NCLEX RN Practice Questions 8 (Practice Mode) By RNpedia.Com

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NCLEX RN Practice Questions 8 (Practice Mode) By RNpedia.Com - Quiz

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Questions and Answers
  • 1. 

    The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?

    • A.

      Report muscle weakness to the physician.

    • B.

      Allow six months for the drug to take effect.

    • C.

      Take the medication with fruit juice.

    • D.

      Ask the doctor to perform a complete blood count before starting the medication.

    Correct Answer
    A. Report muscle weakness to the physician.
    Explanation
    The client taking antilipidemics should be encouraged to report muscle weakness because this is a sign of rhabdomyositis. The medication takes effect within 1 month of beginning therapy, so allowing six months for the drug to take effect is incorrect. The medication should be taken with water because fruit juice, particularly grapefruit, can decrease the effectiveness, making take the medication with fruit juice. incorrect. Liver function studies should be checked before beginning the medication, not after the fact, making ask the doctor to perform a complete blood count before starting the medication incorrect.

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  • 2. 

    The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should: 

    • A.

      Utilize an infusion pump

    • B.

      Check the blood glucose level

    • C.

      Place the client in Trendelenburg position

    • D.

      Cover the solution with foil

    Correct Answer
    B. Check the blood glucose level
    Explanation
    Hyperstat is given IV push for hypertensive crises, but it often causes hyperglycemia. The glucose level will drop rapidly when stopped. Utilizing an infusion pump is incorrect because the hyperstat is given by IV push. The client should be placed in dorsal recumbent position, not a Trendelenburg position. Covering the solution with foil is incorrect because the medication does not have to be covered with foil.

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  • 3. 

    The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor? 

    • A.

      Blood pressure of 126/80

    • B.

      Blood glucose of 110mg/dL

    • C.

      Heart rate of 60bpm

    • D.

      Respiratory rate of 30 per minute

    Correct Answer
    C. Heart rate of 60bpm
    Explanation
    A heart rate of 60 in the baby should be reported immediately. The dose should be held if the heart rate is below 100bpm. The blood glucose, blood pressure, and respirations are within normal limits; thus answers are incorrect.

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  • 4. 

    The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to: 

    • A.

      Replenish his supply every 3 months

    • B.

      Take one every 15 minutes if pain occurs

    • C.

      Leave the medication in the brown bottle

    • D.

      Crush the medication and take with water

    Correct Answer
    C. Leave the medication in the brown bottle
    Explanation
    Nitroglycerine should be kept in a brown bottle (or even a special air- and water-tight, solid or plated silver or gold container) because of its instability and tendency to become less potent when exposed to air, light, or water. The supply should be replenished every 6 months, not 3 months, and one tablet should be taken every 5 minutes until pain subsides, so answers replenishing his supply every 3 months and taking one every 15 minutes if pain occurs are incorrect. If the pain does not subside, the client should report to the emergency room. The medication should be taken sublingually and should not be crushed.

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  • 5. 

    The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?

    • A.

      Macaroni and cheese

    • B.

      Shrimp with rice

    • C.

      Turkey breast

    • D.

      Spaghetti

    Correct Answer
    C. Turkey breast
    Explanation
    Turkey contains the least amount of fats and cholesterol. Liver, eggs, beef, cream sauces, shrimp, cheese, and chocolate should be avoided by the client. The client should bake meat rather than frying to avoid adding fat to the meat during cooking.

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  • 6. 

    The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the: 

    • A.

      Feet

    • B.

      Neck

    • C.

      Hands

    • D.

      Sacrum

    Correct Answer
    B. Neck
    Explanation
    The jugular veins in the neck should be assessed for distension. The other parts of the body will be edematous in right-sided congestive heart failure, not left-sided; thus, feet, hands, and sacrum are incorrect.

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  • 7. 

    The nurse is checking the client’s central venous pressure. The nurse should place the zero of the manometer at the:

    • A.

      Phlebostatic axis

    • B.

      PMI

    • C.

      Erb’s point

    • D.

      Tail of Spence

    Correct Answer
    A. Phlebostatic axis
    Explanation
    The phlebostatic axis is located at the fifth intercostals space midaxillary line and is the correct placement of the manometer. The PMI or point of maximal impulse is located at the fifth intercostals space midclavicular line. Erb’s point is the point at which you can hear the valves close simultaneously. The Tail of Spence (the upper outer quadrant) is the area where most breast cancers are located and has nothing to do with placement of a manometer.

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  • 8. 

    The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:

    • A.

      Question the order

    • B.

      Administer the medications

    • C.

      Administer separately

    • D.

      Contact the pharmacy

    Correct Answer
    B. Administer the medications
    Explanation
    Zestril is an ACE inhibitor and is frequently given with a diuretic such as Lasix for hypertension. Questioning the order , administering separately , and contacting the pharmacy are incorrect because the order is accurate. There is no need to question the order, administer the medication separately, or contact the pharmacy.

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  • 9. 

    The best method of evaluating the amount of peripheral edema is: 

    • A.

      Weighing the client daily

    • B.

      Measuring the extremity

    • C.

      Measuring the intake and output

    • D.

      Checking for pitting edema

    Correct Answer
    B. Measuring the extremity
    Explanation
    The best indicator of peripheral edema is measuring the extremity. A paper tape measure should be used rather than one of plastic or cloth, and the area should be marked with a pen, providing the most objective assessment. Weighing the client daily is incorrect because it will not indicate peripheral edema. Measuring the intake and output is incorrect because it will not indicate peripheral edema. Checking for pitting edema is incorrect it is less reliable than measuring with a paper tape measure.

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  • 10. 

    A client with vaginal cancer is being treated with a radioactive vaginal implant. The client’s husband asks the nurse if he can spend the night with his wife. The nurse should explain that: 

    • A.

      Overnight stays by family members is against hospital policy.

    • B.

      There is no need for him to stay because staffing is adequate.

    • C.

      His wife will rest much better knowing that he is at home.

    • D.

      Visitation is limited to 30 minutes when the implant is in place.

    Correct Answer
    D. Visitation is limited to 30 minutes when the implant is in place.
    Explanation
    Clients with radium implants should have close contact limited to 30 minutes per visit. The general rule is limiting time spent exposed to radium, putting distance between people and the radium source, and using lead to shield against the radium. Teaching the family member these principles is extremely important. Other choices are not empathetic and do not address the question; therefore, they are incorrect.

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  • 11. 

    The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client?

    • A.

      Roast beef sandwich, potato chips, pickle spear, iced tea

    • B.

      Split pea soup, mashed potatoes, pudding, milk

    • C.

      Tomato soup, cheese toast, Jello, coffee

    • D.

      Hamburger, baked beans, fruit cup, iced tea

    Correct Answer
    B. Split pea soup, mashed potatoes, pudding, milk
    Explanation
    The client with a facial stroke will have difficulty swallowing and chewing, and the foods split pea soup, mashed potatoes, pudding, milk provide the least amount of chewing. Other choices in the question would require more chewing and, thus, are incorrect.

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  • 12. 

    The physician has prescribed Novalog insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs? 

    • A.

      "I will make sure I eat breakfast within 10 minutes of taking my insulin."

    • B.

      "I will need to carry candy or some form of sugar with me all the time."

    • C.

      "I will eat a snack around three o’clock each afternoon."

    • D.

      "I can save my dessert from supper for a bedtime snack."

    Correct Answer
    A. "I will make sure I eat breakfast within 10 minutes of taking my insulin."
    Explanation
    Novalog insulin onsets very quickly, so food should be available within 10–15 minutes of taking the insulin. Answer "I will need to carry candy or some form of sugar with me all the time." does not address a particular type of insulin, so it is incorrect. NPH insulin peaks in 8–12 hours, so a snack should be eaten at the expected peak time. It may not be 3 p.m. as stated in answer "I will eat a snack around three o’clock each afternoon." . Answer "I can save my dessert from supper for a bedtime snack." is incorrect because there is no need to save the dessert until bedtime.

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  • 13. 

    The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath is recommended for the first 2 weeks of life because: 

    • A.

