NCLEX- PN Practice Exam 1

Practice Mode

Welcome to your NCLEX- PN Practice Exam 1! This exam is carefully curated to help you consolidate your knowledge and gain deeper understanding on the topic.

 

βœ” Exam Details

  • Number of Questions: 25 items
  • Mode: Practice Mode

βœ” Exam Instructions

  1. Practice Mode: This mode aims to facilitate effective learning and review.
  2. Instant Feedback: After each question, the correct answer along with an explanation will be revealed. This is to help you understand the reasoning behind the correct answer, helping to reinforce your learning.
  3. Time Limit: There is no time limit for this exam. Take your time to understand each question and the corresponding choices.

βœ” Tips For Success

  • Read each question carefully. Take your time and don't rush.
  • Understand the rationale behind each answer. This will not only help you during this exam, but also assist in reinforcing your learning.
  • Don't be discouraged by incorrect answers. Use them as an opportunity to learn and improve.
  • Take breaks if you need them. It's not a race, and your understanding is what's most important.
  • Keep a positive attitude and believe in your ability to succeed.

Remember, this exam is not just a test of your knowledge, but also an opportunity to enhance your understanding and skills. Enjoy the learning journey!

 

Click 'Start Exam' when you're ready to begin. Best of luck!

πŸ’‘ Hint

Consider emotions that are closely tied to self-perception and self-esteem.

1 / 25

1. Emma, an experienced psychiatric nurse, approaches Alex, a patient admitted with severe depression and suicidal thoughts. She notices that despite her best efforts, Alex remains silent and avoids conversation. Given this observation, what might Emma understand about the challenges Alex faces from the options below?

πŸ’‘ Hint

When considering digoxin for infants, it's common to withhold the drug if the heart rate is below a specific threshold, often set around 90 to 110 beats per minute. Always ensure the rate is within the safe range before proceeding.

2 / 25

2. In the pediatric cardiac unit, nurse Matthew prepares to give digoxin elixir to a 6-month-old baby diagnosed with a congenital heart defect. Before administering the medication, he determines the baby's apical pulse rate to be 100. Given this heart rate and the significance of monitoring before digoxin administration, what should nurse Matthew's subsequent step be?

πŸ’‘ Hint

Think of a fruit that is often associated with athletes to prevent muscle cramps due to its high potassium content.

3 / 25

3. Nurse Benjamin is discussing dietary changes with a patient on hydrochlorothiazide therapy. Recognizing the medication's potential to deplete potassium levels, he recommends specific foods rich in potassium. Which of the following snacks would be the most beneficial for a client needing to boost their potassium intake?

πŸ’‘ Hint

Remember that Timoptic is a beta-blocker, which can potentially cause bronchoconstriction. Think of a respiratory condition that would be particularly sensitive to this effect.

4 / 25

4. Nurse Elaine is reviewing the medication profile of a patient diagnosed with glaucoma who has been prescribed Timoptic (timolol) eyedrops. With her knowledge of timolol's potential interactions and side effects, she's vigilant about certain conditions that may warrant caution. Which of the following health histories should raise concern for Elaine when considering Timoptic administration?

πŸ’‘ Hint

Think of the medication that generally requires close monitoring and adjustment based on lab values. The order lacks specificity related to frequency.

5 / 25

5. Nurse Lucy is reviewing a list of medication orders for her patients during the beginning of her shift. She knows that clear and specific orders are crucial for patient safety. As she goes through the list, which of the following orders appears to require additional clarification?

πŸ’‘ Hint

This finding is associated with fluid buildup in the body, which is a common symptom of right-sided heart failure.

6 / 25

6. Nurse Emily is assessing Mr. Hansen, a patient suspected of having right-sided heart failure. She knows the signs and symptoms associated with each type of heart failure and is vigilant in her assessment. Which of the following findings is typically linked to right-sided heart failure?

πŸ’‘ Hint

Think about which situation demands a higher level of nursing expertise and comprehensive assessment capabilities.

7 / 25

7. Daniel, the charge nurse, is organizing the day's assignments for the nursing team. When allocating tasks, he needs to be certain of the responsibilities a licensed vocational nurse (LVN) can undertake. Which of the following clients should Daniel avoid assigning as the primary patient to the LVN?

πŸ’‘ Hint

For accurate readings, the pulse oximeter probe needs a capillary-rich area where it can detect blood flow well. Think of a common location on a child where this is typically done.

8 / 25

8. Nurse Jessica is preparing to measure the oxygen saturation of Timmy, an 8-year-old boy admitted with an upper-respiratory infection. She knows the importance of correctly placing the pulse oximeter to get an accurate reading. What should Nurse Jessica do to ensure the most accurate O2 saturation measurement for Timmy?

πŸ’‘ Hint

In situations where the jaw has been wired shut, consider an emergency tool that can swiftly release the wires if there's a need for immediate mouth opening, like in cases of breathing difficulties or vomiting.

9 / 25

9. Nurse Martin is preparing Mr. James, a patient with a recently repaired fractured mandible, for discharge. Given the nature of the injury and the typical postoperative care requirements, which piece of safety equipment should be always accessible to the patient after heading home?

πŸ’‘ Hint

Consider which non-pharmacological intervention can help orient a person by providing a gentle source of light during the nighttime.

10 / 25

10. Nurse Miranda frequently cares for Mr. Thompson, an elderly patient who often becomes disoriented and wanders during nighttime hours. In her attempts to minimize his confusion and ensure the safety of all patients, she considers several strategies. Which of the following interventions would be the most effective in reducing Mr. Thompson's nighttime confusion?

πŸ’‘ Hint

Think about foods that often contain preservatives and might be high in sodium.

11 / 25

11. Mark, a seasoned nurse in the gastroenterology department, recently attended a seminar on dietary habits and their implications for gastric diseases. While caring for a patient diagnosed with chronic dyspepsia who just found out he has gastric cancer, Mark ponders which dietary item from the following list has been linked to a higher occurrence of gastric cancer?

πŸ’‘ Hint

Before a potentially discomforting procedure, it's vital to ensure the patient's comfort and ease any distress that might arise.

12 / 25

12. Lila, a nurse in the burn unit, is prepping for a dressing change on a patient with full-thickness burns on the hands and arms. The doctor prescribed dressings with Sulfamylon cream. Before proceeding with the change, which action should Lila prioritize?

πŸ’‘ Hint

Think about the distinct pattern that is often associated with a tick bite leading to Lyme's disease. It resembles a specific target-like appearance.

13 / 25

13. Nurse Olivia is conducting a community health seminar about the risks and symptoms associated with tick-borne illnesses. When discussing Lyme's disease, she emphasizes the characteristic skin lesion that often presents in the early stages. Which skin manifestation is she referring to that's commonly linked with Lyme's disease?

πŸ’‘ Hint

After thyroid surgery, it's crucial to ensure that the patient's airway remains clear and that there's minimal strain on the surgical site. Consider which position would best address these priorities.

14 / 25

14. Nurse Alex is assigned to care for Mrs. Wallace, who just underwent thyroid removal surgery. Given the delicate nature of the surgery and its potential implications on breathing and neck mobility, Nurse Alex recalls the best post-operative care practices. What should he prioritize immediately after the surgery for Mrs. Wallace's safety and comfort?

πŸ’‘ Hint

The primary goal after the surgery is to prevent the child from reaching the surgical site with their hands, so focus on the restraints that will deter arm bending.

15 / 25

15. Nurse Olivia is preparing the room for a post-operative 18-month-old child who just underwent a cleft palate repair. She knows that to prevent the child from touching the surgical site, specific restraints are typically used. What are the common restraints used in such cases?

πŸ’‘ Hint

Reflect on behaviors in youth that might serve as red flags or precursors to more severe actions in adulthood.

16 / 25

16. Ethan, a psychiatric nurse, receives a new patient for forensic evaluation following accusations of arson. The initial diagnosis hints at antisocial personality disorder. As Ethan delves into the patient's medical records, what particular detail is he most likely to encounter given the tentative diagnosis?

πŸ’‘ Hint

Recall that Meniere's syndrome is associated with a fluid balance disruption in the inner ear. The right diet can help manage fluid retention.

17 / 25

17. Nurse Aaron is counseling a patient newly diagnosed with Meniere's syndrome regarding dietary adjustments. To manage the symptoms and progression of the condition, it's essential to choose the right diet. What is the most appropriate dietary recommendation for a client with Meniere’s syndrome?

πŸ’‘ Hint

This particular side effect can make swallowing and speech challenging due to the overproduction of a certain fluid in the mouth.

18 / 25

18. During her shift at the mental health clinic, Nurse Martin reviews the medication side effects with Mr. Thompson, who has schizophrenia and is on chlorpromazine (Thorazine) 400mg twice daily. As part of the patient's education, Nurse Martin emphasizes a particular side effect that Mr. Thompson should monitor while on this medication. Which side effect is Nurse Martin highlighting that's commonly associated with chlorpromazine (Thorazine)?

πŸ’‘ Hint

This medication can have an impact on a specific aspect of oral health. Regular check-ups can help monitor potential changes.

19 / 25

19. Nurse James is conducting a medication education session with Ms. Lopez, who has been prescribed phenytoin (Dilantin). To ensure Ms. Lopez's well-being and adherence to the medication, Nurse James emphasizes a specific point related to its side effects. What information is Nurse James particularly stressing that's associated with the use of phenytoin (Dilantin)?

πŸ’‘ Hint

Think of snacks that don't contain ingredients made from wheat, barley, or rye. Some snacks are naturally free from these components.

20 / 25

20. Nurse Kara is working with a group of parents to promote understanding of dietary needs for children with specific health issues. When discussing gluten-induced enteropathy, she provides a list of snacks that are suitable for affected children. Which of the following snacks would she recommend for a child with gluten-induced enteropathy?

πŸ’‘ Hint

Think about the most accurate way to ensure the right dose of medication for the infant without diluting or spilling it.

21 / 25

21. Nurse Eliza is preparing Mrs. Johnson and her infant, diagnosed with Tetralogy of Fallot, for discharge. The baby has been prescribed Lanoxin elixir. Nurse Eliza knows that educating the mother about proper medication administration is crucial for safety and effectiveness. What instruction should she provide to Mrs. Johnson regarding the administration of Lanoxin elixir?

πŸ’‘ Hint

The chosen treatment for lead poisoning often involves substances that bind to heavy metals, aiding in their elimination from the body.

22 / 25

22. In the pediatric unit, nurse Amelia meets a concerned mother whose 3-year-old daughter has been admitted with lead poisoning. Eager for information, the mother seeks clarity on her daughter's treatment plan. Based on Amelia's knowledge about the management of lead poisoning, which of the following treatments is commonly employed?

πŸ’‘ Hint

The most therapeutic response acknowledges the patient's feelings, provides reassurance, and offers further information, all while maintaining a supportive and empathetic tone.

23 / 25

23. Nurse Bennett is caring for Mrs. Clarke, who is scheduled for electroconvulsive therapy (ECT). Mrs. Clarke appears anxious and voices her concerns about the procedure. In an attempt to provide comfort and information, what is the most therapeutic statement Nurse Bennett can offer to address Mrs. Clarke's fears?

πŸ’‘ Hint

Think of a symptom related to the build-up of waste products in the blood that can affect the skin.

24 / 25

24. Nurse Karen is overseeing the care of Mr. Rodriguez, who is diagnosed with end-stage renal failure. Throughout her nursing career, Karen has observed various symptoms commonly reported by patients with this condition. Which symptom is frequently voiced by clients in the terminal stages of renal failure?

πŸ’‘ Hint

Think about activities that involve larger movements of the arms, legs, feet, or entire body.

25 / 25

25. Sarah, a pediatric nurse, is conducting a workshop for parents to understand the growth and motor development milestones of toddlers. During the session, she presents various examples. Which of the following behaviors best illustrates a typical gross motor skill for a toddler?

Exam Mode

Welcome to your NCLEX- PN Practice Exam 1! This exam is carefully designed to provide you with a realistic test-taking experience, preparing you for the pressures of an actual nursing exam.

 

βœ” Exam Details

  • Number of Questions: 25 items
  • Mode: Exam Mode

βœ” Exam Instructions

  1. Exam Mode: This mode is intended to simulate the environment of an actual exam. Questions and choices will be presented one at a time.
  2. Time Limit: Each question must be answered within 90 seconds. The entire exam should be completed within 37 minutes and 30 seconds.
  3. Feedback and Grading: Upon completion of the exam, you will be able to see your grade and the correct answers to all questions. This will allow you to evaluate your performance and understand areas for improvement.

βœ” Tips For Success

  • Read each question carefully. You have 90 seconds per question, so make sure you understand the question before selecting your answer.
  • Pace yourself. Remember, you have 37 minutes and 30 seconds in total, so try to maintain a steady rhythm.
  • Focus on one question at a time. Try not to worry about the questions to come.
  • Stay calm under pressure. Use your knowledge and trust your instincts.
  • Remember, it's not just about the score, but about the learning process.

This exam is not only a measurement of your current understanding, but also a valuable learning tool to prepare you for your future nursing career. Click 'Start Exam' when you're ready to begin. Good luck!

1 / 25

1. Daniel, the charge nurse, is organizing the day's assignments for the nursing team. When allocating tasks, he needs to be certain of the responsibilities a licensed vocational nurse (LVN) can undertake. Which of the following clients should Daniel avoid assigning as the primary patient to the LVN?

2 / 25

2. Nurse Emily is assessing Mr. Hansen, a patient suspected of having right-sided heart failure. She knows the signs and symptoms associated with each type of heart failure and is vigilant in her assessment. Which of the following findings is typically linked to right-sided heart failure?

3 / 25

3. Nurse Jessica is preparing to measure the oxygen saturation of Timmy, an 8-year-old boy admitted with an upper-respiratory infection. She knows the importance of correctly placing the pulse oximeter to get an accurate reading. What should Nurse Jessica do to ensure the most accurate O2 saturation measurement for Timmy?

4 / 25

4. Nurse Eliza is preparing Mrs. Johnson and her infant, diagnosed with Tetralogy of Fallot, for discharge. The baby has been prescribed Lanoxin elixir. Nurse Eliza knows that educating the mother about proper medication administration is crucial for safety and effectiveness. What instruction should she provide to Mrs. Johnson regarding the administration of Lanoxin elixir?

5 / 25

5. Nurse Kara is working with a group of parents to promote understanding of dietary needs for children with specific health issues. When discussing gluten-induced enteropathy, she provides a list of snacks that are suitable for affected children. Which of the following snacks would she recommend for a child with gluten-induced enteropathy?

6 / 25

6. Emma, an experienced psychiatric nurse, approaches Alex, a patient admitted with severe depression and suicidal thoughts. She notices that despite her best efforts, Alex remains silent and avoids conversation. Given this observation, what might Emma understand about the challenges Alex faces from the options below?

7 / 25

7. Nurse James is conducting a medication education session with Ms. Lopez, who has been prescribed phenytoin (Dilantin). To ensure Ms. Lopez's well-being and adherence to the medication, Nurse James emphasizes a specific point related to its side effects. What information is Nurse James particularly stressing that's associated with the use of phenytoin (Dilantin)?

8 / 25

8. Nurse Miranda frequently cares for Mr. Thompson, an elderly patient who often becomes disoriented and wanders during nighttime hours. In her attempts to minimize his confusion and ensure the safety of all patients, she considers several strategies. Which of the following interventions would be the most effective in reducing Mr. Thompson's nighttime confusion?

9 / 25

9. Nurse Elaine is reviewing the medication profile of a patient diagnosed with glaucoma who has been prescribed Timoptic (timolol) eyedrops. With her knowledge of timolol's potential interactions and side effects, she's vigilant about certain conditions that may warrant caution. Which of the following health histories should raise concern for Elaine when considering Timoptic administration?

10 / 25

10. During her shift at the mental health clinic, Nurse Martin reviews the medication side effects with Mr. Thompson, who has schizophrenia and is on chlorpromazine (Thorazine) 400mg twice daily. As part of the patient's education, Nurse Martin emphasizes a particular side effect that Mr. Thompson should monitor while on this medication. Which side effect is Nurse Martin highlighting that's commonly associated with chlorpromazine (Thorazine)?

11 / 25

11. Ethan, a psychiatric nurse, receives a new patient for forensic evaluation following accusations of arson. The initial diagnosis hints at antisocial personality disorder. As Ethan delves into the patient's medical records, what particular detail is he most likely to encounter given the tentative diagnosis?

12 / 25

12. Nurse Martin is preparing Mr. James, a patient with a recently repaired fractured mandible, for discharge. Given the nature of the injury and the typical postoperative care requirements, which piece of safety equipment should be always accessible to the patient after heading home?

13 / 25

13. Nurse Aaron is counseling a patient newly diagnosed with Meniere's syndrome regarding dietary adjustments. To manage the symptoms and progression of the condition, it's essential to choose the right diet. What is the most appropriate dietary recommendation for a client with Meniere’s syndrome?

14 / 25

14. Nurse Alex is assigned to care for Mrs. Wallace, who just underwent thyroid removal surgery. Given the delicate nature of the surgery and its potential implications on breathing and neck mobility, Nurse Alex recalls the best post-operative care practices. What should he prioritize immediately after the surgery for Mrs. Wallace's safety and comfort?

15 / 25

15. Sarah, a pediatric nurse, is conducting a workshop for parents to understand the growth and motor development milestones of toddlers. During the session, she presents various examples. Which of the following behaviors best illustrates a typical gross motor skill for a toddler?

16 / 25

16. Mark, a seasoned nurse in the gastroenterology department, recently attended a seminar on dietary habits and their implications for gastric diseases. While caring for a patient diagnosed with chronic dyspepsia who just found out he has gastric cancer, Mark ponders which dietary item from the following list has been linked to a higher occurrence of gastric cancer?

17 / 25

17. In the pediatric cardiac unit, nurse Matthew prepares to give digoxin elixir to a 6-month-old baby diagnosed with a congenital heart defect. Before administering the medication, he determines the baby's apical pulse rate to be 100. Given this heart rate and the significance of monitoring before digoxin administration, what should nurse Matthew's subsequent step be?

18 / 25

18. Nurse Olivia is conducting a community health seminar about the risks and symptoms associated with tick-borne illnesses. When discussing Lyme's disease, she emphasizes the characteristic skin lesion that often presents in the early stages. Which skin manifestation is she referring to that's commonly linked with Lyme's disease?

19 / 25

19. Nurse Benjamin is discussing dietary changes with a patient on hydrochlorothiazide therapy. Recognizing the medication's potential to deplete potassium levels, he recommends specific foods rich in potassium. Which of the following snacks would be the most beneficial for a client needing to boost their potassium intake?

