who only has the trait. Determining the client’s sickle cell status by checking the percentage of hemoglobin S is essential for any African American client who has a burn injury. 3 / 100 Situation: ENTEROSTOMAL THERAPY is now considered a specialty in nursing. You are participating in the OSTOMY CARE CLASS. Q. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if Fermin: Clamps of the flow of fluid when feeling uncomfortable Discontinues the insertion of fluid after only 500 ml of fluid has been instilled Lubricates the tip of the catheter prior to inserting into the stoma Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion Right Answer is: Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion 4 / 100 Ms. Hull has had an electrocauterization of her cervix for chronic cervicitis. Following the procedure the nurse should instruct Ms. Hull to: Avoid straining and heavy lifting until the physician permits this activity Return in bed for the next 5 days Stay in bed for the next 5 days Douche the next day to remove debris and blood cloth Right Answer is: Avoid straining and heavy lifting until the physician permits this activity 5 / 100 A client has undergone surgery for retinal detachment. Which of the following goal should be prioritized? Maintain darkened room Prevent an increase intraocular pressure Promote low-sodium diet Alleviate pain After surgery to correct a detached retina, prevention of increased intraocular pressure is the priority goal. 6 / 100 The nurse is reviewing the lab results of a clients arterial blood gases. The PaCO2 indicates effective functioning of the: Kidneys Liver Lungs Pancreas The PaCO2 (partial pressure of alveolar carbon dioxide) indicates the effectiveness of the lungs. Adequate exchange of carbon dioxide is one of the major determinants in acid/base balance. Answers A B and D are incorrect because they are not represented by the PaCO2. 7 / 100 A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypo ventilating and has a respiratory rate of 10 breaths/min. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/min. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which of the following? A decreased pH and a decreased HCO3 An increased pH with an increased HCO3 An increased pH and a decreased CO2 A decreased pH and an increased CO2 A decreased pH and a decreased HCO3 8 / 100 Situation : Organ donation is a new form of treatment that provides multiple complication such as rejection. Q. Among children candidates for organ transplant, when all selected children have appropriate tissue matches for the same donated organ, the basis for the decision as to which child gets the organ is given to the child who: will receive the most benefit from the new organ is selected by the lottery system for available organs is at the top of the list and has waited the longest time is most likely to die without the transplant Right Answer is: Is at the top of the list and has waited the longest time 9 / 100 The physician orders the administration of high-humidity oxygen by face mask and placement of the patient in a high Fowler’s position. After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. Which of the following nursing interventions has the greatest potential for improving this situation? Continue administering oxygen by high humidity face mask Place a humidifier in the patient’s room. Encourage the patient to increase her fluid intake to 200 ml every 2 hours Perform chest physiotherapy on a regular schedule Adequate hydration thins and loosens pulmonary secretions and also helps to replace fluids lost from elevated temperature, diaphoresis, dehydration and dyspnea. High- humidity air and chest physiotherapy help liquefy and mobilize secretions. 10 / 100 A client arrives at the clinic for the first prenatal assessment. She tells the nurse that the first day of her last normal menstrual period was October 19, 2018. Using Na ̈gele’s rule, which expected date of delivery should the nurse document in the client’s chart? July 12, 2019 August 26, 2019 July 26, 2019 August 12, 2019 Accurate use of Na ̈gele’s rule requires that the woman have a regular 28-day menstrual cycle. Subtract 3 months and add 7 days to the first day of the last menstrual period, and then add 1 year to that date: first day of the last menstrual period, October 19, 2018; subtract 3 months, July 19, 2018; add 7 days, July 26, 2018; add 1 year, July 26, 2019. 11 / 100 A 32-year-old mother of three is brought to the clinic. Her pulse is 52 there is a weight gain of 30 pounds in four months and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority? Hypothermia r/t decreased metabolic rate Decreased cardiac output r/t bradycardia Impaired physical mobility related to decreased endurance Disturbed thought processes r/t interstitial edema The decrease in pulse can affect the cardiac output and lead to shock which would take precedence over the other choices; therefore answers A B and C are incorrect. 12 / 100 The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available? The client with Addisons disease The client with pancreatitis The client with methicillin resistant-staphylococcus aureas (MRSA) The client with diabetes The client with MRSA is placed on contact precautions. The clients in answers B C and D pose no risk to themselves or others. 13 / 100 A 64 year-old man present with a weight gain of four kilograms in the past week. A physical examination shows an enlarged liver, an enlarged abdomen with a fluid wave, and jugular venous distension. The nurse creates a care plan based on the following nursing diagnosis. Decreased cardiac output related to ventricular damage, ischemia and restriction secondary to fluid overload. Which would be an appropriate defining characteristic? Poor ventricular contractility Altered afterload Increased pulmonary congestion Altered preload Poor ventricular contractility 14 / 100 The nurse has received a prescription to transfuse a client with a unit of packed red blood cells. Before explaining the procedure to the client, the nurse should ask which initial question? “Have you ever gone into shock for any reason in the past?†“Why do you think that you need the transfusion?†“Have you ever had a transfusion before?†“Do you know the complications and risks of a transfusion?†Asking the client about personal experience with transfusion therapy provides a good starting point for client teaching about this procedure. Questioning about previous history of shock and knowledge of complications and risks of transfusion is not helpful because it may elicit a fearful response from the client. Although determining whether the client knows the reason for the transfusion is important, it is not an appropriate statement in terms of eliciting information from the client regarding an understanding of the need for the transfusion. 