NCLEX Pn Hardest Exam: Quiz!

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| By Venise Duverna
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Venise Duverna
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1. The nurse is teaching the parents of a 3 month-old infant about nutrition. What is the main source of fluids for an infant until about 12 months of age?

Explanation

Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.

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About This Quiz
NCLEX Pn Hardest Exam: Quiz! - Quiz

This challenging NCLEX PN quiz tests knowledge on various critical nursing scenarios. It covers essential skills such as evaluating cranial nerves, caring for clients with severe diagnoses, managing neonatal conditions, conducting physical assessments, and administering medications to infants.

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2. While the nurse is administering medications to a client, the client states "I do not want to take that medicine today." Which of the following responses by the nurse would be best?

Explanation

When a new problem is identified, it is important for the nurse to collect accurate assessment data. This is crucial to ensure that client needs are adequately identified in order to select the best nursing care approaches. The nurse should try to discover the reason for the refusal which may be that the client has developed untoward side effects.

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3. The nurse is assessing a client who states her last menstrual period was March 17, and she has missed one period. She reports episodes of nausea and vomiting. Pregancy is confirmed by a urine test. What will the nurse calculate as the estimated date of delivery (EDD)?

Explanation

Naegele’s rule: add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery.

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4. Which action by the mother of a preschooler would indicate a disturbing family interaction?

Explanation

Threatening a child with abandonment will destroy the child’s trust in his family

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5. The nurse is assessing a 4 month-old infant. Which motor skill would the nurse anticipate finding?

Explanation

The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.

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6. Which technique would be best in caring for a client following receiving a diagnosis of a state IV tumor in the brain?

Explanation

Providing information for the client is the best technique for a new diagnosis.

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7. An 8.5 lb, 6 oz infant is delivered to a diabetic mother. Which nursing intervention would be implemented when the neonate becomes jittery and lethargic?

Explanation

After birth, the infant of a diabetic mother is often hypoglycemic.

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8. The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:

Explanation

The nose and ears of the aging client actually become longer and broader. The chin line is also altered. Wrinkles on the face become more pronounced and tend to take on the general mood of the client over the years. For example laugh or frown wrinkles about the eyebrows, lips, cheeks, and outer edges of the eye orbit. The change in the androgen-estrogen ration causes an increase in growth of facial hair in most elder adults. The aging process shortens the platysma muscle, which contributes to neck wrinkles.

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9. Which of these statements, when made by the nurse, is most effective when communicating with a 4-year-old?

Explanation

Four-year-olds are egocentric and interested in having the focus on themselves. They will not be interested in what it feels like to other children. Preschoolers are concrete thinkers and would literally interpret any analogies so they are not helpful in explaining procedures. Assurance of confidential communication is most appropriate for the adolescent. In addition, confidentiality is not maintained if the child plans to harm themselves, harm someone else, or discloses abuse.

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10. What equipment would be necessary to complete an evaluation of cranial nerves 9 and 10 during a physical assessment?

Explanation

Cranial nerves 9 and 10 are the glossopharyngeal and vagus nerves. The gag reflex would be evaluated.

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11. During history, which information from a 21-year-old client would indicate a risk for the development of testicular cancer?

Explanation

Undescended testicles make the client a high risk for testicular cancer. Mumps, inguinal hernia in childhood, orchitis, and testicular cancer in the contra lateral testis are other predisposing factors.

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12. A client is admitted to the hospital with a history of confusion. The client has difficulty remembering recent events and becomes disoriented when away from home. Which statement would provide the bestreality orientation for this client?

Explanation

As cognitive ability declines, the nurse provides a calm, predictable environment for the client. This response establishes time, location and the caregivers name.

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13. The nurse assesses a prolonged late deceleration of the fetal heart rate while the client is receiving oxytocin (Pitocin) IV to stimulate labor. The priority nursing intervention would be to:

Explanation

Stopping the infusion will decrease contractions and possibly remove uterine pressure on the fetus, which is a possible cause of the deceleration.

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14. When observing 4-year-old children playing in the hospital playroom, what activity would the nurse expect to see the children participating in?

Explanation

Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.

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15. A 64 year-old client scheduled for surgery with a general anesthetic refuses to remove a set of dentures prior to leaving the unit for the operating room. What would be the most appropriate intervention by the nurse?

Explanation

Clients anticipating surgery may experience a variety of fears. This choice allows the client control over the situation and fosters the client’s sense of self-esteem and self-concept.

