NCLEX Practice Exam 16 (10 Questions)

1. Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site?

Thoroughly irrigate the wound before collecting the specimen.

Use a sterile swab and wipe the crusty area around the outside of the wound.

Gently roll a sterile swab from the center of the wound outward to collect drainage.

Use a sterile swab to collect drainage from the dressing.

Rolling a swab from the center outward is the right way to obtain a culture specimen from a wound.

Explanation

Rolling a swab from the center outward is the right way to obtain a culture specimen from a wound.

2. Which of the following potentially serious complications could occur with therapy for hypothyroidism?

Acute hemolytic reaction.

Angina or cardiac arrhythmia.

Retinopathy.

Thrombocytopenia.

Precipitation of angina or cardiac arrhythmia is a potentially serious complication of hypothyroidism treatment.

Explanation

Precipitation of angina or cardiac arrhythmia is a potentially serious complication of hypothyroidism treatment.

3. When giving intravenous (I.V.) phenytoin. which of the following methods should you use?

Use an in-line filter.

Withhold other anticonvulsants.

Mix the drug with saline solution only.

Flush the I.V. catheter with dextrose solution.

Phenytoin is compatible only with saline solutions; dextrose causes an insoluble precipitate to form. You needn’t withhold additional anticonvulsants or use an in-line filter (Option B.).

Explanation

Phenytoin is compatible only with saline solutions; dextrose causes an insoluble precipitate to form. You needn’t withhold additional anticonvulsants or use an in-line filter (Option B.).

4. After surgical repair of a hip. which of the following positions is best for the patient's legs and hips?

Abduction.

Adduction.

Prone.

Subluxated.

After surgical repair of the hip. keep the legs and hips abducted to stabilize the prosthesis in the acetabulum.

Explanation

After surgical repair of the hip. keep the legs and hips abducted to stabilize the prosthesis in the acetabulum.

5. A patient has partial-thickness burns to both legs and portions of his trunk. Which of the following I.V. fluids is given first?

Albumin.

D5W.

Lactated Ringer’s solution.

0.9% sodium chloride solution with 2 mEq of potassium per 100 ml.

Lactated Ringer’s solution replaces lost sodium and corrects metabolic acidosis. both of which commonly occur following a burn.

Explanation

Lactated Ringer’s solution replaces lost sodium and corrects metabolic acidosis. both of which commonly occur following a burn.

6. Patients with Type 1 diabetes mellitus may require which of the following changes to their daily routine during periods of infection?

No changes.

Less insulin.

More insulin.

Oral diabetic agents.

During periods of infection or illness. patients with Type 1 diabetes may need even more insulin to compensate for increased blood glucose levels.

Explanation

During periods of infection or illness. patients with Type 1 diabetes may need even more insulin to compensate for increased blood glucose levels.

7. After a liver biopsy. place the patient in which of the following positions?

Left side-lying. with the bed flat.

Right side-lying. with the bed flat.

Left side-lying. with the bed in semi-Fowler’s position.

Right side-lying. with the bed in semi-Fowler’s position.

Positioning the patient on his right side with the bed flat will splint the biopsy site and minimize bleeding. The other positions won’t do this and may cause more bleeding at the site or internally.

Explanation

Positioning the patient on his right side with the bed flat will splint the biopsy site and minimize bleeding. The other positions won’t do this and may cause more bleeding at the site or internally.

8. Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes?

Diabetes mellitus.

Diabetes insipidus.

Diabetic ketoacidosis.

Syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Maintaining adequate fluid and replacing vasopressin are the main objectives in treating diabetes insipidus.

Explanation

Maintaining adequate fluid and replacing vasopressin are the main objectives in treating diabetes insipidus.

9. Which of the following factors should be the primary focus of nursing management in a patient with acute pancreatitis?

Nutrition management.

Fluid and electrolyte balance.

Management of hypoglycemia.

Pain control.

Acute pancreatitis is commonly associated with fluid isolation and accumulation in the bowel secondary to ileus or peripancreatic edema. Fluid and electrolyte loss from vomiting is a major concern. Therefore. your priority is to manage hypovolemia and restore electrolyte balance.

Explanation

Acute pancreatitis is commonly associated with fluid isolation and accumulation in the bowel secondary to ileus or peripancreatic edema. Fluid and electrolyte loss from vomiting is a major concern. Therefore. your priority is to manage hypovolemia and restore electrolyte balance.

10. On a follow-up visit after having a vaginal hysterectomy. a 32-year-old patient has a decreased hematocrit level. Which of the following complications does this suggest?

Hematoma.

Hypovolemia.

Infection.

Pulmonary embolus (PE).

A decreased hematocrit level is a sign of hematoma. a delayed complication of abdominal and vaginal hysterectomy.

Explanation

A decreased hematocrit level is a sign of hematoma. a delayed complication of abdominal and vaginal hysterectomy.