NCLEX Practice Exam 35 (10 Questions)

1. The nurse should visit which of the following clients first?

The client with diabetes with a blood glucose of 95mg/dL

The client with hypertension being maintained on Lisinopril

The client with chest pain and a history of angina

The client with Raynaud’s disease

The client with chest pain should be seen first because this could indicate a myocardial infarction. The client in answer A has a blood glucose within normal limits. The client in answer B is maintained on blood pressure medication. The client in answer D is in no distress.

Explanation

The client with chest pain should be seen first because this could indicate a myocardial infarction. The client in answer A has a blood glucose within normal limits. The client in answer B is maintained on blood pressure medication. The client in answer D is in no distress.

2. A client is receiving Pyridium (phenazopyridine hydrochloride) for a urinary tract infection. The client should be taught that the medication may:

Cause diarrhea

Change the color of her urine

Cause mental confusion

Cause changes in taste

Clients taking Pyridium should be taught that the medication will turn the urine orange or red. It is not associated with diarrhea. mental confusion. or changes in taste; therefore. answers A. C. and D are incorrect. Pyridium can also cause a yellowish color to skin and sclera if taken in large doses.

Explanation

Clients taking Pyridium should be taught that the medication will turn the urine orange or red. It is not associated with diarrhea. mental confusion. or changes in taste; therefore. answers A. C. and D are incorrect. Pyridium can also cause a yellowish color to skin and sclera if taken in large doses.

3. Cataracts result in opacity of the crystalline lens. Which of the following best explains the functions of the lens?

The lens controls stimulation of the retina.

The lens orchestrates eye movement.

The lens focuses light rays on the retina.

The lens magnifies small objects.

The lens allows light to pass through the pupil and focus light on the retina. The lens does not stimulate the retina. assist with eye movement. or magnify small objects. so answers A. B. and D are incorrect.

Explanation

The lens allows light to pass through the pupil and focus light on the retina. The lens does not stimulate the retina. assist with eye movement. or magnify small objects. so answers A. B. and D are incorrect.

4. A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most critical during the administration of acyclovir?

Limit the client’s activity

Encourage a high-carbohydrate diet

Utilize an incentive spirometer to improve respiratory function

Encourage fluids

Clients taking Acyclovir should be encouraged to drink plenty of fluids because renal impairment can occur. Limiting activity is not necessary. nor is eating a high-carbohydrate diet. Use of an incentive spirometer is not specific to clients taking Acyclovir; therefore. answers A. B. and C are incorrect.

Explanation

Clients taking Acyclovir should be encouraged to drink plenty of fluids because renal impairment can occur. Limiting activity is not necessary. nor is eating a high-carbohydrate diet. Use of an incentive spirometer is not specific to clients taking Acyclovir; therefore. answers A. B. and C are incorrect.

5. Which of the following tests should be performed before beginning a prescription of Accutane?

Check the calcium level

Perform a pregnancy test

Monitor apical pulse

Obtain a creatinine level

Accutane is contraindicated for use by pregnant clients because it causes teratogenic effects. Calcium levels. apical pulse. and creatinine levels are not necessary; therefore. answers A. C. and D are incorrect.

Explanation

Accutane is contraindicated for use by pregnant clients because it causes teratogenic effects. Calcium levels. apical pulse. and creatinine levels are not necessary; therefore. answers A. C. and D are incorrect.

6. A client with cystic fibrosis is taking pancreatic enzymes. The nurse should administer this medication:

Once per day in the morning

Three times per day with meals

Once per day at bedtime

Four times per day

Pancreatic enzymes should be given with meals for optimal effects. These enzymes assist the body in digesting needed nutrients. Answers A. C. and D are incorrect methods of administering pancreatic enzymes.

Explanation

Pancreatic enzymes should be given with meals for optimal effects. These enzymes assist the body in digesting needed nutrients. Answers A. C. and D are incorrect methods of administering pancreatic enzymes.

7. A client is admitted for an MRI. The nurse should question the client regarding:

Pregnancy

A titanium hip replacement

Allergies to antibiotics

Inability to move his feet

Although there are no evidence to suggest MRI scans can pose a risk during pregnancy. it is considered precaution to not perform MRI during pregnancy. particularly in the first three months. This is particularly the case during the first trimester of pregnancy. as organogenesis takes place during this period. The concerns in pregnancy are the same as for MRI in general. but the fetus may be more sensitive to the effects—particularly to heating and to noise. Clients with a titanium hip replacement can have an MRI. No antibiotics are used with this test and the client should remain still only when instructed. so answers C and D are not specific to this test.

Explanation

Although there are no evidence to suggest MRI scans can pose a risk during pregnancy. it is considered precaution to not perform MRI during pregnancy. particularly in the first three months. This is particularly the case during the first trimester of pregnancy. as organogenesis takes place during this period. The concerns in pregnancy are the same as for MRI in general. but the fetus may be more sensitive to the effects—particularly to heating and to noise. Clients with a titanium hip replacement can have an MRI. No antibiotics are used with this test and the client should remain still only when instructed. so answers C and D are not specific to this test.

8. A client who has glaucoma is to have miotic eye drops instilled in both eyes. The nurse knows that the purpose of the medication is to:

Anesthetize the cornea

Dilate the pupils

Constrict the pupils

Paralyze the muscles of accommodation

Miotic eye drops constrict the pupil and allow aqueous humor to drain out of the Canal of Schlemm. They do not anesthetize the cornea. dilate the pupil. or paralyze the muscles of the eye. making answers A. B. and D incorrect.

Explanation

Miotic eye drops constrict the pupil and allow aqueous humor to drain out of the Canal of Schlemm. They do not anesthetize the cornea. dilate the pupil. or paralyze the muscles of the eye. making answers A. B. and D incorrect.

9. The nurse is caring for the client receiving Amphotericin B. Which of the following indicates that the client has experienced toxicity to this drug?

Changes in vision

Nausea

Urinary frequency

Changes in skin color

Clients taking Amphotericin B should be monitored for liver. renal. and bone marrow function because this drug is toxic to the kidneys and liver. and causes bone marrow suppression. Jaundice is a sign of liver toxicity and is not specific to the use of Amphotericin B. Changes in vision are not related. and nausea is a side effect. not a sign of toxicity; nor is urinary frequency. Thus. answers A. B. and C are incorrect.

Explanation

Clients taking Amphotericin B should be monitored for liver. renal. and bone marrow function because this drug is toxic to the kidneys and liver. and causes bone marrow suppression. Jaundice is a sign of liver toxicity and is not specific to the use of Amphotericin B. Changes in vision are not related. and nausea is a side effect. not a sign of toxicity; nor is urinary frequency. Thus. answers A. B. and C are incorrect.

10. A client with a severe corneal ulcer has an order for Gentamycin gtt. q 4 hours and Neomycin 1 gtt q 4 hours. Which of the following schedules should be used when administering the drops?

Allow 5 minutes between the two medications.

The medications may be used together.

The medications should be separated by a cycloplegic drug.

The medications should not be used in the same client.

When using eyedrops. allow 5 minutes between the two medications; therefore. answer B is incorrect. These medications can be used by the same client but it is not necessary to use a cycloplegic with these medications. making answers C and D incorrect.

Explanation

When using eyedrops. allow 5 minutes between the two medications; therefore. answer B is incorrect. These medications can be used by the same client but it is not necessary to use a cycloplegic with these medications. making answers C and D incorrect.