NCLEX Pn Practice Questions 8 (Exam Mode) By Rnpedia.Com

1. A 10-year-old has an order for Demerol (meperidine) 35mg IM for pain. The medication is available as Demerol 50mg per ml. How much should the nurse administer?

.5mL

.6mL

.7mL

.8mL

The nurse should administer .7mL of the medication. Other answer choices are incorrect because the dosage is incorrect.

Explanation

The nurse should administer .7mL of the medication. Other answer choices are incorrect because the dosage is incorrect.

2. An adolescent with borderline personality is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this client?

The client will remain in her room when feeling overwhelmed by sadness.

The client will request medication when feeling loss of emotional control.

The client will leave group activities to pace when feeling anxious.

The client will seek out a staff member to verbalize feelings of anger and sadness.

Verbalizing feelings of anger and sadness to a staff member is an appropriate therapeutic goal for the client with a risk of self-directed violence. Answers "The client will remain in her room when feeling overwhelmed by sadness" and " The client will leave group activities to pace when feeling anxious" place the client in an isolated situation to deal with her feelings alone; therefore, they are incorrect. Answer "The client will request medication when feeling loss of emotional control" is incorrect because it does not allow the client to ventilate her feelings.

Explanation

Verbalizing feelings of anger and sadness to a staff member is an appropriate therapeutic goal for the client with a risk of self-directed violence. Answers "The client will remain in her room when feeling overwhelmed by sadness" and " The client will leave group activities to pace when feeling anxious" place the client in an isolated situation to deal with her feelings alone; therefore, they are incorrect. Answer "The client will request medication when feeling loss of emotional control" is incorrect because it does not allow the client to ventilate her feelings.

3. The nurse is providing dietary teaching for a client with Meniere's disease. Which statement indicates that the client understands the role of diet in triggering her symptoms?

"I can expect to see more problems with tinnitus if I eat a lot of dairy products."

"I need to limit foods that taste salty or that contain a lot of sodium."

"I can help control problems with vertigo if I avoid breads and cereals."

"I need to eat fewer foods that are high in potassium, such as raisins and bananas."

The client with Meniere’s disease should limit the intake of foods that contain sodium. Other answer choices have no relationship to the symptoms of Meniere’s disease; therefore, they are incorrect.

Explanation

The client with Meniere’s disease should limit the intake of foods that contain sodium. Other answer choices have no relationship to the symptoms of Meniere’s disease; therefore, they are incorrect.

4. A newborn male has been diagnosed with hypospadias with chordee. The nurse understands that the infant will have altered patterns of urination because:

The urinary meatus is on the dorsum of the penis.

The ureters will reflux urine into the kidneys.

The urinary meatus is on the top of the penis.

The bladder lies outside the abdominal cavity.

The infant with hypospadias has altered patterns of urinary elimination caused by the location of the urinary meatus on the dorsum, or underside, of the penis. The ureters will reflux urine into the kidneys is incorrect because it refers to ureteral reflux.The urinary meatus is on the top of the penis is incorrect because it refers to epispadias. The bladder lies outside the abdominal cavity is incorrect because it refers to exstrophy of the bladder.

Explanation

The infant with hypospadias has altered patterns of urinary elimination caused by the location of the urinary meatus on the dorsum, or underside, of the penis. The ureters will reflux urine into the kidneys is incorrect because it refers to ureteral reflux.The urinary meatus is on the top of the penis is incorrect because it refers to epispadias. The bladder lies outside the abdominal cavity is incorrect because it refers to exstrophy of the bladder.

5. An elderly client is admitted to the psychiatric unit from the nursing home. Transfer information indicates that the client has become confused and disoriented, with behavioral problems. The client will also likely show a loss of ability in:

Speech

Judgment

Endurance

Balance

Confusion, disorientation, behavioral changes, and alterations in judgment are early signs of dementia. Other answer choices do not relate to the question; therefore, they are incorrect.

Explanation

Confusion, disorientation, behavioral changes, and alterations in judgment are early signs of dementia. Other answer choices do not relate to the question; therefore, they are incorrect.