15 / 100 He was called the father of sanitation. Abraham Hippocrates Willam Halstead Moses More than 1000 years before Christ, Moses was recognized as the “Father of Sanitation.†He wrote rules for sanitation. He stated that all people preparing and serving public food must be neat and clean. Moses also required that serving dishes and cooking utensils be washed between customers and public restaurants. 16 / 100 Situation : Ronald 23 years old was voluntarily admitted to the in-patient unit with a diagnosis of paranoid schizophrenia. Q. An appropriate activity for the nurse is to recommend for a client who is extremely agitated is: Trivial Pursuit Daily walks Competitive sports Bingo Right Answer is: Daily walks 17 / 100 A client with diabetes insipidus is receiving DDAVP (desmopressin acetate). Which lab finding indicates that the medication is having its intended effect? Glycosylated hemoglobin 3.5mg/dL White blood count of 7 500 Blood glucose 92mg/dL Urine specific gravity 1.020 The medication is having its intended effect when the clients urine specific gravity is within the normal range. Answers A and D refer to the client with diabetes mellitus not diabetes insipidus; therefore they are incorrect. Answer C is incorrect because it is not related to diabetes insipidus. 18 / 100 Postpartum blues is said to be normal provided that the following characteristics are present. These are 1. Within 3-10 days only; 2. Woman exhibits the following symptoms- episodic tearfulness, fatigue, oversensitivity, poor appetite; 3. Maybe more severe symptoms in primpara 2 and 3 All of the above 2 only 1 and 2 Answer: (A) All of the above All the symptoms 1-3 are characteristic of postpartal blues. It will resolve by itself because it is transient and is due to a number of reasons like changes in hormonal levels and adjustment to motherhood. If symptoms lasts more than 2 weeks, this could be a sign of abnormality like postpartum depression and needs treatment. 19 / 100 The nurse is caring for a client with ascites. Which is the best method to use for determining early ascites? Bimanual palpation for hepatomegaly Daily measurement of abdominal girth Assessment for a fluid wave Inspection of the abdomen for enlargement Daily measuring of the abdominal girth is the best method of determining early ascites. Measuring with a paper tape measure and marking the measured area is the most objective method of estimating ascites. Inspection and checking for fluid waves in answers A and D are more subjective and thus are incorrect for this question. Palpation of the liver in answer B will not tell the amount of ascites. 20 / 100 The nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the Scouts about the methods to prevent Lyme disease. Which statement by one of the Scouts indicates a need for further instruction? “I need to bring a hat to wear during the trip.†“I should not use insect repellents because it will attract the ticks.†“I need to wear closed shoes and socks that can be pulled up over my pants.†“Ishould wearlong-sleeved topsand longpants.†In the prevention of Lyme disease, individuals need to be instructed to use an insect repellent on the skin and clothes when in an area where ticks are likely to be found. Long-sleeved tops and long pants, closed shoes, and a hat or cap should be worn. If possible, heavily wooded areas or areas with thick underbrush should be avoided. Socks can be pulled up and over the pant legs to prevent ticks from entering under clothing. 21 / 100 For point of clarification a patient asks for the importance of Folic Acid in pregnancy. The nurse explains that vitamin is especially needed during pregnancy as it: helps in coagulation of red blood cells helps in maternal circulation is essential for cell and RBC formation assists in growth of heart and lungs Right Answer is: assists in growth of heart and lungs 22 / 100 Situation : Nurse Nico is caring to a 38-year-old female, G3P3 client who has been diagnosed with hemorrhoids. Q. The doctor orders for Witch Hazel 5 %. Nurse Nico knows that the action of this astringent is: inhibits the growth of bacteria and other organisms temporarily relieves pain, burning, and itching by numbing the nerve endings causes coagulation (clumping) of proteins in the cells of the perianal skin or the lining of the anal canal causes the outer layers of skin or other tissues to disintegrate Rationale: Option a are local anesthetics; c are antiseptics and d are keratolytics. 23 / 100 A child came to the emergency complaining of diarrhea, abdominal pain and vomiting. After the investigation it reveals that he eats contaminated food and got germs, what kind of germs you suspect to find in the test result? typhoid Streptococcus Atrial Flutter None of the above. typhoid 24 / 100 A nurse is preparing an assessment of a patient’s nutritional status. Which of the following diagnostic test would be the best measure of the patient’s recent nutritional status with a half- life of 2-3 days? 24- urine creatinine Albumin Prealbumin Hemoglobin Hemoglobin 25 / 100 Which nursing action is best when trying to diffuse a client’s impending violent behavior? Leaving the client alone until the client can talk about feelings Involving the client in a quiet activity to divert attention Placing the client in seclusion Helping the client identify and express feelings of anxiety and anger In many instances, the nurse can diffuse impending violence by helping the client identify and express feelings of anger and anxiety. Such statements as “What happened to get you this angry?†may help the client verbalize feelings rather than act on them. Close interaction with the client in a quiet activity may place the nurse at risk for injury should the client suddenly become violent. An agitated and potentially violent client shouldn’t be left alone or unsupervised because the danger of the client acting out is too great. The client should be placed in seclusion only if other interventions fail or the client requests this. Unlocked seclusion can be helpful for some clients because it reduces environmental stimulation and provides a feeling of security. 26 / 100 The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching? “I need to eat regular meals and chew my food well.†“I will take the prescribed medications because they will regulate my bowel patterns.†“I need to limit my intake of dietary fiber.†“I need to drink plenty, at least 8 to 10 cups daily.†IBS is a functional gastrointestinal disorder that causes chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating. Dietary fiber and bulk help to produce bulky, soft stools and establish regular bowel elimination habits. Therefore, the client should consume a high-fiber diet. Eating regular meals, drinking 8 to 10 cups of liquid a day, and chewing food slowly help to promote normal bowel function. Medication therapy depends on the main symptoms of IBS. Bulk-forming laxatives or antidiarrheal agents or other agents may be prescribed. 