NCLEX Pn Practice Questions 2 (Exam Mode) By Rnpedia

The client’s gag reflex is depressed before having an EGD. The nurse should give priority to checking for the return of the gag reflex before offering the client oral fluids. Level of consciousness is incorrect because conscious sedation is used. Urinary output and movement of extremities are not affected by the procedure; therefore, they are incorrect.

Rice cereal, apple juice, and formula are suitable foods for the 6-month-old infant. Whole milk, orange juice, and eggs are not suitable for the young infant.

The nurse should administer the injection in the vastus lateralis muscle. Rectus femoris muscle and deltoid muscle are not as well developed in the newborn; therefore, they are incorrect. Answer dorsogluteal muscle is incorrect because the dorsogluteal muscle is not used for IM injections until the child is 3 years of age.

Providing small, frequent meals will improve the client’s appetite and help reduce nausea. Thoroughly cooking all foods is incorrect because it does not compensate for limited absorption. Foods and beverages containing live cultures are discouraged for the immune-compromised client; therefore, offering yogurt and buttermilk incorrect. Forcing fluids is incorrect because forcing fluids will not compensate for limited absorption of the intestine.

Gout and renal calculi are the result of increased amounts of uric acid. Pancreatitis is incorrect because it does not contribute to renal calculi.Fractured femur and disc disease can result from decreased calcium levels. Renal calculi are the result of excess calcium.

Having a staff member remain with the client for 1 hour after meals will help prevent self-induced vomiting. Weighing the client after she eats is incorrect because the client will weigh more after meals, which can undermine treatment. Placing high-protein foods in the center of the client’s plate is incorrect because the client will need a balanced diet and excess protein might not be well tolerated at first. Providing the client with child-size utensils is incorrect because it treats the client as a child rather than as an adult.

Although cyanosis of the hands and feet is common in the newborn, it accounts for an Apgar score of less than 10. The mottled appearance of the trunk suggests cooling, which is not scored by the Apgar. The presence of conjunctival hemorrhages is incorrect because conjunctival hemorrhages are not associated with the Apgar. Respiratory rate of 20–28 per minute is incorrect because it is within normal range as measured by the Apgar.

The client taking Cytoxan should increase his fluid intake to prevent hemorrhagic cystitis. Other answer choices do not relate to the question; therefore, they are incorrect.

The client should be assessed following completion of antibiotic therapy to determine whether the infection has cleared. Determine whether the ear infection has affected her hearing would be done if there are repeated instances of otitis media; therefore, it is incorrect. Make sure that she has taken all the antibiotic is incorrect because it will not determine whether the child has completed the medication. Obtain a new prescription in case the infection recurs is incorrect because the purpose of the recheck is to determine whether the infection is gone.

The nurse should cover both of the client’s eyes and transport him immediately to the ER or the doctor’s office. Other answer choices are incorrect because they increase the risk of further damage to the eye.

The eye shield should be worn at night or when napping, to prevent accidental trauma to the operative eye. Prescription eyedrops, not over-the-counter eyedrops, are ordered for the client. The client might or might not require glasses following cataract surgery. Cataract surgery is pain free.

The client taking NPH insulin should have a snack midafternoon to prevent hypoglycemia. 8 a.m. and 10 a.m. are incorrect because the times are too early for symptoms of hypoglycemia. 5 a.m. is incorrect because the time is too late and the client would be in severe hypoglycemia.

The child’s symptoms are consistent with those of epiglottitis, an infection of the upper airway that can result in total airway obstruction. Symptoms of strep throat, laryngotracheobronchitis, and bronchiolitis are different than those presented by the client.

According to Kohlberg, in the preconventional stage of development, the behavior of the preschool child is determined by the consequences of the behavior. Other answer choices describe other stages of moral development; therefore, they are incorrect.

The primary purpose for the continuous passive-motion machine is to promote flexion of the artificial joint. The device should be placed at the foot of the client’s bed. Other answer choices do not describe the purpose of the CPM machine; therefore, they are incorrect.

Tremulousness is an early sign of hypoglycemia. Other answer choices are incorrect because they are symptoms of hyperglycemia.

The most common sign associated with exacerbation of multiple sclerosis is double vision. Other answer choices are not associated with a diagnosis of multiple sclerosis; therefore, they are incorrect.

Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Periorbital edema is incorrect because periorbital edema is not associated with meningitis. Positive Babinski reflex is incorrect because a positive Babinski reflex is normal in the infant. Negative scarf sign is incorrect because it relates to the preterm infant, not the infant with meningitis.

Nasogastric suction decompresses the stomach and leaves the abdomen soft and nondistended. The client is able to swallow is incorrect because it does not relate to the effectiveness of the NG suction. The client has active bowel sounds is incorrect because it relates to peristalsis, not the effectiveness of the NG suction. The client’s abdominal dressing is dry and intact is incorrect because it relates to wound healing, not the effectiveness of the NG suction.

A common side effect of prednisone is gastric ulcers. Cimetadine is given to help prevent the development of ulcers. Other answer choices do not relate to the use of cimetadine; therefore, they are incorrect.

Providing additional fluids will help the newborn eliminate excess bilirubin in the stool and urine. Oils and lotions should not be used with phototherapy. Physiologic jaundice is not associated with infection; therefore, wearing a gown, gloves, and a mask and placing the baby on enteric isolation are incorrect.

Benzodiazepines are ordered for the client in alcohol withdrawal to prevent delirium tremens. Antabuse (disulfiram) is incorrect because it is a medication used in aversive therapy to maintain sobriety.Romazicon (flumazenil) is incorrect because it is used for the treatment of benzodiazepine overdose. Dolophine (methodone) is incorrect because it is the treatment for opiate withdrawal.

According to Erikson’s Psychosocial Developmental Theory, the developmental task of middle childhood is industry versus inferiority. Trust is incorrect because it is the developmental task of infancy. Initiative is incorrect because it is the developmental task of the school-age child. Independence is incorrect because it is not one of Erikson’s developmental stages.

A side effect of bronchodilators is nausea. Tinnitus and ataxia are not associated with bronchodilators; therefore, they are incorrect. Hypotension is incorrect because hypotension is a sign of toxicity, not a side effect.

The client with a detached retina will have limitations in mobility before and after surgery. Alteration in comfort is incorrect because a detached retina produces no pain or discomfort. Alteration in skin integrity and alteration in O2 perfusion do not apply to the client with a detached retina; therefore, they are incorrect.