20 / 25

20. Lila, a nurse in the burn unit, is prepping for a dressing change on a patient with full-thickness burns on the hands and arms. The doctor prescribed dressings with Sulfamylon cream. Before proceeding with the change, which action should Lila prioritize?

21 / 25

21. Nurse Karen is overseeing the care of Mr. Rodriguez, who is diagnosed with end-stage renal failure. Throughout her nursing career, Karen has observed various symptoms commonly reported by patients with this condition. Which symptom is frequently voiced by clients in the terminal stages of renal failure?

22 / 25

22. In the pediatric unit, nurse Amelia meets a concerned mother whose 3-year-old daughter has been admitted with lead poisoning. Eager for information, the mother seeks clarity on her daughter's treatment plan. Based on Amelia's knowledge about the management of lead poisoning, which of the following treatments is commonly employed?

23 / 25

23. Nurse Lucy is reviewing a list of medication orders for her patients during the beginning of her shift. She knows that clear and specific orders are crucial for patient safety. As she goes through the list, which of the following orders appears to require additional clarification?

24 / 25

24. Nurse Bennett is caring for Mrs. Clarke, who is scheduled for electroconvulsive therapy (ECT). Mrs. Clarke appears anxious and voices her concerns about the procedure. In an attempt to provide comfort and information, what is the most therapeutic statement Nurse Bennett can offer to address Mrs. Clarke's fears?

25 / 25

25. Nurse Olivia is preparing the room for a post-operative 18-month-old child who just underwent a cleft palate repair. She knows that to prevent the child from touching the surgical site, specific restraints are typically used. What are the common restraints used in such cases?

Text Mode

Text ModeΒ – Text version of the exam

Questions

1. Mark, a seasoned nurse in the gastroenterology department, recently attended a seminar on dietary habits and their implications for gastric diseases. While caring for a patient diagnosed with chronic dyspepsia who just found out he has gastric cancer, Mark ponders which dietary item from the following list has been linked to a higher occurrence of gastric cancer?

A. Sweets made from processed sugars.
B. Processed sandwich meats.
C. Fizzy soft drinks.
D. Products from milk.

2. Emma, an experienced psychiatric nurse, approaches Alex, a patient admitted with severe depression and suicidal thoughts. She notices that despite her best efforts, Alex remains silent and avoids conversation. Given this observation, what might Emma understand about the challenges Alex faces from the options below?

A. Relying on others for support.
B. Conveying resentment or displeasure towards others.
C. Voicing feelings of diminished self-value.
D. Speaking about feelings of regret and guilt.

3. Ethan, a psychiatric nurse, receives a new patient for forensic evaluation following accusations of arson. The initial diagnosis hints at antisocial personality disorder. As Ethan delves into the patient’s medical records, what particular detail is he most likely to encounter given the tentative diagnosis?

A. Indications of lower cognitive capabilities.
B. Records showing consistent job tenure.
C. Statements showing regret for past behaviors.
D. Past incidents highlighting harm or cruelty towards animals.

4. Daniel, the charge nurse, is organizing the day’s assignments for the nursing team. When allocating tasks, he needs to be certain of the responsibilities a licensed vocational nurse (LVN) can undertake. Which of the following clients should Daniel avoid assigning as the primary patient to the LVN?

A. Someone with a controlled chronic illness requiring usual care.
B. An individual needing a basic dressing replacement for a small injury.
C. A patient seeking help with daily personal tasks.
D. A patient with multifaceted medical conditions needing sophisticated evaluation.

5. Lila, a nurse in the burn unit, is prepping for a dressing change on a patient with full-thickness burns on the hands and arms. The doctor prescribed dressings with Sulfamylon cream. Before proceeding with the change, which action should Lila prioritize?

A. Measuring blood sugar using a finger stick.
B. Asking for a daily blood test to assess overall health.
C. Ensuring proper urinary output is being maintained.
D. Providing medication to alleviate pain.

6. Sarah, a pediatric nurse, is conducting a workshop for parents to understand the growth and motor development milestones of toddlers. During the session, she presents various examples. Which of the following behaviors best illustrates a typical gross motor skill for a toddler?

A. Demonstrating the ability to imitate a horizontal stroke.
B. Dragging a toy trailing behind while walking.
C. Executing a wide leap.
D. Constructing a stack of eight toy blocks.

7. In the pediatric cardiac unit, nurse Matthew prepares to give digoxin elixir to a 6-month-old baby diagnosed with a congenital heart defect. Before administering the medication, he determines the baby’s apical pulse rate to be 100. Given this heart rate and the significance of monitoring before digoxin administration, what should nurse Matthew’s subsequent step be?

A. Delay the dose, then reassess the pulse in half an hour.
B. Document the pulse rate and proceed with giving the medication.
C. Provide the medication and re-evaluate the pulse after a quarter of an hour.
D. Take note of the pulse and immediately contact the doctor.

8. In the pediatric unit, nurse Amelia meets a concerned mother whose 3-year-old daughter has been admitted with lead poisoning. Eager for information, the mother seeks clarity on her daughter’s treatment plan. Based on Amelia’s knowledge about the management of lead poisoning, which of the following treatments is commonly employed?

A. Administering activated charcoal.
B. Providing drugs to prevent vomiting.
C. Using chelating agents.
D. Performing a stomach wash or gastric lavage.

9. Nurse Olivia is preparing the room for a post-operative 18-month-old child who just underwent a cleft palate repair. She knows that to prevent the child from touching the surgical site, specific restraints are typically used. What are the common restraints used in such cases?

A. Wrapping the child tightly, similar to a mummy.
B. Restraining the child’s elbows.
C. Securing the child’s wrists.
D. Restricting the full length of the arm.

10. Nurse Benjamin is discussing dietary changes with a patient on hydrochlorothiazide therapy. Recognizing the medication’s potential to deplete potassium levels, he recommends specific foods rich in potassium. Which of the following snacks would be the most beneficial for a client needing to boost their potassium intake?

A. Orange
B. Apple
C. Pear
D. Banana

11. Nurse Elaine is reviewing the medication profile of a patient diagnosed with glaucoma who has been prescribed Timoptic (timolol) eyedrops. With her knowledge of timolol’s potential interactions and side effects, she’s vigilant about certain conditions that may warrant caution. Which of the following health histories should raise concern for Elaine when considering Timoptic administration?

A. Gastroesophageal reflux disease (GERD).
B. Osteoarthritis.
C. Asthma.
D. Hypothyroidism.

12. Nurse Miranda frequently cares for Mr. Thompson, an elderly patient who often becomes disoriented and wanders during nighttime hours. In her attempts to minimize his confusion and ensure the safety of all patients, she considers several strategies. Which of the following interventions would be the most effective in reducing Mr. Thompson’s nighttime confusion?

A. Pairing him with another elderly roommate.
B. Keeping a soft night light illuminated during the evening and night.
C. Giving him a sedative at bedtime.
D. Having a nursing assistant remain by his side until he’s asleep.

13. Nurse Karen is overseeing the care of Mr. Rodriguez, who is diagnosed with end-stage renal failure. Throughout her nursing career, Karen has observed various symptoms commonly reported by patients with this condition. Which symptom is frequently voiced by clients in the terminal stages of renal failure?

A. Persistent itching.
B. Significant weight loss.
C. Ringing sensations in the ears.
D. Frequent bruising.

14. Nurse Martin is preparing Mr. James, a patient with a recently repaired fractured mandible, for discharge. Given the nature of the injury and the typical postoperative care requirements, which piece of safety equipment should be always accessible to the patient after heading home?

A. A ready-to-use tracheostomy kit.
B. Specialized mandibular wire cutters.
C. An emergency oral airway device.
D. Medical-grade pliers.

15. Nurse Lucy is reviewing a list of medication orders for her patients during the beginning of her shift. She knows that clear and specific orders are crucial for patient safety. As she goes through the list, which of the following orders appears to require additional clarification?

A. Coumadin 10 mg taken orally.
B. Nembutal 100 mg to be taken orally at bedtime.
C. Estrace 2 mg orally every day.
D. Darvocet 65 mg taken orally every 4–6 hours as needed.

16. Nurse Aaron is counseling a patient newly diagnosed with Meniere’s syndrome regarding dietary adjustments. To manage the symptoms and progression of the condition, it’s essential to choose the right diet. What is the most appropriate dietary recommendation for a client with Meniere’s syndrome?

A. Low in fiber.
B. High in iodine.
C. Low in sodium.
D. High in fiber.

17. Nurse Emily is assessing Mr. Hansen, a patient suspected of having right-sided heart failure. She knows the signs and symptoms associated with each type of heart failure and is vigilant in her assessment. Which of the following findings is typically linked to right-sided heart failure?

A. Increased urination during the night.
B. Difficulty breathing or shortness of breath.
C. Crackling sounds when listening to the lungs.
D. Reduced urine output during the day.

18. Nurse Jessica is preparing to measure the oxygen saturation of Timmy, an 8-year-old boy admitted with an upper-respiratory infection. She knows the importance of correctly placing the pulse oximeter to get an accurate reading. What should Nurse Jessica do to ensure the most accurate O2 saturation measurement for Timmy?

A. Secure the probe and patiently wait 15 minutes before noting the reading.
B. Attach the probe to Timmy’s abdominal area.
C. Position the probe snugly on Timmy’s finger.
D. Make sure to recalibrate the oximeter at the start of her shift.

19. Nurse Eliza is preparing Mrs. Johnson and her infant, diagnosed with Tetralogy of Fallot, for discharge. The baby has been prescribed Lanoxin elixir. Nurse Eliza knows that educating the mother about proper medication administration is crucial for safety and effectiveness. What instruction should she provide to Mrs. Johnson regarding the administration of Lanoxin elixir?

A. Give the medicine in a baby bottle mixed with 1oz. of water.
B. Use a plastic baby spoon to deliver the medication.
C. Dispense the medicine through a nipple.
D. Use the precise calibrated dropper that comes with the medication bottle.

20. Nurse Bennett is caring for Mrs. Clarke, who is scheduled for electroconvulsive therapy (ECT). Mrs. Clarke appears anxious and voices her concerns about the procedure. In an attempt to provide comfort and information, what is the most therapeutic statement Nurse Bennett can offer to address Mrs. Clarke’s fears?

A. “Don’t worry about the procedure; everything will be fine.”
B. “I understand that this can be a concerning procedure, but it’s done routinely, and I’ll be here with you throughout. Would you like more information about what to expect?”
C. “You should trust the doctors; they know what they’re doing.”
D. “Many patients go through this and it’s not a big deal.”

21. Nurse Alex is assigned to care for Mrs. Wallace, who just underwent thyroid removal surgery. Given the delicate nature of the surgery and its potential implications on breathing and neck mobility, Nurse Alex recalls the best post-operative care practices. What should he prioritize immediately after the surgery for Mrs. Wallace’s safety and comfort?

A. Prompt her to cough and take deep breaths every 2 hours, while keeping her neck flexed.
B. Ensure she remains flat on her back with sandbags on either side of her head and neck for support.
C. Motivate her to rotate her head from side to side to help with oral secretion drainage.
D. Position her in a semi-Fowler’s position, using pillows to provide support to her head and neck.

22. Nurse Olivia is conducting a community health seminar about the risks and symptoms associated with tick-borne illnesses. When discussing Lyme’s disease, she emphasizes the characteristic skin lesion that often presents in the early stages. Which skin manifestation is she referring to that’s commonly linked with Lyme’s disease?

A. Raised patches.
B. Bumpy, crusty spots.
C. A rash resembling a target or bull’s eye.
D. Large fluid-filled blisters.

23. During her shift at the mental health clinic, Nurse Martin reviews the medication side effects with Mr. Thompson, who has schizophrenia and is on chlorpromazine (Thorazine) 400mg twice daily. As part of the patient’s education, Nurse Martin emphasizes a particular side effect that Mr. Thompson should monitor while on this medication. Which side effect is Nurse Martin highlighting that’s commonly associated with chlorpromazine (Thorazine)?

A. Elevated blood pressure levels.
B. Increased heart rate.
C. Producing too much saliva.
D. High blood sugar levels.

24. Nurse James is conducting a medication education session with Ms. Lopez, who has been prescribed phenytoin (Dilantin). To ensure Ms. Lopez’s well-being and adherence to the medication, Nurse James emphasizes a specific point related to its side effects. What information is Nurse James particularly stressing that’s associated with the use of phenytoin (Dilantin)?

A. It may disrupt your sleep patterns.
B. Consuming it with food can enhance its effectiveness.
C. It can reduce the potency of birth control pills.
D. You might need to see your dentist more often due to gum concerns.

25. Nurse Kara is working with a group of parents to promote understanding of dietary needs for children with specific health issues. When discussing gluten-induced enteropathy, she provides a list of snacks that are suitable for affected children. Which of the following snacks would she recommend for a child with gluten-induced enteropathy?

A. A slice of cheese pizza.
B. A sandwich with peanut butter and jelly.
C. A freshly baked soft oatmeal cookie.
D. A bowl of buttered popcorn.

Answers and Rationales

1. Correct answer:

B. Processed sandwich meats. Processed meats, including those used in sandwiches, have been linked to a higher occurrence of gastric cancer. The reason behind this association lies in the preservatives and additives used in processed meats, such as nitrates and nitrites, which can form carcinogenic compounds called nitrosamines.

The consumption of processed meats has been classified by the World Health Organization’s International Agency for Research on Cancer (IARC) as Group 1, carcinogenic to humans. This classification is based on sufficient evidence that consuming processed meats can cause colorectal cancer, and there is also a positive association with stomach cancer. The risk increases with the amount of meat consumed.

Think of a garden where you want to grow healthy plants (cells in the stomach). If you consistently use a fertilizer (processed meats) containing harmful chemicals, over time, these chemicals can damage the plants and soil (cells and tissues in the stomach), leading to unwanted growth (cancer). Just as you would choose organic and natural fertilizers for a healthy garden, selecting unprocessed and natural food items can reduce the risk of harmful effects on the body.

Incorrect answer options:

A. Sweets made from processed sugars. While excessive consumption of processed sugars can lead to obesity and other health issues, there is no direct scientific evidence linking processed sugars specifically to gastric cancer. Obesity itself is a risk factor for many types of cancer, but the connection between processed sugars and gastric cancer is not as direct and well-established as with processed meats.

C. Fizzy soft drinks. Although fizzy soft drinks can contribute to obesity and other metabolic issues, they have not been directly linked to gastric cancer. The high sugar content and acidity may cause other gastrointestinal issues, but the relationship between these drinks and gastric cancer is not supported by current scientific research.

D. Products from milk. Dairy products, including milk, have not been directly linked to gastric cancer. Some studies suggest that dairy products might even have a protective effect against certain types of cancer. However, individual tolerance to lactose and the fat content in dairy products might influence overall health, but they are not directly associated with an increased risk of gastric cancer.

2. Correct answer:

C. Voicing feelings of diminished self-value. Severe depression often leads to feelings of worthlessness, hopelessness, and diminished self-value. Alex’s silence and avoidance of conversation may be indicative of these feelings. It can be incredibly challenging for individuals experiencing severe depression to articulate their emotions, especially when those emotions are tied to a profound sense of inadequacy or self-loathing.

Emma, as a psychiatric nurse, would recognize that Alex’s behavior is not merely a refusal to communicate but a symptom of a deeper struggle. She would understand that engaging with Alex requires patience, empathy, and a non-judgmental approach.

Imagine trying to describe a complex piece of art when you’ve lost all the words for colors, shapes, and emotions. That’s what it might feel like for Alex to voice feelings of diminished self-value. The words and the ability to connect with others are stifled by the overwhelming weight of depression, much like trying to see through a dense fog that obscures everything.

Incorrect answer options:

A. Relying on others for support. While it’s true that individuals with depression may find it difficult to reach out for support, Alex’s silence and avoidance of conversation are more directly related to an internal struggle with self-value rather than a reluctance to rely on others.

B. Conveying resentment or displeasure towards others. Alex’s behavior does not necessarily indicate resentment or displeasure towards others. While irritability can be a symptom of depression, the scenario described focuses more on Alex’s withdrawal and silence, which align more closely with feelings of diminished self-value.

D. Speaking about feelings of regret and guilt. While regret and guilt can be components of depression, the specific behavior described in the scenario (silence and avoidance of conversation) aligns more directly with the challenge of voicing feelings of diminished self-value. These feelings may encompass regret and guilt, but the core issue is likely a profound sense of worthlessness.

3. Correct answer:

D. Past incidents highlighting harm or cruelty towards animals. Antisocial personality disorder (ASPD) is characterized by a persistent pattern of disregard for the rights of others and a lack of empathy. Individuals with this disorder often exhibit behaviors that violate social norms and may engage in acts of aggression, manipulation, and deceit.

One of the early signs of ASPD, especially during childhood and adolescence, is cruelty towards animals. This behavior is considered a red flag and may be indicative of underlying issues related to empathy, impulse control, and aggression.

Think of ASPD as a broken moral compass. While most people’s compasses guide them towards empathy, compassion, and adherence to social norms, those with ASPD have a compass that doesn’t point in the expected direction. Cruelty towards animals can be seen as a manifestation of this broken compass, where the individual fails to recognize or care about the suffering they are causing.

Incorrect answer options:

A. Indications of lower cognitive capabilities. ASPD is not associated with lower cognitive abilities. In fact, some individuals with this disorder may be quite intelligent and use their intelligence to manipulate others.

B. Records showing consistent job tenure. Individuals with ASPD often struggle with maintaining consistent employment due to their impulsivity, lack of adherence to rules, and potential conflicts with coworkers or supervisors. This option is contrary to what might be expected in a person with this diagnosis.

C. Statements showing regret for past behaviors. A hallmark of ASPD is a lack of remorse or guilt for wrongdoing. Individuals with this disorder are unlikely to express genuine regret for their actions, as they typically lack empathy and concern for the feelings and rights of others.

4. Correct answer:

D. A patient with multifaceted medical conditions needing sophisticated evaluation. Licensed Vocational Nurses (LVNs), also known as Licensed Practical Nurses (LPNs) in some jurisdictions, are typically responsible for providing basic nursing care under the supervision of a Registered Nurse (RN) or physician. They can administer medications, perform routine procedures, and assist with daily personal tasks. However, they are generally not trained or authorized to conduct complex evaluations or care for patients with multifaceted medical conditions that require sophisticated assessments and interventions.

Think of the nursing team as a musical ensemble. The RNs are like the lead musicians, capable of playing intricate solos and handling complex compositions, while the LVNs are like the supporting musicians, playing essential but less complex parts. Assigning an LVN to a patient needing sophisticated evaluation would be like asking a supporting musician to play a lead solo for which they haven’t been trained. The result might be discordant and not meet the needs of the composition (patient care).

Incorrect answer options:

A. Someone with a controlled chronic illness requiring usual care. LVNs are well-equipped to care for patients with controlled chronic illnesses, as this typically involves routine monitoring and administration of medications.

B. An individual needing a basic dressing replacement for a small injury. Dressing changes, even for minor injuries, are within the scope of practice for an LVN. They are trained to perform such tasks and can do so under the supervision of an RN or physician.

C. A patient seeking help with daily personal tasks. Assisting with daily personal tasks such as bathing, dressing, and eating is a fundamental part of an LVN’s responsibilities. They are trained to provide this type of care and often do so in various healthcare settings.

5. Correct answer:

D. Providing medication to alleviate pain. When dealing with full-thickness burns, pain management is a critical aspect of care, especially during dressing changes. Sulfamylon cream, an antimicrobial agent used to prevent infection in burn wounds, can cause discomfort when applied. Therefore, administering pain medication prior to the dressing change is essential to ensure the patient’s comfort and cooperation during the procedure.

Imagine trying to clean and repair a delicate piece of machinery while it’s vibrating and shaking uncontrollably. It would be nearly impossible to do the job accurately and safely. Similarly, trying to change the dressing on a painful burn wound without first managing the pain would be like working on that shaking machinery. The patient’s discomfort could lead to movement and tension, making the procedure more difficult and potentially less effective. By “turning off” or at least reducing the pain (the shaking), Lila can perform the dressing change more efficiently and humanely.

Incorrect answer options:

A. Measuring blood sugar using a finger stick. While monitoring blood sugar is important in patient care, it is not the priority action when prepping for a dressing change with Sulfamylon cream on full-thickness burns.

B. Asking for a daily blood test to assess overall health. While assessing overall health is essential, it is not the immediate priority in this specific situation. The focus should be on managing the pain associated with the dressing change.

C. Ensuring proper urinary output is being maintained. Monitoring urinary output is vital in burn care to assess kidney function and hydration, but it is not the immediate priority when preparing for a painful procedure like a dressing change with Sulfamylon cream.

6. Correct answer:

B. Dragging a toy trailing behind while walking. Gross motor skills involve the larger muscles of the body and are responsible for fundamental movements such as walking, running, and jumping. For toddlers, who are typically in the age range of 1 to 3 years, dragging a toy behind while walking is a classic example of a gross motor skill. This action requires coordination, balance, and the use of large muscle groups.

Think of gross motor skills as the foundation of a building. Just as the foundation supports the entire structure, gross motor skills support the child’s ability to move and interact with the world. Dragging a toy while walking is like adding a decorative element to the foundation – it’s a sign that the basic structure (walking) is strong enough to support something more complex (dragging a toy).

Incorrect answer options:

A. Demonstrating the ability to imitate a horizontal stroke. This is more related to fine motor skills, which involve smaller muscle movements, particularly in the hands and fingers.

C. Executing a wide leap. While leaping is a gross motor skill, it’s typically beyond the ability of a toddler. This action requires more advanced coordination and strength.

D. Constructing a stack of eight toy blocks. This activity is more related to fine motor skills, as it requires precise hand-eye coordination and the use of small muscles in the hands and fingers.

7. Correct answer:

B. Document the pulse rate and proceed with giving the medication.Digoxin is a medication used to treat various heart conditions, including congenital heart defects in infants. It works by slowing down the heart rate and allowing the heart to beat more forcefully and efficiently. Before administering digoxin, it’s crucial to check the patient’s apical pulse rate, as a very low heart rate could be a sign of digoxin toxicity.

In infants, the normal apical pulse rate ranges from 100 to 160 beats per minute. Since the baby’s pulse rate is 100, it falls within the normal range, and there is no indication to withhold the medication.

Think of the heart as a pump and the pulse rate as the speed at which it’s pumping. Digoxin is like a tool that fine-tunes this pump. If the pump is going too slow, using the tool might cause it to stop. If it’s within the right speed, the tool can make it work more efficiently. Checking the pulse is like checking the speed of the pump before using the tool.

Incorrect answer options:

A. Delay the dose, then reassess the pulse in half an hour. This would be incorrect because the pulse rate is within the normal range, and there is no need to delay the medication.

C. Provide the medication and re-evaluate the pulse after a quarter of an hour. While it’s essential to monitor the patient after administering digoxin, the specific time frame mentioned here is arbitrary and not aligned with standard nursing practice for digoxin administration.

D. Take note of the pulse and immediately contact the doctor. This action would be unnecessary since the pulse rate is within the normal range, and there is no indication of a problem that would require immediate physician intervention.

8. Correct answer:

C. Using chelating agents.Lead poisoning occurs when lead builds up in the body, often over months or years. It can cause severe mental and physical impairment. In cases of significant lead poisoning, chelating agents are used to bind to the lead in the body, forming a compound that can be excreted in the urine. This treatment helps to reduce the levels of lead in the blood and tissues.

Imagine lead in the body as unwanted stickers stuck to a wall. Chelating agents act like a special solution that loosens the adhesive on the stickers, allowing them to be easily removed and washed away. Without this solution, the stickers (lead) would remain stuck, causing damage to the wall (the body).

Incorrect answer options:

A. Administering activated charcoal. Activated charcoal is used to treat certain types of poisoning by absorbing the toxic substance, but it is not effective in treating lead poisoning.

B. Providing drugs to prevent vomiting. While managing symptoms is essential in any poisoning case, administering drugs to prevent vomiting is not a specific treatment for lead poisoning.

D. Performing a stomach wash or gastric lavage. This procedure is used to cleanse the stomach in cases of acute poisoning with substances that have been ingested. Lead poisoning often occurs over a prolonged period, and a stomach wash would not be effective in removing lead that has already been absorbed into the body.

9. Correct answer:

B. Restraining the child’s elbows. Cleft palate repair is a delicate surgical procedure, and post-operative care is crucial to ensure proper healing. One of the main concerns is to prevent the child from touching or disturbing the surgical site, which could lead to complications such as infection or disruption of the sutures.

In pediatric post-operative care for cleft palate repair, elbow restraints are commonly used. These restraints are soft and padded, designed to limit the child’s ability to bend their elbows, thus preventing them from reaching their mouth and surgical site. The restraints are not overly tight and allow for some movement, ensuring that the child’s circulation is not compromised. They are typically used only during specific times, such as when the child is unsupervised or sleeping, and are removed at regular intervals to allow for movement and exercises to prevent stiffness.

Imagine the child’s arms as the arms of a crane, and the elbows as the joints that allow the crane to bend and reach various locations. If the crane’s joints are temporarily locked, it can still move but cannot bend to reach certain areas. The elbow restraints act like these temporary locks, preventing the child from bending their arms to reach the mouth, but still allowing some movement and flexibility. It’s like putting a safety lock on a machine to ensure it doesn’t perform actions that could cause harm during a critical period.

Incorrect answer options:

A. Wrapping the child tightly, similar to a mummy. This method would be highly restrictive and uncomfortable for the child. It could lead to circulation problems, respiratory issues, and increased anxiety. It is not a standard practice in post-operative care for cleft palate repair.

C. Securing the child’s wrists. Wrist restraints would be overly restrictive and could cause distress to the child. They may also not be effective in preventing the child from reaching the surgical site, as the child might still be able to bend their elbows and reach their mouth.

D. Restricting the full length of the arm. This option would be too restrictive and could lead to complications such as muscle atrophy, joint stiffness, and psychological distress. It would also be unnecessary, as the goal is to prevent the child from reaching the mouth, which can be achieved with less restrictive elbow restraints.

10. Correct answer:

D. Banana. Hydrochlorothiazide is a diuretic medication often prescribed to treat high blood pressure and fluid retention. By increasing urine output, it helps the body get rid of excess salt and water. However, this process can also lead to the depletion of essential minerals like potassium. Low potassium levels can lead to muscle weakness, irregular heartbeat, and other health issues.

Bananas are an excellent source of potassium, containing around 400-450 mg of potassium per medium-sized banana. This makes them one of the most potassium-rich fruits available. Including bananas in the diet can help replenish potassium levels in individuals taking hydrochlorothiazide. The potassium in bananas is readily absorbed by the body and can contribute to maintaining a healthy balance of this essential mineral.

Think of potassium as the fuel that keeps a car’s engine running smoothly. Hydrochlorothiazide is like a process that accidentally lets some of this fuel leak out. Eating a banana is like adding high-quality fuel back into the tank, ensuring that the engine continues to run efficiently. Other fruits might also add fuel, but bananas are like a premium fuel that replenishes the tank more effectively.

In addition to their potassium content, bananas are also rich in other nutrients, including vitamin C, vitamin B6, and dietary fiber. They are easily accessible, affordable, and can be incorporated into various meals and snacks, making them a practical choice for those looking to boost their potassium intake.

Incorrect answer options:

A. Orange. While oranges do contain potassium, they have a lower content compared to bananas, with around 250 mg per medium-sized orange. They are a healthy fruit but would not be the most beneficial option for boosting potassium intake in this specific scenario. Oranges are more like a regular fuel that adds some energy to the tank but not as efficiently as the premium fuel (bananas).

B. Apple. Apples contain even less potassium than oranges, with approximately 150-200 mg per medium-sized apple. While they are a nutritious snack, they would not be the best choice for someone specifically looking to increase potassium levels. Apples in this analogy would be like a lower-grade fuel that adds some energy but is not the optimal choice for replenishing the tank.

