NCLEX Practice Exam 27 (10 Questions)

2.

The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:

Lack of exercise
Hormonal disturbances
Lack of calcium
Genetic predisposition

Correct Answer

A. Hormonal disturbances

Explanation

After menopause. women lack hormones necessary to absorb and utilize calcium. Doing weight-bearing exercises and taking calcium supplements can help to prevent osteoporosis but are not causes. so answers A and C are incorrect. Body types that frequently experience osteoporosis are thin Caucasian females. but they are not most likely related to osteoporosis. so answer D is incorrect.

Rate this question:

2

3.

A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse indicates that the traction is working properly?

The infant no longer complains of pain.
The buttocks are 15° off the bed.
The legs are suspended in the traction.
The pins are secured within the pulley.

Correct Answer

A. The buttocks are 15° off the bed.

Explanation

The infant’s hips should be off the bed approximately 15° in Bryant’s traction. Answer A is incorrect because this does not indicate that the traction is working correctly. nor does C. Answer D is incorrect because Bryant’s traction is a skin traction. not a skeletal traction.

Rate this question:

2

4.

A client with a fractured hip has been placed in Buck’s traction. Which statement is true regarding balanced skeletal traction? Balanced skeletal traction:

Utilizes a Steinman pin
Requires that both legs be secured
Utilizes Kirschner wires
Is used primarily to heal the fractured hips

Correct Answer

A. Utilizes a Steinman pin

Explanation

Balanced skeletal traction uses pins and screws. A Steinman pin goes through large bones and is used to stabilize large bones such as the femur. Answer B is incorrect because only the affected leg is in traction. Kirschner wires are used to stabilize small bones such as fingers and toes. as in answer C. Answer D is incorrect because this type of traction is not used for fractured hips.

Rate this question:

1

5.

The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery. the nurse should give priority to assessing the:

Serum collection (Davol) drain
Client’s pain
Nutritional status
Immobilizer

Correct Answer

A. Serum collection (Davol) drain

Explanation

Bleeding is a common complication of orthopedic surgery. The blood-collection device should be checked frequently to ensure that the client is not hemorrhaging. The client’s pain should be assessed. but this is not life-threatening. When the client is in less danger. the nutritional status should be assessed and an immobilizer is not used; thus. answers B. C. and D are incorrect.

Rate this question:

1

6.

Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates understanding of the nurse’s teaching?

“I must flush the tube with water after feedings and clamp the tube.”
“I must check placement four times per day.”
“I will report to the doctor any signs of indigestion.”
“If my father is unable to swallow. I will discontinue the feeding and call the clinic.”

Correct Answer

A. “I must flush the tube with water after feedings and clamp the tube.”

Explanation

The client’s family member should be taught to flush the tube after each feeding and clamp the tube. The placement should be checked before feedings. and indigestion can occur with the PEG tube. just as it can occur with any client. so answers B and C are incorrect. Medications can be ordered for indigestion. but it is not a reason for alarm. A percutaneous endoscopy gastrostomy tube is used for clients who have experienced difficulty swallowing. The tube is inserted directly into the stomach and does not require swallowing; therefore. answer D is incorrect.

Rate this question:

7.

The nurse is assessing the client with a total knee replacement 2 hours postoperative. Which information requires notification of the doctor?

Bleeding on the dressing is 3cm in diameter.
The client has a temperature of 100.6°F (38.1°C).
The client’s hematocrit is 26%.
The urinary output has been 60 during the last 2 hours.

Correct Answer

A. The client’s hematocrit is 26%.

Explanation

The client with a total knee replacement should be assessed for anemia. A hematocrit of 26% is extremely low and might require a blood transfusion. Bleeding of 2cm on the dressing is not extreme. Circle and date and time the bleeding and monitor for changes in the client’s status. A low-grade temperature is not unusual after surgery. Ensure that the client is well hydrated. and recheck the temperature in 1 hour. If the temperature is above 100.6°F (38.1°C). report this finding to the doctor. Tylenol will probably be ordered. Voiding after surgery is also not uncommon and no need for concern; therefore answers A. B. and D are incorrect.

Rate this question:

8.

The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?

The client has traveled out of the country in the last 6 months.
The client’s parents are skilled stained-glass artists.
The client lives in a house built in 1
The client has several brothers and sisters.

Correct Answer

A. The client’s parents are skilled stained-glass artists.

Explanation

Plumbism is lead poisoning. One factor associated with the consumption of lead is eating from pottery made in Central America or Mexico that is unfired. The child lives in a house built after 1976 (this is when lead was taken out of paint). and 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. Answer A is incorrect because simply traveling out of the country does not increase the risk. In answer C. the house was built after the lead was removed with the paint. Answer D is unrelated to the stem.

Rate this question:

9.

A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?

High-seat commode
Recliner
TENS unit
Abduction pillow

Correct Answer

A. High-seat commode

Explanation

The equipment that can help with activities of daily living is the high-seat commode. The hip should be kept higher than the knee. The recliner is good because it prevents 90° flexion but not daily activities. A TENS (Transcutaneous Electrical Nerve Stimulation) unit helps with pain management and an abduction pillow is used to prevent adduction of the hip and possibly dislocation of the prosthesis; therefore. answers B. C. and D are incorrect.

Rate this question:

10.

An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration. the nurse should:

Administer oxygen via nasal cannula
Have narcan (naloxone) available
Prepare to administer blood products
Prepare to do cardio resuscitation

Correct Answer

A. Have narcan (naloxone) available

Explanation

Narcan is the antidote for narcotic overdose. If hypoxia occurs. the client should have oxygen administered by mask. not cannula. There is no data to support the administration of blood products or cardiac resuscitation. so answers A. C. and D are incorrect.

Rate this question:

NCLEX Practice Exam 27 (10 Questions)

The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit?

Quiz Preview

The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:

A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse indicates that the traction is working properly?

A client with a fractured hip has been placed in Buck’s traction. Which statement is true regarding balanced skeletal traction? Balanced skeletal traction:

The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery. the nurse should give priority to assessing the:

Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates understanding of the nurse’s teaching?

The nurse is assessing the client with a total knee replacement 2 hours postoperative. Which information requires notification of the doctor?

The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?

A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?

An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration. the nurse should: