NCLEX Practice Exam 38 (10 Questions)

1. A client with diabetes has an order for ultrasonography. Preparation for an ultrasound includes:

Increasing fluid intake

Limiting ambulation

Administering an enema

Withholding food for 8 hours

Before ultrasonography. the client should be taught to drink plenty of fluids and not void. The client may ambulate. an enema is not needed. and there is no need to withhold food for 8 hours. Therefore. answers B. C. and D are incorrect.

Explanation

Before ultrasonography. the client should be taught to drink plenty of fluids and not void. The client may ambulate. an enema is not needed. and there is no need to withhold food for 8 hours. Therefore. answers B. C. and D are incorrect.

2. An infant who weighs 8 pounds at birth would be expected to weigh how many pounds at 1 year?

14 pounds

16 pounds

18 pounds

24 pounds

By 1 year of age. the infant is expected to triple his birth weight. Answers A. B. and C are incorrect because they are too low.

Explanation

By 1 year of age. the infant is expected to triple his birth weight. Answers A. B. and C are incorrect because they are too low.

3. The client with varicella will most likely have an order for which category of medication?

Antibiotics

Antipyretics

Antivirals

Anticoagulants

Varicella is chicken pox. This herpes virus is treated with antiviral medications. The client is not treated with antibiotics or anticoagulants as stated in answers A and D. The client might have a fever before the rash appears. but when the rash appears. the temperature is usually gone. so answer B is incorrect.

Explanation

Varicella is chicken pox. This herpes virus is treated with antiviral medications. The client is not treated with antibiotics or anticoagulants as stated in answers A and D. The client might have a fever before the rash appears. but when the rash appears. the temperature is usually gone. so answer B is incorrect.

4. A gravida 3 para 2 is admitted to the labor unit. Vaginal exam reveals that the client's cervix is 8 cm dilated. with complete effacement. The priority nursing diagnosis at this time is:

Alteration in coping related to pain

Potential for injury related to precipitate delivery

Alteration in elimination related to anesthesia

Potential for fluid volume deficit related to NPO status

Transition is the time during labor when the client loses concentration due to intense contractions. Potential for injury related to precipitate delivery has nothing to do with the dilation of the cervix. so answer B is incorrect. There is no data to indicate that the client has had anesthesia or fluid volume deficit. making answers C and D incorrect.

Explanation

Transition is the time during labor when the client loses concentration due to intense contractions. Potential for injury related to precipitate delivery has nothing to do with the dilation of the cervix. so answer B is incorrect. There is no data to indicate that the client has had anesthesia or fluid volume deficit. making answers C and D incorrect.

5. A pregnant client with a history of alcohol addiction is scheduled for a nonstress test. The nonstress test:

Determines the lung maturity of the fetus

Measures the activity of the fetus

Shows the effect of contractions on the fetal heart rate

Measures the neurological well-being of the fetus

A nonstress test is done to evaluate periodic movement of the fetus. It is not done to evaluate lung maturity as in answer A. An oxytocin challenge test shows the effect of contractions on fetal heart rate and a nonstress test does not measure neurological well-being of the fetus. so answers C and D are incorrect.

Explanation

A nonstress test is done to evaluate periodic movement of the fetus. It is not done to evaluate lung maturity as in answer A. An oxytocin challenge test shows the effect of contractions on fetal heart rate and a nonstress test does not measure neurological well-being of the fetus. so answers C and D are incorrect.

6. A client is admitted complaining of chest pain. Which of the following drug orders should the nurse question?

Nitroglycerin

Ampicillin

Propranolol

Verapamil

Clients with chest pain can be treated with nitroglycerin. a beta blocker such as propranolol. or Verapamil. There is no indication for an antibiotic such as Ampicillin. so answers A. C. and D are incorrect.

Explanation

Clients with chest pain can be treated with nitroglycerin. a beta blocker such as propranolol. or Verapamil. There is no indication for an antibiotic such as Ampicillin. so answers A. C. and D are incorrect.

7. Which of the following instructions should be included in the teaching for the client with rheumatoid arthritis?

Avoid exercise because it fatigues the joints.

Take prescribed anti-inflammatory medications with meals.

Alternate hot and cold packs to affected joints.

Avoid weight-bearing activity.

Anti-inflammatory drugs should be taken with meals to avoid stomach upset. Answers A. C. and D are incorrect. Clients with rheumatoid arthritis should exercise. but not to the point of pain. Alternating hot and cold is not necessary. especially because warm. moist soaks are more useful in decreasing pain. Weight-bearing activities such as walking are useful but is not the best answer for the stem.

Explanation

Anti-inflammatory drugs should be taken with meals to avoid stomach upset. Answers A. C. and D are incorrect. Clients with rheumatoid arthritis should exercise. but not to the point of pain. Alternating hot and cold is not necessary. especially because warm. moist soaks are more useful in decreasing pain. Weight-bearing activities such as walking are useful but is not the best answer for the stem.

8. A client with acute pancreatitis is experiencing severe abdominal pain. Which of the following orders should be questioned by the nurse?

Meperidine 100 mg IM q 4 hours PRN pain

Mylanta 30 ccs q 4 hours via NG

Cimetidine 300 mg PO q.i.d.

Morphine 8 mg IM q 4 hours PRN pain

Morphine is contraindicated in clients with gallbladder disease and pancreatitis because morphine causes spasms of the Sphincter of Oddi. Meperidine. Mylanta. and Cimetidine are ordered for pancreatitis. making answers A. B. and C incorrect.

Explanation

Morphine is contraindicated in clients with gallbladder disease and pancreatitis because morphine causes spasms of the Sphincter of Oddi. Meperidine. Mylanta. and Cimetidine are ordered for pancreatitis. making answers A. B. and C incorrect.

9. The client is admitted to the chemical dependence unit with an order for continuous observation. The nurse is aware that the doctor has ordered continuous observation because:

Hallucinogenic drugs create both stimulant and depressant effects.

Hallucinogenic drugs induce a state of altered perception.

Hallucinogenic drugs produce severe respiratory depression.

Hallucinogenic drugs induce rapid physical dependence.

Hallucinogenic drugs can cause hallucinations. Continuous observation is ordered to prevent the client from harming himself during withdrawal. Answers A. C. and D are incorrect because hallucinogenic drugs don’t create both stimulant and depressant effects or produce severe respiratory depression. However. they do produce psychological dependence rather than physical dependence.

Explanation

Hallucinogenic drugs can cause hallucinations. Continuous observation is ordered to prevent the client from harming himself during withdrawal. Answers A. C. and D are incorrect because hallucinogenic drugs don’t create both stimulant and depressant effects or produce severe respiratory depression. However. they do produce psychological dependence rather than physical dependence.

10. A full-term male has hypospadias. Which statement describes hypospadias?

The urethral opening is absent.

The urethra opens on the dorsal side of the penis.

The penis is shorter than usual.

The urethral meatus opens on the underside of the penis.

Hypospadias is a congenital condition in males where the urethral meatus (the opening of the urethra) is located on the underside of the penis, rather than at the tip. The severity of hypospadias can vary, with the opening positioned anywhere along the penile shaft, near the scrotum, or even at the perineum. This condition may require surgical correction to ensure proper urinary function and, in some cases, to improve the cosmetic appearance of the penis. It is a relatively common congenital anomaly, often detected during newborn examination.

Explanation

Hypospadias is a congenital condition in males where the urethral meatus (the opening of the urethra) is located on the underside of the penis, rather than at the tip. The severity of hypospadias can vary, with the opening positioned anywhere along the penile shaft, near the scrotum, or even at the perineum. This condition may require surgical correction to ensure proper urinary function and, in some cases, to improve the cosmetic appearance of the penis. It is a relatively common congenital anomaly, often detected during newborn examination.