6. Which antibiotic is contraindicated for the treatment of infections in infants and young children?

Tetracyn (tetracycline)

Amoxil (amoxicillin)

Cefotan (cefotetan)

E-Mycin (erythromycin)

Tetracycline is contraindicated for use in infants and young children because it stains the teeth and arrests bone development. Other answer choices are incorrect because they can be used to treat infections in infants and children.

Explanation

Tetracycline is contraindicated for use in infants and young children because it stains the teeth and arrests bone development. Other answer choices are incorrect because they can be used to treat infections in infants and children.

7. A client with angina has an order for nitroglycerin ointment. Before applying the medication, the nurse should:

Apply the ointment to the previous application

Obtain both a radial and an apical pulse

Remove the previously applied ointment

Tell the client he will experience pain relief in 15 minutes

The nurse should remove any remaining ointment before applying the medication again. Applying the ointment to the previous application is incorrect because it interferes with absorption. Obtaining both a radial and an apical pulse does not apply to the question of how to administer the medication; therefore, it is incorrect. Telling the client he will experience pain relief in 15 minutes is incorrect because the medication’s action is more immediate.

Explanation

The nurse should remove any remaining ointment before applying the medication again. Applying the ointment to the previous application is incorrect because it interferes with absorption. Obtaining both a radial and an apical pulse does not apply to the question of how to administer the medication; therefore, it is incorrect. Telling the client he will experience pain relief in 15 minutes is incorrect because the medication’s action is more immediate.

8. A client with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin?

Calcium gluconate

Aquamephyton

Methergine

Protamine sulfate

Protamine sulfate is given to counteract the effects of enoxaprin as well as heparin. Calcium gluconate is given to counteract the effects of magnesium sulfate. Aquamephyton is given to counteract the effects of sodium warfarin. Methargine is given to increase uterine contractions following delivery.

Explanation

Protamine sulfate is given to counteract the effects of enoxaprin as well as heparin. Calcium gluconate is given to counteract the effects of magnesium sulfate. Aquamephyton is given to counteract the effects of sodium warfarin. Methargine is given to increase uterine contractions following delivery.

9. Following a generalized seizure, the nurse can expect the client to:

Be unable to move the extremities

Be drowsy and prone to sleep

Remember events before the seizure

Have a drop in blood pressure

Following a generalized seizure, the client frequently experiences drowsiness and postictal sleep. The client is able to move the extremities.The client can remember events before the seizure and the blood pressure is elevated.

Explanation

Following a generalized seizure, the client frequently experiences drowsiness and postictal sleep. The client is able to move the extremities.The client can remember events before the seizure and the blood pressure is elevated.

10. A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client's breakfast should be served within:

15 minutes

20 minutes

30 minutes

45 minutes

The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular insulin.

Explanation

The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular insulin.

11. The physician has prescribed supplemental iron for a prenatal client. The nurse should tell the client to take the medication with:

Milk, to prevent stomach upset

Tomato juice, to increase absorption

Oatmeal, to prevent constipation

Water, to increase serum iron levels

Iron supplements should be taken with a source of vitamin C to promote absorption. Iron should not be taken with milk. High-fiber sources such as oatmeal prevent the absorption of iron. Water, to increase serum iron levels is an inaccurate statement; therefore, it is incorrect.

Explanation

Iron supplements should be taken with a source of vitamin C to promote absorption. Iron should not be taken with milk. High-fiber sources such as oatmeal prevent the absorption of iron. Water, to increase serum iron levels is an inaccurate statement; therefore, it is incorrect.

12. The mother of a child with hemophilia asks the nurse which over-the-counter medication is suitable for her child's joint discomfort. The nurse should tell the mother to purchase:

Advil (ibuprofen)

Tylenol (acetaminophen)

Aspirin (acetylsalicytic acid)

Naproxen (naprosyn)

The nurse should recommend acetaminophen for the child’s joint discomfort because it will have no effect on the bleeding time. Other answer choices are all nonsteroidal anti-inflammatory medications that can prolong bleeding time; therefore, they are not suitable for the child with hemophilia.

Explanation

The nurse should recommend acetaminophen for the child’s joint discomfort because it will have no effect on the bleeding time. Other answer choices are all nonsteroidal anti-inflammatory medications that can prolong bleeding time; therefore, they are not suitable for the child with hemophilia.

13. Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?

Pain associated with angina is relieved by rest.

Pain associated with myocardial infarction is always more severe.

Pain associated with angina is confined to the chest area.

Pain associated with myocardial infarction is referred to the left arm.

Pain associated with angina is relieved by rest. Pain associated with angina can be referred to the jaw, the left arm, and the back. Pain from a myocardial infarction can be referred to areas other than the left arm.

Explanation

Pain associated with angina is relieved by rest. Pain associated with angina can be referred to the jaw, the left arm, and the back. Pain from a myocardial infarction can be referred to areas other than the left arm.

14. A client with oxylate renal calculi should be taught to avoid eating:

Strawberries

Oranges

Apples

Pears

The client with oxylate renal calculi should avoid sources of oxylate, which include strawberries, rhubarb, and spinach. Other answer choices are incorrect because they are not sources of oxylate.

Explanation

The client with oxylate renal calculi should avoid sources of oxylate, which include strawberries, rhubarb, and spinach. Other answer choices are incorrect because they are not sources of oxylate.

15. The nurse is caring for a client who is unconscious following a fall. Which comment by the nurse will help the client become reoriented when he regains consciousness?

"I am your nurse and I will be taking care of you today."

"Can you tell me your name and where you are?"

"I know you are confused right now, but everything will be alright."

"You were in an accident that hurt your head. You are in the hospital."

Telling the client what happened and where he is helps with reorientation. The statement "I am your nurse and I will be taking care of you today." does not explain what happened to the client; therefore, it is incorrect. The statement "Can you tell me your name and where you are?" is not helpful because the client regaining consciousness will not know where he is; therefore, the answer is incorrect. The nurse should not offer false reassurances, such as "everything will be alright"; therefore, it is incorrect.

Explanation

Telling the client what happened and where he is helps with reorientation. The statement "I am your nurse and I will be taking care of you today." does not explain what happened to the client; therefore, it is incorrect. The statement "Can you tell me your name and where you are?" is not helpful because the client regaining consciousness will not know where he is; therefore, the answer is incorrect. The nurse should not offer false reassurances, such as "everything will be alright"; therefore, it is incorrect.

16. A 6-year-old is diagnosed with Legg-Calve Perthes disease of the right femur. An important part of the child's care includes instructing the parents:

To increase the amount of dietary protein

About exercises to strengthen affected muscles

About relaxation exercises to minimize pain in the joints

To prevent weight bearing on the affected leg

The child with Legg-Calve Perthes disease should be prevented from bearing weight on the affected extremity until revascularization has occurred.Increasing the amount of dietary protein is incorrect because it does not relate to the condition. Instructing about exercises to strengthen affected muscles and relaxation exercises to minimize pain in the joints are incorrect choices because the condition does not involve the muscles or the joints.

Explanation

The child with Legg-Calve Perthes disease should be prevented from bearing weight on the affected extremity until revascularization has occurred.Increasing the amount of dietary protein is incorrect because it does not relate to the condition. Instructing about exercises to strengthen affected muscles and relaxation exercises to minimize pain in the joints are incorrect choices because the condition does not involve the muscles or the joints.

17. Which home remedy is suitable to relieve the itching associated with varicella?

Dusting the lesions with baby powder

Applying gauze saturated in hydrogen peroxide

Using cool compresses of normal saline

Applying a paste of baking soda and water

Applying a paste of baking soda and water soothes the itching and helps to dry the vesicles. The use of baby powder is not recommended for either children. Hydrogen peroxide and saline will not relieve the itching and will prevent the vesicles from crusting.

Explanation

Applying a paste of baking soda and water soothes the itching and helps to dry the vesicles. The use of baby powder is not recommended for either children. Hydrogen peroxide and saline will not relieve the itching and will prevent the vesicles from crusting.