27 / 100 A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation? It is inconclusive. It is negative. It requires rescreening at age 6 weeks. It is positive. Phenylketonuria is a genetic (autosomal recessive) disorder that results in central nervous system damage from toxic levels of phenylalanine (an essential amino acid) in the blood. It is characterized by blood phenylalanine levels greater than 20 mg/dL (12.1 mcmol/L); normal level is 0 to 2mg/dL(0to121mcmol/L).A result of 1mg/dL is a negative test result. 28 / 100 Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to inhibit? Yellow sclera Shortness of breath Tarry stool Watery stool Liver inflammation and obstruction block the normal flow of bile. Excess bilirubin turns the skin and sclera yellow and the urine dark and frothy. 29 / 100 The nurse is administering augmentin to her patient with a sinus infection. Which is the best way for her to insure that she is giving it to the right patient? Read the name of the patient on the patient’s door Call the patient by name Check the patient’s room number on the unit census list Check the patient’s wristband The correct way to identify a patient before giving a medication is to check the name on the medication administration record with the patient’s identification band. The nurse should also ask the patient to state their name. The name on the door or the census list are not sufficient proof of identification. Calling the patient by name is not as effective as having the patient state their name; patients may not hear well or understand what the nurse is saying, and may respond to a name which is not their own. 30 / 100 The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society (ACS) guidelines, the nurse should recommend that the women: have a mammogram annually have a hormonal receptor assay annually perform breast self-examination annually have a physician conduct a clinical evaluation every 2 years According to the ACS guidelines, “Women older than age 40 should perform breast self examination monthly (not annually).†The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent. 31 / 100 Situation: Nanette was rushed to the hospital due to burns. Witnesses told the emergency team that Nanette fell asleep while she is holding her cigarette thus, burning the bed sheets and herself. 2nd and 3rd degree burns are on the face, neck, anterior and posterior trunk as well as the anterior of the left leg and the whole right arm was burned. First degree burns are located on the anterior portion of the right leg and the anterior portion of the right and left arm. Nanette is a 110 lbs female client. Q. Using the rule of nine, the percentage of the burned area on Nanette’s skin is: 0.63 0.72 0.9 0.81 Right Answer is: 63% 32 / 100 During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the mother at the upper quadrant. The interpretation is that the position of the fetus is: ROP LOA ROA LOP Answer: (A) LOA The landmark used in determine fetal position is the posterior fontanel because this is the nearest to the occiput. So if the nurse palpated the occiput (O) at the left (L) side of the mother and at the upper/anterior (A) quadrant then the fetal position is LOA. 33 / 100 The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia? Occasional constipation Decreased force in the stream of urine Scrotal edema Nocturia Decreased force in the stream of urine is an early symptom of benign prostatic hyperplasia. The stream later becomes weak and dribbling. The client then may develop hematuria, frequency, urgency, urge incontinence, and nocturia. If untreated, complete obstruction and urinary retention can occur. Constipation or scrotal edema is not associated with benign prostatic hyperplasia. 34 / 100 Dorsal recumbent position is used when performing the following procedures EXCEPT: Suppository insertion Urinary catheter insertion Cystoscopic examination Vaginal examination Suppository insertion 35 / 100 The nurse is teaching the client regarding use of sodium warfarin. Which statement made by the client would require further teaching? I will assess my skin for a rash. I will use an electric razor to shave. I will have blood drawn every month. I take aspirin for a headache. The client taking an anticoagulant should not take aspirin because it will further increase bleeding. He should return to have a Protime drawn for bleeding time report a rash and use an electric razor. Therefore answers A B and D are incorrect. 36 / 100 When caring for a patient with new sigmoid colostomy, the nurse knows that the stoma may be expected to decrease in size from up to: One months Two months One year Six months One months 37 / 100 The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply. 1. Provide a cool environment for the client. 2. Instruct the client to consume a high-fat diet. 3. Instruct the client about thyroid replacement therapy. 4. Encourage the client to consume fluids and high-fiber foods in the diet. 5. Inform the client that iodine preparations will be prescribed to treat the disorder. 6. Instruct the client to contact the health care provider (HCP) if episodes of chest pain occur. 1, 2, 3 3, 4, 6 1, 2, 4, 5 1, 3, 5 The clinical manifestations of hypothyroidism are the result of decreased metabolism from low levels of thyroid hormone. Interventions are aimed at replacement of the hormone and providing measures to support the signs and symptoms related to decreased metabolism. The client often has cold intolerance and requires a warm environment. The nurse encourages the client to consume a well-balanced diet that is low in fat for weight reduction and high in fluids and high-fiber foods to prevent constipation. Iodine preparations may be used to treat hyperthyroidism. Iodine preparations decrease blood flow through the thyroid gland and reduce the production and release of thyroid hormone; they are not used to treat hypothyroidism. The client is instructed to notify the HCP if chest pain occurs because it could be an indication of overreplacement of thyroid hormone. 38 / 100 Aclient receiving a transfusion of packed red blood cells (PRBCs) begins to vomit. The client’s blood pressure is 90/50 mm Hg from a baseline of 125/ 78 mm Hg. The client’s temperature is 100.8 °F (38.2 °C) orally from a baseline of 99.2 °F (37.3 °C) orally. The nurse determines that the client may be experiencing which complication of a blood transfusion? Hyperkalemia Delayed transfusion reaction Circulatory overload Septicemia Septicemia occurs with the transfusion of blood contaminated with microorganisms. Signs include chills, fever, vomiting, diarrhea, hypotension, and the development of shock. Hyperkalemia causes weakness, paresthesias, abdominal cramps, diarrhea, and dysrhythmias. Circulatory overload causes cough, dyspnea, chest pain, wheezing, tachycardia, and hypertension. Adelayed transfusion reaction can occur days to years after a transfusion. Signs include fever, mild jaundice, and a decreased hematocrit level. 39 / 100 A client has begun therapy with theophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication? Oysters, lobster, and shrimp Melons, oranges, and pineapple Cottage cheese, cream cheese, and dairy creamers Coffee, cola, and chocolate Theophylline is a methylxanthine bronchodilator. The nurse teaches the client to limit the intake of xanthine containing foods while taking this medication. These foods include coffee, cola, and chocolate. 40 / 100 The nurse is assisting in the assessment of the patient admitted with extreme abdominal pain. The nurse asks the client about the medication that he has been taking because: Interactions between medications will cause abdominal pain. Various medications taken by mouth can affect the alimentary tract. The types of medications might be attributable to an abdominal pathology not already identified. This will provide an opportunity to educate the patient regarding the medications used. Many medications can irritate the stomach and contribute to abdominal pain. For answer A not all interactions between medications will cause abdominal pain. Although this might provide an opportunity for teaching this is not the best time to teach. Therefore answer C is incorrect. Answer D is incorrect because medication may not be the cause of the pain. 41 / 100 A patient visiting the clinic 10 days after sinus surgery for checkup complains of having a bad taste in the mouth. When the nurse smells a foul odor while examining the patients mouth, the nurse suspects the patient have an: Pulmonarydecompensation Infection Aspiration Hemorrhage Infection 42 / 100 Situation : Ms. J., a 34-year old white female, is admitted via the emergency room complaining of abdominal pain, fatigue, anorexia, muscle cramping, and nausea. She is a diabetic who been managed at 30 U NPH insulin every AM and a 1200-calorie ADA diet. Her glucose in ER 700 mg/dL. Regular insulin 30 U was given and a repeat glucose were drawn. Results were not avaiIable upon transfer to the unit. Q. Given the above Information, which nursing activities should be highest priority? Assessing neurological status Monitoring vita i signs Assessing pedal pulses and feet Obtaining blood glucose results Right Answer is: Obtaining blood glucose results 43 / 100 When should the nurse starts giving XANAX? When the client starts to have a narrow perceptual field and selective inattentiveness When problem solving is not possible When anxiety is +1 When the client is immobile and disorganized When the client starts to have a narrow perceptual field and selective inattentiveness 44 / 100 Following mitral valve replacement surgery a client develops PVC’s. The health care provider orders a bolus of Lidocaine followed by a continuous Lidocaine infusion at a rate of 2 mgm/minute. The IV solution contains 2 grams of Lidocaine in 500 cc’s of D5W. The infusion pump delivers 60 microdrops/cc. What rate would deliver 4 mgm of Lidocaine/minute? 20 microdrops/minute 40 microdrops/minute 60 microdrops/minute 30 microdrops/minute 2 gm=2000 mgm 2000 mgm/500 cc = 4 mgm/x cc 2000x = 2000 x= 2000/2000 = 1 cc of IV solution/minute CC x 60 microdrops = 60 microdrops/minute 45 / 100 A process of heat loss which involves the transfer of heat from one surface to another is Convection Conduction Radiation Evaporation Conduction 46 / 100 In preventing the development of an external rotation deformity of the hip in a client who must remain in bed for any period of time, the most appropriate nursing action would be to use: Trochanter roll extending from the crest of the ileum to the midthigh. Pillows under the lower legs. Hip-abductor pillow Footboard A trochanter roll, properly placed, provides resistance to the external rotation of the hip. 47 / 100 The nurse is assisting in planning care for a client with a diagnosis of immunodeficiency and should incorporate which action as a priority in the plan? Identifying factors that decreased the immune function Providing emotional support to decrease fear Encouraging discussion about lifestyle changes Protecting the client from infection The client with immunodeficiency has inadequate or absence of immune bodies and is at risk for infection. The priority nursing intervention would be to protect the client from infection. Options 2, 3, and 4 may be components of care but are not the priority. 48 / 100 Situation: Mr. Roberto was long diagnosed with chronic renal failure. You are his nurse and the following question assesses your knowledge in the different fluid and electrolyte imbalances that are associated with chronic renal failure. Q. Mr. Roberto’s chronic renal failure was caused by a crush injury to the lower leg right after an accident. The acute renal failure progresses to chronic renal failure until now, his case is irreversible. The nurse is correct in determining that the cause of Mr. Roberto’s Acute renal failure before was: Renal Prerenal Extrarenal Post renal Right Answer is: Renal 49 / 100 A hospitalized client has begun taking bupropion as an antidepressant agent. The nurse determines that which is an adverse effect, indicating that the client is taking an excessive amount of medication? Dizziness when getting upright Increased weight Seizure activity Constipation Seizure activity can occur in clients taking bupropion dosages greater than 450 mg daily. Weight gain is an occasional side effect, whereas constipation is a common side effect of this medication. This medication does not cause significant orthostatic blood pressure changes. 50 / 100 Which method of oxygenation least likely produces anxiety and apprehension? Partial Rebreather mask Simple Face mask Nasal Cannula Non Rebreather mask Among the methods of oxygenation, nasal cannulas least likely produce anxiety and apprehension. However, patients with nasal cannulas sometimes complain of nasal dryness, particularly when receiving oxygen at high levels. New devices can help with this by adding moisture and warmth to the delivery process. 51 / 100 Situation : After abdominal surgery, the circulating and scrub nurses have critical responsibility about sponge and instrument count. Q. Like any nursing intervention, counts should be documented. To whom does the scrub nurse report any discrepancy of counts so that immediate and appropriate action is instituted? Anaesthesiologist Circulating nurse OR nurse supervisor Surgeon Right Answer is: Surgeon 52 / 100 The nurse is caring for a client with laryngeal cancer. Which finding ascertained in the health history would not be common for this diagnosis? Dysphagia Foul breath Diarrhea Chronic hiccups The client with mouth and throat cancer will have all the findings in answers A B and D except the correct answer of diarrhea. 