C. Pear. Pears contain a similar amount of potassium to apples, around 170-200 mg per medium-sized pear. Again, while they are a healthy fruit, they are not the most effective option for increasing potassium levels in the context of hydrochlorothiazide therapy. Pears would also fall into the category of lower-grade fuel, providing some replenishment but not as effectively as bananas.

11. Correct answer:

C. Asthma. Timolol is a beta-blocker used in the form of eye drops to treat glaucoma by reducing intraocular pressure. While it is primarily used to affect the eyes, it can be absorbed systemically and have effects on other parts of the body. One of the significant concerns with timolol is its potential to cause bronchoconstriction, making it a risky medication for patients with asthma.

Asthma is a chronic inflammatory condition of the airways that leads to narrowing and spasms, causing difficulty in breathing. Beta-blockers like timolol can exacerbate this condition by blocking beta-2 receptors in the lungs, leading to increased bronchoconstriction. This can result in an asthma attack or worsen existing asthma symptoms.

Imagine the airways in the lungs as a series of tunnels, and asthma as a condition that causes these tunnels to narrow. Timolol is like a substance that can cause these already narrow tunnels to become even more constricted. For someone without asthma, this might not be a significant issue, but for someone with asthma, it’s like trying to drive through a tunnel that’s becoming increasingly narrow, making it difficult or even impossible to get through.

Nurse Elaine must be vigilant about this interaction and consider alternative treatments or closely monitor the patient if timolol is deemed necessary. Communication with the prescribing physician and patient education about potential symptoms and what to do if they occur would also be essential components of care.

Incorrect answer options:

A. Gastroesophageal reflux disease (GERD). While GERD is a common condition, it does not have a known interaction with timolol. Timolol’s mechanism of action is not related to the gastrointestinal system, and it is unlikely to exacerbate GERD symptoms. This option is like a road unrelated to the tunnels (airways) that timolol affects.

B. Osteoarthritis. Osteoarthritis is a degenerative joint disease and does not have a direct relationship with timolol administration. Timolol’s effects on the eyes and potential impact on the respiratory system do not interact with the joints or the underlying pathology of osteoarthritis. This option is like a bridge, another structure entirely, unrelated to the tunnels (airways) affected by timolol.

D. Hypothyroidism. Hypothyroidism, a condition characterized by an underactive thyroid gland, does not have a known significant interaction with timolol. Timolol’s effects are not related to thyroid function, and it is unlikely to impact the management or symptoms of hypothyroidism. This option is like a railway system, another transportation route, but not connected to the tunnels (airways) that timolol affects.

12. Correct answer:

B. Keeping a soft nightlight illuminated during the evening and night. Nighttime confusion, often referred to as “sundowning,” is a common issue in elderly patients, particularly those with cognitive impairments such as dementia. It can lead to agitation, wandering, and disorientation. Keeping a soft nightlight illuminated during the evening and night can be an effective intervention to reduce Mr. Thompson’s nighttime confusion.

A soft nightlight provides gentle illumination that helps orient the patient to their surroundings without disrupting their sleep. It can reduce anxiety and fear that may arise from waking up in a completely dark room, unfamiliar surroundings, or not being able to see clearly. The gentle light can provide comfort and a sense of safety, making it easier for the patient to recognize their environment and reduce disorientation.

Imagine waking up in a completely unfamiliar place with no light to guide you. The confusion and fear you might feel are similar to what Mr. Thompson experiences. A soft nightlight acts like a gentle guide, providing just enough light to help him recognize his surroundings without startling him. It’s like having a familiar landmark in sight when you’re navigating an unknown place.

This intervention is non-invasive and respects the patient’s autonomy and dignity. It aligns with a person-centered approach to care, recognizing the individual’s unique needs and preferences. Nurse Miranda can also combine this strategy with other non-pharmacological interventions, such as maintaining a consistent bedtime routine, providing familiar objects, and offering reassurance, to create a comprehensive plan to minimize Mr. Thompson’s confusion.

Incorrect answer options:

A. Pairing him with another elderly roommate. While social interaction can be beneficial, pairing Mr. Thompson with another elderly roommate may not necessarily reduce his nighttime confusion. It could even lead to increased agitation if the roommate’s habits or needs conflict with Mr. Thompson’s. This approach might not address the underlying cause of his confusion.

C. Giving him a sedative at bedtime. While sedatives might seem like a quick solution, they can have serious side effects, especially in the elderly. They may lead to increased confusion, falls, and other health complications. This approach might mask the symptoms without addressing the underlying issue and could compromise Mr. Thompson’s overall well-being.

D. Having a nursing assistant remain by his side until he’s asleep. While personal attention can be comforting, this approach may not be practical or sustainable in a busy healthcare setting. It also doesn’t address what happens if Mr. Thompson wakes up during the night, and it may create dependency without addressing the underlying cause of his confusion.

13. Correct answer:

A. Persistent itching. End-stage renal failure, also known as end-stage renal disease (ESRD), is the final stage of chronic kidney disease. The kidneys lose their ability to filter waste products and excess minerals from the blood effectively. One of the common symptoms in this stage is persistent itching, also known as pruritus.

The itching in ESRD is often a result of the accumulation of waste products, particularly phosphorus, in the blood. When the kidneys are unable to filter phosphorus properly, it can bind with calcium and deposit in the skin, leading to itching. Additionally, the imbalance of other minerals and the dryness of the skin, often seen in renal failure, can contribute to this uncomfortable symptom.

Imagine the kidneys as a water purification system that filters out impurities from the water (blood). In end-stage renal failure, this system is broken, and the impurities start to build up. The persistent itching is like a constant reminder or alarm signal that the filtration system is not working, and the impurities are accumulating.

Persistent itching can significantly impact the quality of life, leading to discomfort, sleep disturbances, and emotional distress. Management may include phosphate binders to reduce phosphorus levels, proper skin care to prevent dryness, and sometimes antihistamines to alleviate the itching. Nurse Karen’s understanding of this symptom and its underlying cause is essential in providing effective care and support to Mr. Rodriguez.

Incorrect answer options:

B. Significant weight loss. While weight changes can occur in renal failure, significant weight loss is not typically a hallmark symptom of end-stage renal failure. Instead, patients may experience weight gain due to fluid retention. Weight loss might be associated with other underlying conditions or advanced illness but is not specific to ESRD.

C. Ringing sensations in the ears. Ringing in the ears, or tinnitus, is not commonly associated with end-stage renal failure. It may be related to other conditions, such as hearing loss, earwax blockage, or certain medications, but it is not a characteristic symptom of terminal stages of renal failure.

D. Frequent bruising. While patients with renal failure may have abnormalities in their blood clotting due to imbalances in electrolytes and other factors, frequent bruising is not a commonly voiced symptom specific to end-stage renal failure. It may occur in some cases but is not as prevalent or characteristic as persistent itching.

14. Correct answer:

B. Specialized mandibular wire cutters. A fractured mandible, or broken jaw, is often repaired using wires, plates, or screws to stabilize the bone as it heals. In the case of wiring, the jaws may be wired shut to keep them aligned. This can pose a risk of airway obstruction, particularly if the patient were to vomit or experience other issues that might require the mouth to be opened quickly.

Specialized mandibular wire cutters are designed to quickly cut through the wires used in jaw fixation. Having these wire cutters readily accessible allows for rapid intervention in an emergency situation where the wires need to be cut to open the mouth.

Think of the wires holding the jaw as a locked gate, and the specialized mandibular wire cutters as the key to that gate. In an emergency, you would need that specific key to unlock the gate quickly. Other tools might eventually open the gate, but they would take longer and might cause additional damage.

Nurse Martin should educate Mr. James and his caregivers about the importance of keeping these wire cutters accessible at all times and provide clear instructions on when and how to use them. This education is a crucial part of discharge planning and ensures that the patient and family are prepared to manage potential emergencies at home.

Incorrect answer options:

A. A ready-to-use tracheostomy kit. While maintaining an open airway is a priority, a tracheostomy kit would not typically be required for a patient with a repaired fractured mandible going home. It is a more invasive intervention and would not be the first line of action in an emergency.

C. An emergency oral airway device. An oral airway device might not be suitable for a patient with a wired jaw, as it requires insertion into the mouth. The specialized wire cutters would be the more appropriate tool to address an airway emergency in this context.

D. Medical-grade pliers. While pliers might be used in a medical setting, specialized mandibular wire cutters are designed specifically to cut the wires used in jaw fixation. They are the appropriate tool to have on hand for a patient with a repaired fractured mandible.

15. Correct answer:

A. Coumadin 10 mg taken orally. Coumadin (warfarin) is an anticoagulant medication used to prevent blood clots. The dosage of Coumadin requires careful monitoring and adjustment based on laboratory values, specifically the International Normalized Ratio (INR). The order “Coumadin 10 mg taken orally” lacks essential information regarding the frequency of administration and the context in which the dose should be given (e.g., based on INR levels).

The correct dosage of Coumadin is highly individualized and depends on various factors, including the patient’s age, weight, diet, other medications, and specific medical condition. Regular monitoring of INR levels is crucial to ensure that the patient is receiving the appropriate dose to achieve the desired anticoagulant effect without increasing the risk of bleeding.

Think of Coumadin dosage as a finely tuned musical instrument. Just as a musician must carefully tune an instrument to achieve the perfect sound, healthcare providers must carefully adjust the dosage of Coumadin to achieve the perfect balance between preventing clots and avoiding excessive bleeding. The order “Coumadin 10 mg taken orally” is like telling a musician to “play a note” without specifying which note, how loud, or how often.

