NCLEX- PN Practice Exam 2

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1. A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client’s:

  1. Level of consciousness
  2. Gag reflex
  3. Urinary output
  4. Movement of extremities

2. Which instruction should be included in the discharge teaching for the client with cataract surgery?

  1. Over-the-counter eyedrops can be used to treat redness and irritation.
  2. The eye shield should be worn at night.
  3.  It will be necessary to wear special cataract glasses.
  4. A prescription for medication to control post-operative pain will be needed.

3. An 8-year-old is admitted with drooling, muffled phonation, and a temperature of 102°F. The nurse should immediately notify the doctor because the child’s symptoms are suggestive of:

  1. Strep throat
  2. Epiglottitis
  3. Laryngotracheobronchitis
  4. Bronchiolitis

4. Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:

  1. Offer the baby sterile water between feedings of formula
  2. Apply an emollient to the baby’s skin to prevent drying
  3. Wear a gown, gloves, and a mask while caring for the infant
  4. Place the baby on enteric isolation

5. A teen hospitalized with anorexia nervosa is now permitted to leave her room and eat in the dining room. Which of the following nursing interventions should be included in the client’s plan of care?

  1. Weighing the client after she eats
  2. Having a staff member remain with her for 1 hour after she eats
  3. Placing high-protein foods in the center of the client’s plate
  4. Providing the client with child-size utensils

6. According to Erickson’s stage of growth and development, the developmental task associated with middle childhood is:

  1. Trust
  2. Initiative
  3. Independence
  4. Industry

7. The nurse should observe for side effects associated with the use of bronchodilators. A common side effect of bronchodilators is:

  1. Tinnitus
  2. Nausea
  3. Ataxia
  4. Hypotension

8. The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is:

  1. The mottled appearance of the trunk
  2. The presence of conjunctival hemorrhages
  3. Cyanosis of the hands and feet
  4. Respiratory rate of 20–28 per minute

9. A 5-month-old infant is admitted to the ER with a temperature of 103.6°F and irritability. The mother states that the child has been listless for the past several hours and that he had a seizure on the way to the hospital. A lumbar puncture confirms a diagnosis of bacterial meningitis. The nurse should assess the infant for:

  1. Periorbital edema
  2. Tenseness of the anterior fontanel
  3. Positive Babinski reflex
  4. Negative scarf sign

10. A client with a bowel resection and anastamosis returns to his room with an NG tube attached to intermittent suction. Which of the following observations indicates that the nasogastric suction is working properly?

  1. The client’s abdomen is soft.
  2. The client is able to swallow.
  3. The client has active bowel sounds.
  4. The client’s abdominal dressing is dry and intact.

11. The nurse is teaching the client with insulin-dependent diabetes the signs of hypoglycemia. Which of the following signs is associated with hypoglycemia?

  1. Tremulousness
  2. Slow pulse
  3. Nausea
  4. Flushed skin

12. Which of the following symptoms is associated with exacerbation of multiple sclerosis?

  1.  Anorexia
  2.  Seizures
  3.  Diplopia
  4.  Insomnia

13. Which of the following conditions is most likely related to the development of renal calculi?

  1. Gout
  2.  Pancreatitis
  3.  Fractured femur
  4.  Disc disease

14. A client with AIDS is admitted for treatment of wasting syndrome. Which of the following dietary modifications can be used to compensate for the limited absorptive capability of the intestinal tract?

  1. Thoroughly cooking all foods
  2. Offering yogurt and buttermilk between meals
  3. Forcing fluids
  4. Providing small, frequent meals

15. The treatment protocol for a client with acute lymphatic leukemia includes prednisone, methotrexate, and cimetadine. The purpose of the cimetadine is to:

  1. Decrease the secretion of pancreatic enzymes
  2. Enhance the effectiveness of methotrexate
  3. Promote peristalsis
  4. Prevent a common side effect of prednisone

16. Which of the following meal choices is suitable for a 6-month-old infant?

  1. Egg white, formula, and orange juice
  2. Apple juice, carrots, whole milk
  3. Rice cereal, apple juice, formula
  4. Melba toast, egg yolk, whole milk

17. The LPN is preparing to administer an injection of vitamin K to the newborn. The nurse should administer the injection in the:

  1. Rectus femoris muscle
  2. Vastus lateralis muscle
  3. Deltoid muscle
  4. Dorsogluteal muscle

18. The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephotic syndrome. The nurse should:

  1. Encourage the client to drink extra fluids
  2. Request a low-protein diet for the client
  3. Bathe the client using only mild soap and water
  4. Provide additional warmth for swollen, inflamed joints

19. The nurse is caring for a client with detoxification from alcohol. Which medication is used in the treatment of alcohol withdrawal?