53 / 100 When planning the discharge of a client with chronic anxiety, Nurse Chris evaluates achievement of the discharge maintenance goals. Which goal would be most appropriately having been included in the plan of care requiring evaluation? The client eliminates all anxiety from daily situations The client identifies anxiety producing situations The client ignores feelings of anxiety The client maintains contact with a crisis counselor Recognizing situations that produce anxiety allows the client to prepare to cope with anxiety or avoid specific stimulus. 54 / 100 The nurse is caring for the client with a five-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism? The client lives in a house built in 1990. The client has traveled out of the country in the last six months. The client has several brothers and sisters. The clients parents are skilled stained-glass artists. The parents make stained glass as a hobby. Stained glass is put together with lead which can drop on the work area where the child can consume the lead beads. Answers A C and D do not pose a threat to the child. 55 / 100 Is a multi dimensional model developed by PENDER that describes the nature of persons as they interact within the environment to pursue health Health Belief Model Health Promotion Model Health Prevention Model Ecologic Model Pender developed the concept of HEALTH PROMOTION MODEL which postulated that an individual engages in health promotion activities to increase well being and attain self actualization. These includes exercise, immunization, healthy lifestyle, good food, self responsibility and all other factors that minimize if not totally eradicate risks and threats of health. 56 / 100 The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply. 1. Initiate an infusion of 3% NaCl. 2. Administer intravenous furosemide. 3. Restrict fluids to 800 mL over 24 hours. 4. Elevate the head of the bed to high Fowler’s. 5. Administer a vasopressin antagonist as prescribed. 1, 2, 3 1, 2, 4, 5 1, 3, 5 1, 3, 4 Clients with SIADH experience excess secretion of antidiuretic hormone (ADH), which leads to excess intravascular volume, a declining serum osmolarity, and dilutional hyponatremia. Management is directed at correcting the hyponatremia and preventing cerebral edema. Hypertonic saline is prescribed when the hyponatremia is severe, less than 120 mEq/L (120 mmol/L). An intravenous (IV) infusion of 3% saline is hypertonic. Hypertonic saline must be infused slowly as prescribed and an infusion pump must be used. Fluid restriction is a useful strategy aimed at correcting dilutional hyponatremia. Vasopressin is an ADH; vasopressin antagonists are used to treat SIADH. Furosemide may be used to treat extravascular volume and dilutional hyponatremia in SIADH, but it is only safe to use if the serum sodium is at least 125 mEq/L (125 mmol/L). When furosemide is used, potassium supplementation should also occur and serum potassium levels should be monitored. To promote venous return, the head of the bed should not be raised more than 10 degrees for the client with SIADH. Maximizing venous return helps to avoid stimulating stretch receptors in the heart that signal to the pituitary that more ADH is needed. 57 / 100 A boy with skin disease, when you recommend the boy to go back to school? When he has temperature When all symptom of skin disease are disappear When you see scaly over the skin None of the above. When you see scaly over the skin 58 / 100 Situation: Anesthesia is used even during the Ancient times. In its evolution, modern marvels in the use of anesthesia enables the nurses to develop a more competitive approach in patient care. Q. After spinal anesthesia, to prevent spinal headache, the client is placed on which of the following position? Side Lying position affected side Flat on bed, supine Flat on bed, prone Sitting position Right Answer is: Flat on bed, prone 59 / 100 The client is admitted to the emergency room with shortness of breath anxiety and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. The doctor orders quinidine sulfate. While he is receiving quinidine the nurse should monitor his ECG for: Inverted T wave Elevated ST segment Prolonged QT interval Peaked P wave Quinidine can cause widened Q-T intervals and heart block. Other signs of myocardial toxicity are notched P waves and widened QRS complexes. The most common side effects are diarrhea nausea and vomiting. The client might experience tinnitus vertigo headache visual disturbances and confusion. Answers A B and C are not related to the use of quinidine. 60 / 100 Situation : Milo 16 y/o has been diagnosed to have AIDS, he worked as entertainer in a cruise ship: Which method of transmission is common to contract AIDS: Body fluids Syringe and needles Sexual contact Transfusion Sexual contact 61 / 100 A client has just returned to a nursing unit after an above-knee amputation of the right leg. The nurse should place the client in which position? Prone. Reverse Trendelenburg’s Supine, with the residual limb flat on the bed Supine, with the residual limb supported with pillows The residual limb is usually supported on pillows for the first 24 hours following surgery to promote venous return and decrease edema. After the first 24 hours, the residual limb usually is placed flat on the bed to reduce hip contracture. Edema also is controlled by limb-wrapping techniques. In addition, it is important to check health care provider prescriptions regarding positioning following amputation. 62 / 100 Which of the following is TRUE with regards to the concept of Modern Stress Theory? Stress is essential Stress always leads to distress Man does not encounter stress if he is asleep A single stress can cause a disease Stress is ESSENTIAL. No man can live normally without stress. It is essential because it is evoked by the body’s normal pattern of response and leads to a favorable adaptive mechanism that are utilized in the future when more stressors are encountered by the body. Man can encounter stress even while asleep (i.e., nightmares). Disease are multifactorial and are not caused by a single stressor. Stress is sometimes favorable and are not always a cause for distress. 