Nurse Lucy should seek clarification from the prescribing provider to ensure that the order includes specific instructions regarding the frequency of administration and any necessary monitoring or adjustments based on laboratory values. This clarification is essential to ensure patient safety and the effectiveness of the medication.

Incorrect answer options:

B. Nembutal 100 mg to be taken orally at bedtime. This order is clear and specific, providing the medication name, dose, route, and timing of administration. Nembutal (pentobarbital) is a barbiturate, and the order provides all the necessary information for safe administration.

C. Estrace 2 mg orally every day. This order for Estrace (estradiol), a form of estrogen used in hormone replacement therapy, is also clear and specific. It includes the medication name, dose, route, and frequency of administration, providing all the necessary information for proper dispensing and administration.

D. Darvocet 65 mg taken orally every 4–6 hours as needed. Darvocet is a combination of acetaminophen and propoxyphene, used for pain relief. This order is clear, providing the medication name, dose, route, frequency, and indication (as needed for pain), allowing for safe administration.

16. Correct answer:

C. Low in sodium. Meniere’s syndrome is a disorder of the inner ear that can lead to vertigo, hearing loss, tinnitus, and ear fullness. One of the key management strategies for Meniere’s syndrome is dietary modification, specifically a low-sodium diet.

A low-sodium diet helps regulate the fluid balance within the inner ear. In Meniere’s syndrome, there is an abnormal buildup of fluid in the inner ear, leading to the symptoms of the condition. Sodium plays a crucial role in regulating fluid balance in the body, and a high-sodium diet can exacerbate fluid retention. By reducing sodium intake, the fluid balance in the inner ear can be better controlled, potentially reducing the frequency and severity of symptoms.

Imagine the inner ear as a delicate garden that requires just the right amount of water to thrive. Too much water (fluid) can drown the plants (cause symptoms), while too little can cause them to wither. Sodium in the diet acts like a garden hose with a faulty nozzle that can either release too much or too little water. By controlling the sodium (adjusting the nozzle), you can regulate the water flow to keep the garden healthy.

Nurse Aaron should provide detailed guidance on following a low-sodium diet, including reading food labels, choosing fresh and unprocessed foods, avoiding high-sodium condiments and seasonings, and cooking with herbs and spices to enhance flavor without adding salt. Patient education and support are vital to help the patient understand the importance of this dietary change and how to implement it effectively.

Incorrect answer options:

A. Low in fiber. A low-fiber diet is not specifically related to the management of Meniere’s syndrome. Fiber is essential for digestive health, but it does not have a direct impact on the fluid balance in the inner ear or the symptoms of Meniere’s syndrome.

B. High in iodine. While iodine is essential for thyroid function, a high-iodine diet is not a recommended treatment for Meniere’s syndrome. Iodine does not have a direct impact on the fluid balance in the inner ear or the symptoms of this condition.

D. High in fiber. A high-fiber diet is generally recommended for overall health, particularly digestive health, but it is not specifically related to the management of Meniere’s syndrome. Fiber does not affect the fluid balance in the inner ear or the symptoms of Meniere’s syndrome.

17. Correct answer:

D. Reduced urine output during the day. Right-sided heart failure, also known as right ventricular failure, occurs when the right side of the heart is unable to pump blood effectively to the lungs. This leads to a backup of blood in the systemic venous system, causing symptoms related to fluid retention and systemic congestion.

Reduced urine output during the day is a typical finding in right-sided heart failure. The decreased pumping ability of the right heart leads to reduced blood flow to the kidneys. This, in turn, causes the kidneys to retain sodium and water, leading to decreased urine production. The retention of fluid can also lead to swelling in the legs, ankles, and abdomen.

Think of the right side of the heart as a pump that sends water (blood) to a filtration system (the lungs). If the pump is not working efficiently, the water starts to back up, causing a flood in other areas (the systemic venous system). This backup leads to less water reaching the filtration plant (kidneys), resulting in less filtered water (urine) being produced.

Nurse Emily’s understanding of this symptom and its underlying cause is essential in accurately assessing Mr. Hansen’s condition and contributing to an appropriate care plan. Monitoring urine output and other signs of fluid retention will be crucial in managing his right-sided heart failure.

Incorrect answer options:

A. Increased urination during the night. This symptom, known as nocturia, is more commonly associated with left-sided heart failure, where fluid retention during the day leads to increased urination at night when the patient is lying down.

B. Difficulty breathing or shortness of breath. While this can be a symptom of heart failure, it is more typically associated with left-sided heart failure, where fluid backs up into the lungs, causing breathing difficulties.

C. Crackling sounds when listening to the lungs. This finding, known as crackles or rales, is also more indicative of left-sided heart failure, where fluid accumulation in the lungs leads to these characteristic sounds during auscultation.

18. Correct answer:

C. Position the probe snugly on Timmy’s finger. Measuring oxygen saturation (O2 saturation) is a vital part of assessing a patient’s respiratory function, especially in a child with an upper-respiratory infection. The pulse oximeter works by shining light through a translucent part of the patient’s body, usually a finger, toe, or earlobe, and measuring the amount of oxygenated hemoglobin.

Positioning the probe snugly on Timmy’s finger ensures that the oximeter has a good contact with the skin and can accurately measure the oxygen saturation. It’s essential that the probe is neither too tight (which could restrict blood flow) nor too loose (which could allow ambient light to interfere with the reading). The finger is typically a suitable site for children and adults, providing a reliable reading when properly positioned.

Think of the pulse oximeter as a detective trying to solve a mystery (the oxygen saturation level). The finger is like a reliable witness who can provide accurate information. If the detective doesn’t listen carefully (the probe is not positioned snugly), the information might be misunderstood or missed entirely.

Nurse Jessica should also ensure that Timmy’s finger is clean and warm, as dirt or nail polish and poor circulation can affect the reading. She should observe the oximeter’s waveform and wait for the reading to stabilize, which usually takes a few seconds to a minute, rather than 15 minutes. Her understanding of proper probe placement and attention to these details will contribute to an accurate assessment of Timmy’s respiratory status.

Incorrect answer options:

A. Secure the probe and patiently wait 15 minutes before noting the reading. Waiting 15 minutes is unnecessary and not a standard practice. The oximeter usually provides a stable reading within a few seconds to a minute. Prolonged waiting could delay necessary interventions or care.

B. Attach the probe to Timmy’s abdominal area. The abdominal area is not a suitable site for measuring oxygen saturation with a pulse oximeter. The oximeter requires a translucent part of the body, such as a finger, toe, or earlobe, where it can detect the pulsatile flow of oxygenated blood.

D. Make sure to recalibrate the oximeter at the start of her shift. While proper maintenance of medical equipment is essential, recalibration of a pulse oximeter is typically done by biomedical technicians or as per the manufacturer’s guidelines. Regular recalibration at the start of each shift is not a standard nursing practice.

19. Correct answer:

D. Use the precise calibrated dropper that comes with the medication bottle. Lanoxin (digoxin) is a medication used to treat heart conditions, including Tetralogy of Fallot in infants. Proper administration is crucial, as incorrect dosing can lead to toxicity or reduced effectiveness. The calibrated dropper that comes with the medication bottle is designed to deliver the exact prescribed dose.

Using the calibrated dropper ensures that Mrs. Johnson administers the correct amount of medication to her infant. Nurse Eliza should demonstrate how to fill the dropper to the correct line and how to dispense the medication into the baby’s mouth, usually to the side of the mouth to prevent choking. She should also emphasize the importance of not using any other tools to measure the medication, as they may not provide an accurate dose.

Think of the calibrated dropper as a tailor-made suit for the baby. Just as a tailor-made suit fits perfectly, the calibrated dropper is designed to fit the specific needs of the medication, ensuring the right dose. Using a different tool would be like trying to dress the baby in an adult’s suit – it might cover the baby, but it won’t fit properly.

Nurse Eliza’s education should also include information about storing the medication, potential side effects, and what to do if a dose is missed. Her thorough instruction will empower Mrs. Johnson to administer the medication safely and effectively at home, contributing to the ongoing care of her infant with Tetralogy of Fallot.

Incorrect answer options:

A. Give the medicine in a baby bottle mixed with 1oz. of water. Mixing the medication with water in a baby bottle can lead to inaccurate dosing, as the baby may not consume the entire bottle. This method also risks diluting the medication, reducing its effectiveness.

B. Use a plastic baby spoon to deliver the medication. A plastic baby spoon is not a precise measuring tool for medication administration. Using a spoon could lead to underdosing or overdosing, as it is not calibrated to deliver the exact prescribed amount of Lanoxin elixir.

C. Dispense the medicine through a nipple. Administering medication through a nipple can also lead to inaccurate dosing, as it does not provide a precise way to measure the medication. Additionally, the baby may associate the nipple with medication taste, leading to feeding difficulties.

20. Correct answer:

B. “I understand that this can be a concerning procedure, but it’s done routinely, and I’ll be here with you throughout. Would you like more information about what to expect?” Electroconvulsive therapy (ECT) can be an anxiety-provoking procedure for many patients. Nurse Bennett’s statement in option B acknowledges Mrs. Clarke’s feelings, reassures her of the routine nature of the procedure, and offers support and additional information if desired. This approach is therapeutic because it validates the patient’s emotions, provides comfort, and empowers her with knowledge.