      New parents need time to learn how to hold the baby.

    • B.

      The umbilical cord needs time to separate.

    • C.

      Newborn skin is easily traumatized by washing.

    • D.

      The chance of chilling the baby outweighs the benefits of bathing.

    Correct Answer
    B. The umbilical cord needs time to separate.
    Explanation
    The umbilical cord needs time to dry and fall off before putting the infant in the tub. Although other choices might be important, they are not the primary answer to the question.

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  • 14. 

    A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to: 

    • A.

      Treat iron-deficiency anemia caused by chemotherapeutic agents

    • B.

      Create a synergistic effect that shortens treatment time

    • C.

      Increase the number of circulating neutrophils

    • D.

      Reverse drug toxicity and prevent tissue damage

    Correct Answer
    D. Reverse drug toxicity and prevent tissue damage
    Explanation
    Leucovorin is the antidote for Methotrexate and Trimetrexate which are folic acid antagonists. Leucovorin is a folic acid derivative. Other choices are incorrect because Leucovorin does not treat iron deficiency, increase neutrophils, or have a synergistic effect.

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  • 15. 

    A 4-month-old is brought to the well-baby clinic for immunization. In addition to the DPT and polio vaccines, the baby should receive: 

    • A.

      Hib titer

    • B.

      Mumps vaccine

    • C.

      Hepatitis B vaccine

    • D.

      MMR

    Correct Answer
    A. Hib titer
    Explanation
    The Hemophilus influenza vaccine is given at 4 months with the polio vaccine. Other choices are incorrect because these vaccines are given later in life.

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  • 16. 

    The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication: 

    • A.

      30 minutes before meals

    • B.

      With each meal

    • C.

      In a single dose at bedtime

    • D.

      30 minutes after meals

    Correct Answer
    B. With each meal
    Explanation
    Proton pump inhibitors such as Nexium and Protonix should be taken with meals, for optimal effect. Histamine-blocking agents such as Zantac should be taken 30 minutes before meals, so taking 30 minutes before meals is incorrect. Tagamet can be taken in a single dose at bedtime, taking in a single dose at bedtime incorrect. Taking 30 minutes after meals does not treat the problem adequately and, therefore, is incorrect.

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  • 17. 

    A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take? 

    • A.

      Call security for assistance and prepare to sedate the client.

    • B.

      Tell the client to calm down and ask him if he would like to play cards.

    • C.

      Tell the client that if he continues his behavior he will be punished.

    • D.

      Leave the client alone until he calms down

    Correct Answer
    A. Call security for assistance and prepare to sedate the client.
    Explanation
    If the client is a threat to the staff and to other clients the nurse should call for help and prepare to administer a medication such as Haldol to sedate him. Telling the client to calm down and ask him if he would like to play cards is incorrect because simply telling the client to calm down will not work. Telling the client that if he continues his behavior he will be punished is incorrect because telling the client that if he continues he will be punished is a threat and may further anger him. Leaving the client alone until he calms down is incorrect because if the client is left alone he might harm himself.

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  • 18. 

    When the nurse checks the fundus of a client on the first postpartum day, she notes that the fundus is firm, is at the level of the umbilicus, and is displaced to the right. The next action the nurse should take is to:

    • A.

      Check the client for bladder distention

    • B.

      Assess the blood pressure for hypotension

    • C.

      Determine whether an oxytocic drug was given

    • D.

      Check for the expulsion of small clots

    Correct Answer
    A. Check the client for bladder distention
    Explanation
    If the fundus of the client is displaced to the side, this might indicate a full bladder. The next action by the nurse should be to check for bladder distention and catheterize, if necessary. Other answer choices are actions that relate to postpartal hemorrhage.

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  • 19. 

    A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood-tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are consistent with a diagnosis of: 

    • A.

      Pneumonia

    • B.

      Reaction to antiviral medication

    • C.

      Tuberculosis

    • D.