63 / 100 The following are skin changes in pregnancy EXCEPT: Chadwick’s sign Linea negra Striae gravidarum Chloasma Chadwick’s sign is bluish discoloration of the vaginal mucosa as a result of the increased vascularization in the area. 64 / 100 A nursing home resident with chronic osteoarthritis complains of knee pain. A routine order of acetaminophen (Tylenol) 500 mg every 6 hours was administered 2 hours ago with no relief. The patient also has an order for ibuprofen (Motrin) 400 mg every 6 hours as needed. The patient reports some relief, but is still bothered by mild pain. The nurse should Administer ibuprofen (Motrin) 400mg Administer acetaminophen (Tylenol) 500 mg Educate the patient that mild pain is expected with osteoarthritis Call the physician for additional pain medication Administer ibuprofen (Motrin) 400mg 65 / 100 A 32 year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on this history/ which disease condition will you suspect? Tetanus Leptospirosis Hepatitis A Hepatitis B Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats. 66 / 100 The client has surgery for removal of a Prolactinoma. Which of the following interventions would be appropriate for this client? Place the client in Trendelenburg position for postural drainage. Encourage the Valsalva maneuver for bowel movements. Elevate the head of the bed 30°. Encourage coughing and deep breathing every two hours. A prolactinoma is a type of pituitary tumor. Elevating the head of the bed 30° avoids pressure on the sella turcica and helps to prevent headaches. Answers A B and D are incorrect because Trendelenburg Valsalva maneuver and coughing all increase the intracranial pressure. 67 / 100 Which of the following is true about an individual’s caloric needs? During cold weather, people need more calories due to increase BMR All individual have the same caloric needs Dinner should be the heaviest meal of the day Females in general have higher BMR and therefore, require more calories Temperature affects how many calories we burn. According to the American Dietetic Association Complete Food and Nutrition Guide, both the heat and cold raise the BMR. If we are too cold we shiver. Shivering burns up much energy from the constant contraction and relaxation of muscle cells trying to produce heat to maintain body temperature. When we are hot we also burn more energy through the process of sweating. 68 / 100 A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse’s best response to the client’s question? “It will help to promote insulin absorption when your glucose levels are high.†“It is for the times when your blood glucose is too low from too much insulin.†“It will help to prevent lipoatrophy from the multiple insulin injections over the years.†“It will boost the cells in your pancreas if you have insufficient insulin.†Glucagon is used to treat hypoglycemia resulting from insulin overdose. The family of the client is instructed in how to administer the medication. In an unconscious client, arousal usually occurs within 20 minutes of glucagon injection. When consciousness has been regained, oral carbohydrates should be given. Lipoatrophy and lipohypertrophy result from insulin injections. 69 / 100 Situation :– Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications. Q. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain: blood replacement supplementary oxygen chest tube drainage ventilation exchange Right Answer is: supplementary oxygen 70 / 100 Dervid, an adolescent has a history of truancy from school, running away from home and “borrowing†other people’s things without their permission. The adolescent denies stealing, rationalizing instead that as long as no one was using the items, it was all right to borrow them. It is important for the nurse to understand the psychodynamically, this behavior may be largely attributed to a developmental defect related to the: Oedipal complex Superego Id Ego This behavior shows a weak sense of moral consciousness. According to Freudian theory, personality disorders stem from a weak superego. 71 / 100 A client is to receive Dilantin (phenytoin) via a nasogastric (NG) tube. When giving the medication the nurse should: Flush the NG tube with 5mL of normal saline and administer the medication Flush the NG tube with 2-4mL of water before giving the medication Administer the medication flush with 5mL of water and clamp the NG tube Flush the NG tube with 2-4oz of water before and after giving the medication The nurse should flush the NG tube with 2-4oz of water before and after giving the medication. Answers A and B are incorrect because they do not use sufficient amounts of water. Answer C is incorrect because water not normal saline is used to flush the NG tube. 72 / 100 Situation:– Graciela 1 ½ year old is admitted the hospital from the emergency room with a fracture of the left femur due to a Tall down a flight of stairs. Graciela is placed oh Bryant’s traction. Q. Graciela is assessed to have no head injury. The Bryant’s traction is removed. A plaster of Paris his spica is applied. Which of these finding as a concern of immediate attention that must be reported to the physician immediately? The toes of Graciela’s left foot blanch when the nurse applies pressure on them The nurse is unable to insert a finger under the edge of Graciela’s cast on her left foot Graciela’s cast is still damp Graciela is scratching the cast over her abdomen The nurse is unable to insert a finger under the edge of Graciela’s cast on her left foot 73 / 100 Nurse Jocelyn is caring for a client with nasogastric tube that is attached to low suction. Nurse Jocelyn assesses the client for symptoms of which acid-base disorder? Respiratory alkalosis Metabolic acidosis Respiratory acidosis Metabolic alkalosis Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis because of the loss of hydrochloric acid which is a potent acid in the body. 74 / 100 Which of the following antituberculosis drugs can damage the 8th cranial nerve? Isoniazid (INH) Para Aminosalicylic acid (PAS) Ethambutol hydrochloride (myambutol) Streptomycin Streptomycin is an aminoglycoside and damage on the 8th cranial nerve (ototoxicity) is a common side effect of aminoglycosides. 75 / 100 Situation : Understanding different models of care is a necessary part of the nurse patient relationship. Q. The client asks the nurse about the Milieu therapy. The nurse responds knowing that the primary focus of milieu therapy can be best described by which of the following? A behavioural approach to changing behaviour A form of behaviour modification therapy A living learning or working environment A cognitive approach of changing the behaviour A living learning or working environment 76 / 100 Situation: Sexually Transmitted Diseases are important to identify during pregnancy because of their potential effect on the pregnancy, fetus, or newborn. The following questions pertain to STD’s. Syphilis is another infection that may impose risk during pregnancy. Since we are under the practice of health science, you know that Syphilis is caused by: Treponema Syphilis Neisseria gonorrhoeae Chlamydia Trachomatis Treponema Pallidum Treponema Pallidum 77 / 100 Situation: Miss Matias, found out that Mr. Carding, newly admitted patient, has terminal cancer and that his nurse has not yet informed him of the diagnosis. Q. Initially, Miss Matias should: Inform Mr. Carding about his Diagnosis Call in the family and the team to prepare Mr. Carding about his impending death Tell the doctor the Mang Carding hinted that he feels he has Cancer Be available to listen when the patient decides to discuss his illness Right Answer is: Be available to listen when the patient decides to discuss his illness 78 / 100 A nurse caring for a patient with acute pulmonary edema observes that the patient’s cough produces white, frothy and that the patient is extremely dyspneic. The patient has inspiratory and expiratory wheezing on auscultation of the lungs. The immediate objective of treatment is to Improve oxygenation Improve tissue perfusion Decrease risk for aspiration Decrease anxiety Improve oxygenation 79 / 100 A patient has had hepatitis B (HBV) and is now a chronic carrier. In planning care, the nurse would explain an HBV carrier would most likely be at risk for developing a super infection with which other type of hepatitis? D C A B D 80 / 100 You are supervising a senior nursing student who is caring for a patient with a right hemisphere stroke. Which action by the student nurse requires that you intervene? The student instructs the patient to sit up straight, resulting in the patient’s puzzled expression. The student assists the patient with passive range-of-motion (ROM) exercises. The student moves the patient’s tray to the right side of her over-bed tray. The student combs the left side of the patient’s hair when the patient combs only the right side. A – Patients with right cerebral hemisphere stroke often present with neglect syndrome. They lean to the left and when asked, respond that they believe they are sitting up straight. They often neglect the left side of their bodies and ignore food on the left side of their food trays. The nurse would need to remind the student of this phenomenon and discuss the appropriate interventions. Focus: Delegation/supervision 81 / 100 When should a nurse suction a client? As needed As desired Every 1 hour Every 4 hours A nurse should suction a patient as needed and indicated to maintain patency and integrity of airway. 82 / 100 While a nurse is assessing a patient who reports indigestion that radiates into the jaw. The jaw pain is rated 8 scale of 0 (no pain) to 10 (severe pain). The patient reports the pain started an hour ago. The nurse should IMMEDIATELY: Place the patient in reverse Trendelenburg position Assess the patient’s oral temperature Obtain order and administer morphine sulfate Determine what foods the patient ate Obtain order and administer morphine sulfate 83 / 100 A patient with SLE( systemic lupus erythematous ) report decreased urinary output during the past 2-4 days and chest pain that is aggravated by breathing and coughing. The patient vital signs remain within the baseline normal range s1 and s2 are present with audible friction rub. Which of the following statement would be appropriate for the nurse to make? I need to get some nitroglycerine for your chest pain There may be some inflammation surrounding your heart It sounds like SLE is being well controlled Your symptoms may be due to a urinary tract infection There may be some inflammation surrounding your heart 84 / 100 Nurse Daisy is aware that the following pharmacologic agents are sedative hypnotic medication is used to induce sleep for a client experiencing a sleep disorder is: Fluoxetine (Prozac) Paroxetine (Paxil) Triazolam (Halcion) Risperidone (Risperdal) Triazolam is one of a group of sedative hypnotic medication that can be used for a limited time because of the risk of dependence. Paroxetine is a serotonin-specific reuptake inhibitor used for treatment of depression panic disorder, and obsessive-compulsive disorder. Fluoxetine is a serotonin-specific reuptake inhibitor used for depressive disorders and obsessive-compulsive disorders. Risperidone is indicated for psychotic disorders. 85 / 100 Situation :– ENTEROSTOMAL THERAPY is now considered especially in nursing. You are participating in the OSTOMY CARE CLASS. Q. You are aware that teaching about colostomy care is understood when Fermin states, “I will contact my physician and report: When mucus is passed from the stoma between irrigation.†If I notice a loss of sensation to touch in the stoma tissue.†If I have any difficulty inserting the irrigating tub into the stoma.†The expulsion of flatus while the irrigating fluid is running out.†Right Answer is: If I have any difficulty inserting the irrigating tub into the stoma.†86 / 100 Ricardo is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist’s instructions. Why does the client require special positioning for this type of anesthesia? To prevent confusion To prevent cardiac arrhythmias To prevent seizures To prevent cerebrospinal fluid (CSF) leakage The client receiving a subarachnoid block requires special positioning to prevent CSF leakage and headache and to ensure proper anesthetic distribution. Proper positioning doesn’t help prevent confusion, seizures, or cardiac arrhythmias. 87 / 100 The nurse is assessing a client for meningeal irritation and elicits a positive Brudzinski’s sign. Which finding did the nurse observe? The client’s upper arms are flexed and held tightly to the sides of the body and the legs are extended and internally rotated. The client flexes a leg at the hip and knee and reports pain in the vertebral column when the leg is extended. The client rigidly extends the arms with pronated forearms and plantar flexion of the feet. The client passively flexes the hip and knee in response to neck flexion and reports pain in the vertebral column. Brudzinski’s sign is tested with the client in the supineposition.The nurse flexes the client’s head (gentlymoves the head to the chest) and there should be no reports of pain or resistance to the neck flexion. A positive Brudzinski’s sign is observed if the client passively flexes the hip and knee in response to neck flexion and reports pain in the vertebral column. Kernig’s sign also tests for meningeal irritation and is positive when the client flexes the legs at the hip and knee and complains of pain along the vertebral column when the leg is extended. Decorticate posturing is abnormal flexion and is noted when the client’s upper arms are flexed and held tightly to the sides of the body and the legs are extended and internally rotated. Decerebrate posturing is abnormal extension and occurs when the arms are fully extended, forearms pronated, wrists and fingers flexed, jaws clenched, neck extended, and feet plantar-flexed. 88 / 100 What clinical manifestation indicates that an escharotomy is needed on a circumferential extremity burn? The burn is full thickness rather than partial thickness. Capillary refill is slow in the digits and the distal pulse is absent. The client is unable to fully pronate and supinate the extremity. The client cannot distinguish the sensation of sharp versus dull in the extremity. Circumferential eschar can act as a tourniquet when edema forms from the fluid shift, increasing tissue pressure and preventing blood flow to the distal extremities and increasing the risk for tissue necrosis. This problem is an emergency and, without intervention, can lead to loss of the distal limb. This problem can be reduced or corrected with an escharotomy. 