Think of ECT as a journey through an unfamiliar tunnel. Mrs. Clarke is understandably anxious about what lies ahead. Nurse Bennett’s role is like that of a guide who has been through the tunnel many times. By acknowledging the fear, reassuring her of the routine nature of the journey, and offering to explain what to expect, Nurse Bennett helps Mrs. Clarke feel more comfortable and prepared for the experience.

Incorrect answer options:

A. “Don’t worry about the procedure; everything will be fine.” This statement dismisses Mrs. Clarke’s feelings and fails to provide any concrete information or reassurance. It may come across as insincere or patronizing.

C. “You should trust the doctors; they know what they’re doing.” While it’s true that medical professionals are trained and experienced, this statement doesn’t address Mrs. Clarke’s specific concerns or offer any comfort or support. It may feel dismissive of her feelings.

D. “Many patients go through this and it’s not a big deal.” This statement minimizes Mrs. Clarke’s anxiety and may make her feel isolated or misunderstood. What may not be a “big deal” to others may indeed be a significant concern for her, and this response fails to acknowledge that.

21. Correct answer:

D. Position her in a semi-Fowler’s position, using pillows to provide support to her head and neck. After thyroid removal surgery, it’s essential to prioritize the patient’s airway and comfort. The semi-Fowler’s position, where the patient is reclined with the head elevated at an angle of 30 to 45 degrees, helps maintain an open airway and reduces swelling. Supporting the head and neck with pillows provides stability and comfort, minimizing strain on the surgical site.

The positioning in semi-Fowler’s allows for close monitoring of potential complications such as bleeding, respiratory distress, or nerve damage. It also facilitates drainage and minimizes tension on the suture line, promoting healing. Nurse Alex should also be vigilant for signs of hypocalcemia, a potential complication of thyroid surgery, and provide appropriate care and education.

Think of the neck as a newly constructed bridge, and the surgical site as the main supporting pillar. Just as the bridge needs proper support and alignment to function well and avoid unnecessary stress, Mrs. Wallace’s neck requires careful positioning and support to heal properly and maintain function.

Incorrect answer options:

A. Prompt her to cough and take deep breaths every 2 hours, while keeping her neck flexed. While deep breathing is generally encouraged post-surgery, flexing the neck after thyroid surgery could put undue stress on the surgical site, potentially leading to complications.

B. Ensure she remains flat on her back with sandbags on either side of her head and neck for support. Lying flat on the back can compromise the airway and increase swelling in the neck area. Sandbags may cause unnecessary pressure and discomfort, potentially affecting the surgical site.

C. Motivate her to rotate her head from side to side to help with oral secretion drainage. Rotating the head from side to side could strain the surgical site and may not be appropriate immediately after thyroid surgery. Controlled and gentle movements may be encouraged later in the recovery process under medical guidance.

22. Correct answer:

C. A rash resembling a target or bull’s eye. Lyme disease is a tick-borne illness caused by the bacterium *Borrelia burgdorferi*. One of the most characteristic and recognizable signs of Lyme disease is a skin rash that resembles a target or bull’s eye. This rash, known as erythema migrans, typically develops within 3 to 30 days after a tick bite.

The rash often starts as a small red spot at the site of the tick bite and expands over time, forming a circular pattern with a central clearing that looks like a bull’s eye. It’s usually not painful or itchy but may feel warm to the touch. The presence of this rash is a significant clue in diagnosing Lyme disease, especially in areas where the disease is prevalent.

Nurse Olivia’s emphasis on this symptom in her community health seminar is crucial, as early recognition and treatment of Lyme disease can prevent more serious complications such as joint, heart, and neurological problems. Educating the community about this distinctive rash helps empower individuals to seek medical care promptly if they notice the sign.

Think of the bull’s eye rash as a unique signature or logo for a brand. Just as a logo helps identify a specific company or product, the bull’s eye rash is a distinguishing feature that helps identify Lyme disease. Recognizing this “signature” symptom is key to early diagnosis and effective treatment.

Incorrect answer options:

A. Raised patches. Raised patches are not typically associated with Lyme disease. They can be a sign of various other skin conditions but are not characteristic of the erythema migrans rash seen in Lyme disease.

B. Bumpy, crusty spots. Bumpy, crusty spots can be indicative of other skin disorders, such as eczema or psoriasis, but they are not a typical manifestation of Lyme disease. This description does not match the characteristic bull’s eye rash.

D. Large fluid-filled blisters. Large fluid-filled blisters are not a common symptom of Lyme disease. They may be associated with other skin conditions or infections but are not indicative of the erythema migrans rash that is often present in early Lyme disease.

23. Correct answer:

C. Producing too much saliva. Chlorpromazine (Thorazine) is an antipsychotic medication commonly used to treat schizophrenia and other psychotic disorders. One of the common side effects of this medication is hypersalivation, or producing too much saliva. This can be a bothersome and noticeable side effect for patients.

Hypersalivation may lead to drooling and can be embarrassing for the patient. It can also cause difficulties in speaking and eating. Nurse Martin’s emphasis on this side effect is essential as part of patient education, as recognizing and managing side effects can improve adherence to medication. Strategies to manage this side effect might include chewing sugar-free gum to help swallow the excess saliva or using anticholinergic medications if the problem becomes severe.

Think of the salivary glands as a water faucet. Normally, the faucet releases just enough water (saliva) to keep the sink (mouth) moist. When taking chlorpromazine, it’s as if the faucet has been turned on too high, releasing more water than needed. This excess water can be inconvenient and requires strategies to manage, just as excess saliva requires attention and care.

Incorrect answer options:

A. Elevated blood pressure levels. While antipsychotic medications can have various cardiovascular effects, chlorpromazine is not specifically known to elevate blood pressure levels. In fact, it may cause low blood pressure, especially when standing up from a sitting or lying position.

B. Increased heart rate. Chlorpromazine can actually lead to a decreased heart rate rather than an increased one. It has a sedative effect and may slow down some of the body’s functions, including heart rate.

D. High blood sugar levels. Although some atypical antipsychotics are associated with an increased risk of high blood sugar levels and diabetes, chlorpromazine, a typical antipsychotic, is not particularly known for this side effect. Monitoring blood sugar levels is generally more relevant for patients on atypical antipsychotics.

24. Correct answer:

D. You might need to see your dentist more often due to gum concerns. Phenytoin (Dilantin) is an anticonvulsant medication used to treat and prevent seizures. One of the well-known side effects of phenytoin is gingival hyperplasia, or overgrowth of the gum tissue. This condition can lead to discomfort, difficulty in chewing, and an increased risk of gum infection.

Gingival hyperplasia usually starts as an inflammation and enlargement of the gums, particularly between the teeth. It can progress to involve more of the gums if left untreated. Regular dental check-ups and proper oral hygiene are essential to prevent or manage this side effect. Nurse James’s emphasis on this aspect of care is vital, as it directly impacts Ms. Lopez’s quality of life and her adherence to the medication.

Think of the gums as a garden, and phenytoin as a specific type of fertilizer that causes certain plants (gum tissue) to grow excessively. Just as a garden needs regular care and trimming to keep the plants healthy and in shape, the gums need regular dental care to manage the overgrowth caused by phenytoin.

Incorrect answer options:

A. It may disrupt your sleep patterns. Phenytoin is not typically associated with sleep disturbances. While any medication can have a wide range of side effects, this is not one that is commonly linked to phenytoin.

B. Consuming it with food can enhance its effectiveness. Phenytoin’s absorption is not significantly affected by food, and it doesn’t necessarily need to be taken with meals. The emphasis on taking it with food is not a key point in patient education for this medication.

C. It can reduce the potency of birth control pills. While some anticonvulsant medications can interact with hormonal birth control, phenytoin is not particularly known for this effect. It’s essential to review all medications and potential interactions, but this is not a primary concern with phenytoin.

25. Correct answer:

D. A bowl of buttered popcorn. Gluten-induced enteropathy, also known as celiac disease, is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Gluten is a protein found in wheat, barley, and rye. Therefore, individuals with celiac disease must avoid foods containing these grains.

A bowl of buttered popcorn is generally a suitable snack for a child with gluten-induced enteropathy, as popcorn is made from corn, which does not contain gluten. However, it’s essential to check the labels for any added flavorings or coatings that might contain gluten. Plain popcorn with butter (assuming no gluten-containing additives) can be a tasty and satisfying snack that aligns with a gluten-free diet.

Imagine gluten as a type of key that fits into specific locks (receptors) in the small intestine of a person with celiac disease. When the key fits into the lock, it triggers an immune response that damages the intestine. Foods without gluten don’t have this specific key, so they don’t trigger the reaction. Popcorn doesn’t have this “key,” making it a safe choice for those with gluten-induced enteropathy.

Incorrect answer options:

A. A slice of cheese pizza. Traditional pizza crust is made from wheat flour, which contains gluten. Therefore, a slice of cheese pizza would not be suitable for a child with gluten-induced enteropathy. Special gluten-free pizza crusts are available, but they were not specified in this option.

B. A sandwich with peanut butter and jelly. Standard bread used for sandwiches is made from wheat flour, containing gluten. While peanut butter and jelly themselves are usually gluten-free, the bread would make this snack unsuitable for a child with celiac disease.

C. A freshly baked soft oatmeal cookie. While oats themselves do not contain gluten, they are often processed in facilities that handle gluten-containing grains, leading to cross-contamination. Additionally, traditional oatmeal cookies may contain wheat flour. Unless specifically made with certified gluten-free oats and without wheat flour, this snack would not be suitable.