NCLEX Practice Exam Quiz

1. Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell's traction?

16-year-old female with scoliosis

12-year-old male with a fractured femur

10-year-old male with sarcoma

6-year-old male with osteomyelitis

The 6-year-old should have a roommate as close to the same age as possible. so the 12-year-old is the best match. The 10-year-old with sarcoma has cancer and will be treated with chemotherapy that makes him immune suppressed. the 6-year-old with osteomyelitis is infected. and the client in answer A is too old and is female; therefore. answers A. C. and D are incorrect.

Explanation

The 6-year-old should have a roommate as close to the same age as possible. so the 12-year-old is the best match. The 10-year-old with sarcoma has cancer and will be treated with chemotherapy that makes him immune suppressed. the 6-year-old with osteomyelitis is infected. and the client in answer A is too old and is female; therefore. answers A. C. and D are incorrect.

2. A client with a fractured hip is being taught correct use of the walker. The nurse is aware that the correct use of the walker is achieved if the:

Palms rest lightly on the handles

Elbows are flexed 0°

Client walks to the front of the walker

Client carries the walker

The client’s palms should rest lightly on the handles. The elbows should be flexed no more than 30° but should not be extended. Answer B is incorrect because 0° is not a relaxed angle for the elbows and will not facilitate correct walker use. The client should walk to the middle of the walker. not to the front of the walker. making answer C incorrect. The client should be taught not to carry the walker because this would not provide stability; thus. answer D is incorrect.

Explanation

The client’s palms should rest lightly on the handles. The elbows should be flexed no more than 30° but should not be extended. Answer B is incorrect because 0° is not a relaxed angle for the elbows and will not facilitate correct walker use. The client should walk to the middle of the walker. not to the front of the walker. making answer C incorrect. The client should be taught not to carry the walker because this would not provide stability; thus. answer D is incorrect.

3. The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?

“It will be alright for your friends to autograph the cast.”

“Because the cast is made of plaster. autographing can weaken the cast.”

“If they don’t use chalk to autograph. it is okay.”

“Autographing or writing on the cast in any form will harm the cast.”

There is no reason that the client’s friends should not be allowed to autograph the cast; it will not harm the cast in any way. so answers B. C. and D are incorrect.

Explanation

There is no reason that the client’s friends should not be allowed to autograph the cast; it will not harm the cast in any way. so answers B. C. and D are incorrect.

4. The nurse is assigned to care for the client with a Steinmann pin. During pin care. she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?

Assisting the LPN with opening sterile packages and peroxide

Telling the LPN that clean gloves are allowed

Telling the LPN that the registered nurse should perform pin care

Asking the LPN to clean the weights and pulleys with peroxide

The nurse is performing the pin care correctly when she uses sterile gloves and Q-tips. A licensed practical nurse can perform pin care. there is no need to clean the weights. and the nurse can help with opening the packages but it isn’t required; therefore. answers B. C. and D are incorrect.

Explanation

The nurse is performing the pin care correctly when she uses sterile gloves and Q-tips. A licensed practical nurse can perform pin care. there is no need to clean the weights. and the nurse can help with opening the packages but it isn’t required; therefore. answers B. C. and D are incorrect.

5. A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates understanding of a plaster-of-Paris cast? The nurse:

Handles the cast with the fingertips

Petals the cast

Dries the cast with a hair dryer

Allows 24 hours before bearing weight

A plaster-of-Paris cast takes 24 hours to dry. and the client should not bear weight for 24 hours. The cast should be handled with the palms. not the fingertips. so answer A is incorrect. Petaling a cast is covering the end of the cast with cast batting or a sock. to prevent skin irritation and flaking of the skin under the cast. making answer B incorrect. The client should be told not to dry the cast with a hair dryer because this causes hot spots and could burn the client. This also causes unequal drying; thus. answer C is incorrect.

Explanation

A plaster-of-Paris cast takes 24 hours to dry. and the client should not bear weight for 24 hours. The cast should be handled with the palms. not the fingertips. so answer A is incorrect. Petaling a cast is covering the end of the cast with cast batting or a sock. to prevent skin irritation and flaking of the skin under the cast. making answer B incorrect. The client should be told not to dry the cast with a hair dryer because this causes hot spots and could burn the client. This also causes unequal drying; thus. answer C is incorrect.

6. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?

Take the medication with milk.

Report chest pain.

Remain upright after taking for 30 minutes.

Allow 6 weeks for optimal effects.

Cox II inhibitors have been associated with heart attacks and strokes. Any changes in cardiac status or signs of a stroke should be reported immediately. along with any changes in bowel or bladder habits because bleeding has been linked to use of Cox II inhibitors. The client does not have to take the medication with milk. remain upright. or allow 6 weeks for optimal effect. so answers A. C. and D are incorrect.

Explanation

Cox II inhibitors have been associated with heart attacks and strokes. Any changes in cardiac status or signs of a stroke should be reported immediately. along with any changes in bowel or bladder habits because bleeding has been linked to use of Cox II inhibitors. The client does not have to take the medication with milk. remain upright. or allow 6 weeks for optimal effect. so answers A. C. and D are incorrect.

7. The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?

Russell’s traction

Buck’s traction

Halo traction

Crutchfield tong traction

Halo traction will be ordered for the client with a cervical fracture. Russell’s traction is used for bones of the lower extremities. as is Buck’s traction. Crutchfield tongs are used while in the hospital and the client is immobile; therefore. answers A. B. and D are incorrect.

Explanation

Halo traction will be ordered for the client with a cervical fracture. Russell’s traction is used for bones of the lower extremities. as is Buck’s traction. Crutchfield tongs are used while in the hospital and the client is immobile; therefore. answers A. B. and D are incorrect.

8. A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?

Check the bowel sounds

Assess the blood pressure

Offer pain medication

Check for swelling

A body cast or spica cast extends from the upper abdomen to the knees or below. Bowel sounds should be checked to ensure that the client is not experiencing a paralytic ileus. Checking the blood pressure is a treatment for any client. offering pain medication is not called for. and checking for swelling isn’t specific to the stem. so answers B. C. and D are incorrect.

Explanation

A body cast or spica cast extends from the upper abdomen to the knees or below. Bowel sounds should be checked to ensure that the client is not experiencing a paralytic ileus. Checking the blood pressure is a treatment for any client. offering pain medication is not called for. and checking for swelling isn’t specific to the stem. so answers B. C. and D are incorrect.

9. When assessing a laboring client. the nurse finds a prolapsed cord. The nurse should:

Attempt to replace the cord

Place the client on her left side

Elevate the client’s hips

Cover the cord with a dry. sterile gauze

The client with a prolapsed cord should be treated by elevating the hips and covering the cord with a moist. sterile saline gauze. The nurse should use her fingers to push up on the presenting part until a cesarean section can be performed. Answers A. B. and D are incorrect. The nurse should not attempt to replace the cord. turn the client on the side. or cover with a dry gauze.

Explanation

The client with a prolapsed cord should be treated by elevating the hips and covering the cord with a moist. sterile saline gauze. The nurse should use her fingers to push up on the presenting part until a cesarean section can be performed. Answers A. B. and D are incorrect. The nurse should not attempt to replace the cord. turn the client on the side. or cover with a dry gauze.

10. A client with a total knee replacement has a CPM (continuous passive motion device) applied during the post-operative period. Which statement made by the nurse indicates understanding of the CPM machine?

“Use of the CPM will permit the client to ambulate during the therapy.”

“The CPM machine controls should be positioned distal to the site.”

“If the client complains of pain during the therapy. I will turn off the machine and call the doctor.”

“Use of the CPM machine will alleviate the need for physical therapy after the client is discharged.”

The controller for the continuous passive-motion device should be placed away from the client. Many clients complain of pain while having treatments with the CPM. so they might turn off the machine. The CPM flexes and extends the leg. The client is in the bed during CPM therapy. so answer A is incorrect. Answer C is incorrect because clients will experience pain with the treatment. Use of the CPM does not alleviate the need for physical therapy. as suggested in answer D.

Explanation

The controller for the continuous passive-motion device should be placed away from the client. Many clients complain of pain while having treatments with the CPM. so they might turn off the machine. The CPM flexes and extends the leg. The client is in the bed during CPM therapy. so answer A is incorrect. Answer C is incorrect because clients will experience pain with the treatment. Use of the CPM does not alleviate the need for physical therapy. as suggested in answer D.