NCLEX Practice Exam 30 (10 Questions)

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

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

Split pea soup. mashed potatoes. pudding. milk

Tomato soup. cheese toast. Jello. coffee

Hamburger. baked beans. fruit cup. iced tea

The client with a facial stroke will have difficulty swallowing and chewing. and the foods in answer B provide the least amount of chewing. The foods in answers A. C. and D would require more chewing and. thus. are incorrect.

Explanation

The client with a facial stroke will have difficulty swallowing and chewing. and the foods in answer B provide the least amount of chewing. The foods in answers A. C. and D would require more chewing and. thus. are incorrect.

2. 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:

Pneumonia

Reaction to antiviral medication

Tuberculosis

Superinfection due to low CD4 count

A low-grade temperature. blood-tinged sputum. fatigue. and night sweats are symptoms consistent with tuberculosis. If the answer in A had said pneumocystis pneumonia. answer A would have been consistent with the symptoms given in the stem. but just saying pneumonia isn’t specific enough to diagnose the problem. Answers B and D are not directly related to the stem.

Explanation

A low-grade temperature. blood-tinged sputum. fatigue. and night sweats are symptoms consistent with tuberculosis. If the answer in A had said pneumocystis pneumonia. answer A would have been consistent with the symptoms given in the stem. but just saying pneumonia isn’t specific enough to diagnose the problem. Answers B and D are not directly related to the stem.

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

30 minutes before meals

With each meal

In a single dose at bedtime

30 minutes after meals

Proton pump inhibitors reduce the production of acid in the stomach. Proton pump inhibitors work best when they are taken 30 minutes before the first meal of the day.

Explanation

Proton pump inhibitors reduce the production of acid in the stomach. Proton pump inhibitors work best when they are taken 30 minutes before the first meal of the day.

4. 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:

Check the client for bladder distention

Assess the blood pressure for hypotension

Determine whether an oxytocic drug was given

Check for the expulsion of small clots

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. The answers in B. C. and D are actions that relate to postpartal hemorrhage.

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. The answers in B. C. and D are actions that relate to postpartal hemorrhage.

5. 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?

Call security for assistance and prepare to sedate the client.

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

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

Leave the client alone until he calms down.

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. Answer B is incorrect because simply telling the client to calm down will not work. Answer C is incorrect because telling the client that if he continues he will be punished is a threat and may further anger him. Answer D is incorrect because if the client is left alone he might harm himself.

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. Answer B is incorrect because simply telling the client to calm down will not work. Answer C is incorrect because telling the client that if he continues he will be punished is a threat and may further anger him. Answer D is incorrect because if the client is left alone he might harm himself.

6. 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?

Diabetes

Prinzmetal’s angina

Cancer

Cluster headaches

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 making answers A. C. and D incorrect.

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 making answers A. C. and D incorrect.

7. 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:

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

The umbilical cord needs time to separate.

Newborn skin is easily traumatized by washing.

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

The umbilical cord needs time to dry and fall off before putting the infant in the tub. Although answers A. C. and D might be important. they are not the primary answer to the question.

Explanation

The umbilical cord needs time to dry and fall off before putting the infant in the tub. Although answers A. C. and D might be important. they are not the primary answer to the question.

8. 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:

Treat iron-deficiency anemia caused by chemotherapeutic agents

Create a synergistic effect that shortens treatment time

Increase the number of circulating neutrophils

Reverse drug toxicity and prevent tissue damage

Leucovorin is the antidote for Methotrexate and Trimetrexate which are folic acid antagonists. Leucovorin is a folic acid derivative. Answers A. B. and C are incorrect because Leucovorin does not treat iron deficiency. increased neutrophils. or have a synergistic effect.

Explanation

Leucovorin is the antidote for Methotrexate and Trimetrexate which are folic acid antagonists. Leucovorin is a folic acid derivative. Answers A. B. and C are incorrect because Leucovorin does not treat iron deficiency. increased neutrophils. or have a synergistic effect.

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

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

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

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

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

NovoLog insulin onsets very quickly. so food should be available within 10–15 minutes of taking the insulin. Answer B 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 C. Answer D is incorrect because there is no need to save the dessert until bedtime.

Explanation

NovoLog insulin onsets very quickly. so food should be available within 10–15 minutes of taking the insulin. Answer B 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 C. Answer D is incorrect because there is no need to save the dessert until bedtime.

10. 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:

HibTITER

Mumps vaccine

Hepatitis B vaccine

MMR

The Haemophilus influenza vaccine is given at 4 months with the polio vaccine. Answers B. C. and D are incorrect because these vaccines are given later in life.

Explanation

The Haemophilus influenza vaccine is given at 4 months with the polio vaccine. Answers B. C. and D are incorrect because these vaccines are given later in life.