  1. Antabuse (disulfiram)
  2. Romazicon (flumazenil)
  3. Dolophine (methodone)
  4. Ativan (lorazepam)

20. A client with insulin-dependent diabetes takes 20 units of NPH insulin at 7 a.m. The nurse should observe the client for signs of hypoglycemia at:

  1. 8 a.m.
  2. 10 a.m.
  3. 3 p.m.
  4. 5 a.m.

21. The licensed practical nurse is assisting the charge nurse in planning care for a client with a detached retina. Which of the following nursing diagnoses should receive priority?

  1. Alteration in comfort
  2. Alteration in mobility
  3. Alteration in skin integrity
  4. Alteration in O2 perfusion

22. The primary purpose for using a CPM machine for the client with a total knee repair is to help:

  1. Prevent contractures
  2. Promote flexion of the artificial joint
  3. Decrease the pain associated with early ambulation
  4. Alleviate lactic acid production in the leg muscles

23. Which of the following statements reflects Kohlberg’s theory of the moral development of the preschool-age child?

  1. Obeying adults is seen as correct behavior.
  2. Showing respect for parents is seen as important.
  3. Pleasing others is viewed as good behavior.
  4. Behavior is determined by consequences.

24. A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:

  1. Determine whether the ear infection has affected her hearing
  2. Make sure that she has taken all the antibiotic
  3. Document that the infection has completely cleared
  4. Obtain a new prescription in case the infection recurs