18. The nurse is developing a bowel-retraining plan for a client with multiple sclerosis. Which measure is likely to be least helpful to the client:

Limiting fluid intake to 1000mL per day

Providing a high-roughage diet

Elevating the toilet seat for easy access

Establishing a regular schedule for toileting

It would not be helpful to limit the fluid intake of a client during bowel retraining.

Explanation

It would not be helpful to limit the fluid intake of a client during bowel retraining.

19. The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?

"I need to reduce my daily intake to 1,200 calories a day."

"I need to drink at least a quart of milk a day."

"I shouldn’t add salt when I am cooking."

"I need to eat more protein and fiber each day."

The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus. Other answer choices indicate that the client understands the nurse’s dietary teaching regarding obesity and hypertension; therefore, they are incorrect.

Explanation

The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus. Other answer choices indicate that the client understands the nurse’s dietary teaching regarding obesity and hypertension; therefore, they are incorrect.

20. The nurse is formulating a plan of care for a client with a cognitive disorder. Which activity is most appropriate for the client with confusion and short attention span?

Taking part in a reality-orientation group

Participating in unit community goal setting

Going on a field trip with a group of clients

Meeting with an assertiveness training group

Participating in reality orientation is the most appropriate activity for the client who is confused. Other answer choices are incorrect because they are not suitable activities for a client who is confused.

Explanation

Participating in reality orientation is the most appropriate activity for the client who is confused. Other answer choices are incorrect because they are not suitable activities for a client who is confused.

21. The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:

Facial swelling

Pulse deficits

Ankle edema

Diminished reflexes

The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Pulse deficits is not related to the question; therefore, it is incorrect. Ankle edema is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, diminished reflexes is incorrect.

Explanation

The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Pulse deficits is not related to the question; therefore, it is incorrect. Ankle edema is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, diminished reflexes is incorrect.

22. The nurse is assessing an infant with Hirschsprung's disease. The nurse can expect the infant to:

Weigh less than expected for height and age

Have a scaphoid-shaped abdomen

Exhibit clubbing of the fingers and toes

Have hyperactive deep tendon reflexes

The child with Hirschsprung’s disease will have a scaphoid or hollowed abdomen. Other answer choices do not apply to the condition; therefore, they are incorrect.

Explanation

The child with Hirschsprung’s disease will have a scaphoid or hollowed abdomen. Other answer choices do not apply to the condition; therefore, they are incorrect.

23. The physician has ordered an external monitor for a laboring client. If the fetus is in the left occipital posterior (LOP) position, the nurse knows that the ultrasound transducer will be located:

Near the symphysis pubis

Near the umbilicus

Over the fetal back

Over the fetal abdomen

In the left occipital posterior position, the heart sounds will be heard loudest through the fetal back. Other answer choices are incorrect locations.

Explanation

In the left occipital posterior position, the heart sounds will be heard loudest through the fetal back. Other answer choices are incorrect locations.

24. The recommended time for administering Zantac (ranitidine) is:

Before breakfast

Midafternoon

After dinner

At bedtime

Zantac (ranitidine) should be administered in one dose at bedtime or with meals. Other answer choices have incorrect times for dosing.

Explanation

Zantac (ranitidine) should be administered in one dose at bedtime or with meals. Other answer choices have incorrect times for dosing.

25. A client develops tremors while withdrawing from alcohol. Which medication is routinely administered to lessen physiological effects of alcohol withdrawal?

Dolophine (methodone)

Klonopin (clonazepam)

Narcan (Naloxone)

Antabuse (disulfiram)

Benzodiazepines such as clonazepam and lorazepam are given to the client withdrawing from alcohol. Methodone is given to the client withdrawing from opiates.Naloxone is an antidote for narcotic overdose. Disufiram is used in aversive therapy for alcohol addiction.

Explanation

Benzodiazepines such as clonazepam and lorazepam are given to the client withdrawing from alcohol. Methodone is given to the client withdrawing from opiates.Naloxone is an antidote for narcotic overdose. Disufiram is used in aversive therapy for alcohol addiction.