89 / 100 Situation: Mr. Gonzales was admitted to the hospital with ascites and jaundice. To rule out cirrhosis of the liver: Q. When Mr. Gonzales regained consciousness, the physician orders 50 ml of Lactulose p.o. every 2 hours. Mr. Gonzales develops diarrhea. The nurse best action would be: “I’ll see if your physician is in the hospitalâ€. “Maybe you’re reacting to the drug; I will withhold the next doseâ€. “I’ll lower the dosage as ordered so the drug causes only 2 to 4 stools a dayâ€. “Frequently, bowel movements are needed to reduce sodium levelâ€. Lactulose is given to a patients with hepatic encephalopathy to reduce absorption of ammonia in the intestines by binding with ammonia and promoting more frequent bowel movements. If the patient experience diarrhea, it indicates over dosage and the nurse must reduce the amount of medication given to the patient. The stool will be mushy or soft. Lactulose is also very sweet and may cause cramping and bloating. 90 / 100 Prior to administering a client’s daily dose of digoxin, the nurse reviews the client’s laboratory data and notes the following results: serum calcium, 9.8 mg/dL (2.45 mmol/L); serum magnesium, 1.0 mEq/L (0.5 mmol/L); serum potassium, 4.1 mEq/L (4.1 mmol/L); serum creatinine, 0.9 mg/ dL (79.5 mcmol/L). Which result should alert the nurse that the client is at risk for digoxin toxicity? Serum potassium level Serum magnesium level Serum calcium level Serum creatinine level An increased risk of toxicity exists in clients with hypercalcemia, hypokalemia, hypomagnesemia, hypothyroidism, and impaired renal function. The calcium, creatinine, and potassium levels are all within normal limits. The normal range for magnesium is 1.3 to 2.1 mEq/L(0.65-1.05 mmol/L) and the results in the correct option are reflective of hypomagnesemia. 91 / 100 The best size cathlon for administration of a blood transfusion to a six-year-old is: 19 gauge 20 gauge 22 gauge 18 gauge D is correct because the best size cathlon to use in a child receiving blood is a 20 gauge. A B and C are incorrect because the size is either too large or too small. 92 / 100 A client is recovering from a gastric resection for peptic ulcer disease. Which of the following outcomes indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery? Experiences occasional episodes of nausea and vomiting Increases food intake and tolerance gradually Experiences a rapid weight gain within 1 week Drinks 2000 mL/day of water Right Answer is: Increases food intake and tolerance gradually 93 / 100 SITUATION: John Lloyd, a 27 basketball player sustained inhalation burn that required him to have tracheostomy due to massive upper airway edema. Q. Wilma knew that the maximum time when suctioning John Lloyd is 10 seconds 20 seconds 30 seconds 45 seconds According to our reviewers and lecturers, 10 to 15 seconds is the maximum suction time. But according to almost all foreign books I read, it should only be 10 seconds at max. I prefer following Saunders,Mosby and Lippinncots when they are all united. 94 / 100 Situation : Mr. Punsalan is 36 years old, was admitted to the hospital with complaints of a burning sensation in the epigastric area after eating and inability to sleep at night. He was placed on bed rest and schedule for diagnostic studies. A diagnosis of Peptic Ulcer was made. Q. Diet that prevents gastric irritation in case of Mr. Punsalan is: Full Diet Liquid Diet Bland Diet High Protein low fat diet Right Answer is: Bland Diet 95 / 100 Situation : Mrs. Andres brought his son, Juanito, age 3 to the Pediatric clinic. She noticed that her son is not speaking and tend to repeat everything she says. The mother also told the nurse that Juanito prefers to be alone, will cry when someone will come near him and tend to rock himself from morning till he will fell asleep. Q. There is no definite cause identified for autism, but a strong link has been found on: MMR vaccination Environmental factors Genetic factors Upbringing Genetic factors 96 / 100 The nurse is caring for a client who is receiving a blood transfusion. The transfusion was started 30 mins ago at a rate of 100 ml/hr. The client begins to complain of low back pain and headache and is increasing restless, what is the first nursing action? Stop the transfusion, disconnect the blood tubing and begin a primary infusion of normal saline solution Slow the infusion and evaluate the V/S and client’s history of transfusion reaction. Stop the infusion of blood and begin infusion of NSS from the Y connector. Recheck the unit of blood for correct identification numbers and cross-match information Right Answer is: Stop the transfusion, disconnect the blood tubing and begin a primary infusion of normal saline solution 97 / 100 Situation : Nurse Nico is caring to a 38-year-old female, G3P3 client who has been diagnosed with hemorrhoids. Q. Client education should include minimizing client discomfort due to hemorrhoids. Nursing management should include: Suggest to eat low roughage diet Advise to wear silk undergarments Avoid straining during defecation Use of sitz bath for 30 minutes Rationale: Straining can increase intra abdominal pressure. Health teachings also include: suggest to eat high roughage diet, wearing of cotton undergarments and use of sitz bath for 15 minutes. 98 / 100 A 4 week old baby was brought to the health center for his first immunization. Which can be given to him? Infant BCG Hepatitis B Vaccin OPV1 DPT1 Infant BCG may be given at birth. All the other immunizations mentioned can be given at 6 weeks of age. 99 / 100 Included in teaching the client with tuberculosis taking INH about follow-up home care, the nurse should emphasize that a laboratory appointment for which of the following lab tests is critical? Blood sugar Cardiac enzymes Liver function Kidney function This side effect is age-related and can be detected with regular assessment of liver enzymes, which are released into the blood from damaged liver cells. 100 / 100 The nurse is preparing to insert a nasogastric tube into a client. The nurse should place the client in which position for insertion? Low Fowler’s High Fowler’s Supine with the head flat Rightside During insertion of a nasogastric tube, the client is placed in a sitting or high Fowler’s position to facilitate insertion of the tube and reduce the risk of pulmonary aspiration if the client should vomit. The right side, and low Fowler’s and supine positions place the client at risk for aspiration; in addition, these positions do not facilitate insertion of the tube. Your score is The average score is 0% LinkedIn Facebook Twitter VKontakte 0% Restart quiz