25. A factory worker is brought to the nurse’s office after a metal fragment enters his right eye. The nurse should:

  1. Cover the right eye with a sterile 4×4
  2. Attempt to remove the metal with a cotton-tipped applicator
  3. Flush the eye for 10 minutes with running water
  4. Cover both eyes and transport the client to the ER
Answers and Rationales
  1. Answer B is correct. The client’s gag reflex is depressed before having an EGD. The nurse should give priority to checking for the return of the gag reflex before offering the client oral fluids. Answer A is incorrect because conscious sedation is used. Answers C and D are not affected by the procedure; therefore, they are incorrect.
  2. Answer B is correct. The eye shield should be worn at night or when napping, to prevent accidental trauma to the operative eye. Prescription eyedrops, not over-the-counter eyedrops, are ordered for the client; therefore, Answer A is incorrect. The client might or might not require glasses following cataract surgery; therefore, answer C is incorrect. Answer D is incorrect because cataract surgery is pain free.
  3. Answer B is correct. The child’s symptoms are consistent with those of epiglottitis, an infection of the upper airway that can result in total airway obstruction. Symptoms of strep throat, laryngotracheobronchitis, and bronchiolitis are different than those presented by the client; therefore, answers A, C, and D are incorrect.
  4. Answer A is correct. Providing additional fluids will help the newborn eliminate excess bilirubin in the stool and urine. Answer B is incorrect because oils and lotions should not be used with phototherapy. Physiologic jaundice is not associated with infection; therefore, answers C and D are incorrect.
  5. Answer B is correct. Having a staff member remain with the client for 1 hour after meals will help prevent self-induced vomiting. Answer A is incorrect because the client will weigh more after meals, which can undermine treatment. Answer C is incorrect because the client will need a balanced diet and excess protein might not be well tolerated at first. Answer D is incorrect because it treats the client as a child rather than as an adult.
  6. Answer D is correct. According to Erikson’s Psychosocial Developmental Theory, the developmental task of middle childhood is industry versus inferiority. Answer A is incorrect because it is the developmental task of infancy. Answer B is incorrect because it is the developmental task of the school-age child. Answer C is incorrect because it is not one of Erikson’s developmental stages.
  7. Answer B is correct. A side effect of bronchodilators is nausea. Answers A and C are not associated with bronchodilators; therefore, they are incorrect. Answer D is incorrect because hypotension is a sign of toxicity, not a side effect.
  8. Answer C is correct. Although cyanosis of the hands and feet is common in the newborn, it accounts for an Apgar score of less than 10. Answer B suggests cooling, which is not scored by the Apgar. Answer B is incorrect because conjunctival hemorrhages are not associated with the Apgar. Answer D is incorrect because it is within normal range as measured by the Apgar.
  9. Answer B is correct. Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Answer A is incorrect because periorbital edema is not associated with meningitis. Answer C is incorrect because a positive Babinski reflex is normal in the infant. Answer D is incorrect because it relates to the preterm infant, not the infant with meningitis.
  10. Answer A is correct. Nasogastric suction decompresses the stomach and leaves the abdomen soft and nondistended. Answer B is incorrect because it does not relate to the effectiveness of the NG suction. Answer C is incorrect because it relates to peristalsis, not the effectiveness of the NG suction. Answer D is incorrect because it relates to wound healing, not the effectiveness of the NG suction.
  11. Answer A is correct. Tremulousness is an early sign of hypoglycemia. Answers B, C, and D are incorrect because they are symptoms of hyperglycemia.
  12. Answer C is correct. The most common sign associated with exacerbation of multiple sclerosis is double vision. Answers A, B, and D are not associated with adiagnosis of multiple sclerosis; therefore, they are incorrect.
  13. Answer A is correct. Gout and renal calculi are the result of increased amounts of uric acid. Answer B is incorrect because it does not contribute to renal calculi. Answers C and D can result from decreased calcium levels. Renal calculi are the result of excess calcium; therefore, answers C and D are incorrect.
  14. Answer D is correct. Providing small, frequent meals will improve the client’s appetite and help reduce nausea. Answer A is incorrect because it does not compensate for limited absorption. Foods and beverages containing live cultures are discouraged for the immune-compromised client; therefore, answer B is incorrect. Answer C is incorrect because forcing fluids will not compensate for limited absorption of the intestine.
  15.  Answer D is correct. A common side effect of prednisone is gastric ulcers. Cimetadine is given to help prevent the development of ulcers. Answers A, B, and C do not relate to the use of cimetadine; therefore, they are incorrect.
  16. Answer C is correct. Rice cereal, apple juice, and formula are suitable foods for the 6-month-old infant. Whole milk, orange juice, and eggs are not suitable for the young infant; therefore, they are incorrect.
  17. Answer B is correct. The nurse should administer the injection in the vastus lateralis muscle. Answers A and C are not as well developed in the newborn; therefore, they are incorrect. Answer D is incorrect because the dorsogluteal muscle is not used for IM injections until the child is 3 years of age.
  18. Answer A is correct. The client taking Cytoxan should increase his fluid intake to prevent hemorrhagic cystitis. Answers B, C, and D do not relate to the question; therefore, they are incorrect.
  19. Answer D is correct. Benzodiazepines are ordered for the client in alcohol withdrawal to prevent delirium tremens. Answer A is incorrect because it is a medication used in aversive therapy to maintain sobriety. Answer B is incorrect because it is used for the treatment of benzodiazepine overdose. Answer C is incorrect because it is the treatment for opiate withdrawal.
  20. Answer C is correct. The client taking NPH insulin should have a snack midafternoon to prevent hypoglycemia. Answers A and B are incorrect because the times are too early for symptoms of hypoglycemia. Answer D is incorrect because the time is too late and the client would be in severe hypoglycemia.
  21. Answer B is correct. The client with a detached retina will have limitations in mobility before and after surgery. Answer A is incorrect because a detached retina produces no pain or discomfort. Answers C and D do not apply to the client with a detached retina; therefore, they are incorrect.
  22. Answer B is correct. The primary purpose for the continuous passive-motion machine is to promote flexion of the artificial joint. The device should be placed at the foot of the client’s bed. Answers A, C, and D do not describe the purpose of the CPM machine; therefore, they are incorrect.
  23. Answer D is correct. According to Kohlberg, in the preconventional stage of development, the behavior of the preschool child is determined by the consequences of the behavior. Answers A, B, and C describe other stages of moral development; therefore, they are incorrect.
  24. Answer C is correct. The client should be assessed following completion of antibiotic therapy to determine whether the infection has cleared. Answer A would be done if there are repeated instances of otitis media; therefore, it is incorrect. Answer B is incorrect because it will not determine whether the child has completed the medication. Answer D is incorrect because the purpose of the recheck is to determine whether the infection is gone.
  25. Answer D is correct. The nurse should cover both of the client’s eyes and transport him immediately to the ER or the doctor’s office. Answers A, B, and D are incorrect because they increase the risk of further damage to the eye.

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