      Superinfection due to low CD4 count

    Correct Answer
    C. Tuberculosis
    Explanation
    A low-grade temperature, blood-tinged sputum, fatigue, and night sweats are symptoms consistent with tuberculosis. If the answer in pneumonia had said pneumocystis pneumonia, pneumonia would have been consistent with the symptoms given in the stem, but just saying pneumonia isn’t specific enough to diagnose the problem. Reaction to antiviral medication and superinfection due to low CD4 count are not directly related to the stem.

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  • 20. 

    The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client’s history should be reported to the doctor? 

    • A.

      Diabetes

    • B.

      Prinzmetal’s angina

    • C.

      Cancer

    • D.

      Cluster headaches

    Correct Answer
    B. Prinzmetal’s angina
    Explanation
    If the client has a history of Prinzmetal’s angina, he should not be prescribed triptan preparations because they cause vasoconstriction and coronary spasms. There is no contraindication for taking triptan drugs in clients with diabetes, cancer, or cluster headaches .

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  • 21. 

    The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes: 

    • A.

      Pain on flexion of the hip and knee

    • B.

      Nuchal rigidity on flexion of the neck

    • C.

      Pain when the head is turned to the left side

    • D.

      Dizziness when changing positions

    Correct Answer
    A. Pain on flexion of the hip and knee
    Explanation
    Kernig’s sign is positive if pain occurs on flexion of the hip and knee. The Brudzinski reflex is positive if pain occurs on flexion of the head and neck onto the chest so nuchal rigidity on flexion of the neck is incorrect. Pain when the head is turned to the left side and dizziness when changing positions might be present but are not related to Kernig’s sign.

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  • 22. 

    The client with Alzheimer’s disease is being assisted with activities of daily living when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is aware that the client is exhibiting:

    • A.

      Agnosia

    • B.

      Apraxia

    • C.

      Anomia

    • D.

      Aphasia

    Correct Answer
    B. Apraxia
    Explanation
    Apraxia is the inability to use objects appropriately. Agnosia is loss of sensory comprehension, anomia is the inability to find words, and aphasia is the inability to speak or understand .

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  • 23. 

    The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:

    • A.

      Chronic fatigue syndrome

    • B.

      Normal aging

    • C.

      Sundowning

    • D.

      Delusions

    Correct Answer
    C. Sundowning
    Explanation
    Increased confusion at night is known as "sundowning" syndrome. This increased confusion occurs when the sun begins to set and continues during the night. Chronic fatigue syndrome is incorrect because fatigue is not necessarily present. Increased confusion at night is not part of normal aging; therefore, normal aging is incorrect. A delusion is a firm, fixed belief; therefore, delusions is incorrect.

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  • 24. 

    The client with confusion says to the nurse, "I haven’t had anything to eat all day long. When are they going to bring breakfast?" The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this conversation. Which response would be best for the nurse to make? 

    • A.

      "You know you had breakfast 30 minutes ago."

    • B.

      "I am so sorry that they didn’t get you breakfast. I’ll report it to the charge nurse."

    • C.

      "I’ll get you some juice and toast. Would you like something else?"

    • D.

      "You will have to wait a while; lunch will be here in a little while."

    Correct Answer
    C. "I’ll get you some juice and toast. Would you like something else?"
    Explanation
    The client who is confused might forget that he ate earlier. Don’t argue with the client. Simply get him something to eat that will satisfy him until lunch. Statements, "You know you had breakfast 30 minutes ago." and "You will have to wait a while; lunch will be here in a little while" are incorrect because the nurse is dismissing the client. Statement, "I am so sorry that they didn’t get you breakfast. I’ll report it to the charge nurse." is validating the delusion.

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  • 25. 

    The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s disease. Which side effect is most often associated with this drug? 

    • A.

      Urinary incontinence

    • B.

      Headaches

    • C.

      Confusion

    • D.

      Nausea

    Correct Answer
    D. Nausea
    Explanation
    Nausea and gastrointestinal upset are very common in clients taking acetlcholinesterase inhibitors such as Exelon. Other side effects include liver toxicity, dizziness, unsteadiness, and clumsiness. The client might already be experiencing urinary incontinence or headaches, but they are not necessarily associated; and the client with Alzheimer’s disease is already confused. Therefore, urinary incontinence, headaches , and confusion are incorrect.

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