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16. What question would be most important to ask a male client who is in for a digital rectal examination?

Explanation

This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.

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17. While performing a physical examination on a newborn, which assessment should be reported to the physician?

Explanation

Average circumference of the head for a neonate ranges between 32 to 36 cm. An increase in size may indicate hydrocephaly or increased intracranial pressure.

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18. When assessing a newborn whose mother consumed alcohol during the pregnancy, the nurse would assess for which of these clinical manifestations?

Explanation

The nurse should anticipate that the infant may have fetal alcohol syndrome and should assess for signs and symptoms of it like wide-spaced eyes, smooth filtrum, flattened nose.

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19. While caring for a client, the nurse notes a pulsating mass in the client's periumbilical area. Which of the following assessments is appropriate for the nurse to perform?

Explanation

Auscultate the mass. Auscultation of the abdomen and finding a bruit will confirm the presence of an abdominal aneurysm and will form the basis of information given to the provider. The mass should not be palpated because of the risk of rupture.

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20. Which nursing approach would be most appropriate to use while administering oral medication to a 4-month-old?

Explanation

This is a convenient method for administering medications to an infant. Placing in supine position and administering medication using a plastic syringe is partially correct however, the infant is never placed in a reclining position during a procedure due to a potential aspiration.

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21. The family of a 6 year-old with a fractured femur asks the nurse if the child's height will be affected by the injury. Which statement is true concerning long bone fractures in children?

Explanation

Epiphyseal fractures often interrupt a child’s normal growth pattern

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22. All of the following characteristics would indicate to the nurse that an elder client might experience undesirable effects of medicines except:

Explanation

Oxidative enzyme levels decrease in the elderly, which affects the disposition of medication and can alter the therapeutic effects of medication. Alcohol has a smaller water distribution level in the elderly, resulting in higher blood alcohol levels. Alcohol also interacts with various drugs to either potentate or interfere with their effects. Magnesium is contained in a lot of medications elder clients routinely obtain over the counter. Magnesium toxicity is a real concern. Albumin is the major drug-binding protein. Decreased levels of serum albumin mean that higher levels of the drug remain free and that there are less therapeutic effects and increased drug interactions.

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23. When a client wishes to improve the appearance of their eyes by removing excess skin from the face and neck, the nurse should provide teaching regarding which of the following procedures?

Explanation

Rhytidectomy is the procedure for removing excess skin from the face and neck. It is commonly called a face lift. Dermabrasion involves the spraying of a chemical to cause light freezing of the skin, which is then abraded with sandpaper or a revolving wire brush. It is used to remove facial scars, severe acne, and pigment from tattoos. Rhinoplasty is done to improve the appearance of the nose and involves reshaping the nasal skeleton and overlying skin. Blepharoplasty is the procedure that removes loose and protruding fat from the upper and lower eyelids.

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24. Which nursing intervention would be a priority during the care of a 2-month-old after surgery?

Explanation

Tactile stimulation is imperative for an infant’s normal emotional development. After the trauma of surgery, sensory deprivation can cause failure to thrive.

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The nurse is teaching the parents of a 3 month-old infant about...
While the nurse is administering medications to a client, the client...
The nurse is assessing a client who states her last menstrual period...
Which action by the mother of a preschooler would indicate a...
The nurse is assessing a 4 month-old infant. Which motor skill would...
Which technique would be best in caring for a client following...
An 8.5 lb, 6 oz infant is delivered to a diabetic mother. Which...
The nurse should recognize that all of the following physical changes...
Which of these statements, when made by the nurse, is most effective...
What equipment would be necessary to complete an evaluation of cranial...
During history, which information from a 21-year-old client would...
A client is admitted to the hospital with a history of confusion. The...
The nurse assesses a prolonged late deceleration of the fetal heart...
When observing 4-year-old children playing in the hospital playroom,...
A 64 year-old client scheduled for surgery with a general anesthetic...
What question would be most important to ask a male client who is in...
While performing a physical examination on a newborn, which assessment...
When assessing a newborn whose mother consumed alcohol during the...
While caring for a client, the nurse notes a pulsating mass in the...
Which nursing approach would be most appropriate to use while...
The family of a 6 year-old with a fractured femur asks the nurse if...
All of the following characteristics would indicate to the nurse that...
When a client wishes to improve the appearance of their eyes by...
Which nursing intervention would be a priority during the care of a...
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