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NCLEX- PN Practice Exam 2 (PM)
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Question 1
Which of the following statements reflects Kohlberg’s theory of the moral development of the preschool-age child?
A
Obeying adults is seen as correct behavior.
B
Showing respect for parents is seen as important.
C
Behavior is determined by consequences.
D
Pleasing others is viewed as good behavior.
Question 1 Explanation:
According to Kohlberg, in the preconventional stage of development, the behavior of the preschool child is determined by the consequences of the behavior. Other answer choices describe other stages of moral development; therefore, they are incorrect.
Question 2
Which instruction should be included in the discharge teaching for the client with cataract surgery?
A
Over-the-counter eyedrops can be used to treat redness and irritation.
B
It will be necessary to wear special cataract glasses.
C
The eye shield should be worn at night.
D
A prescription for medication to control post-operative pain will be needed.
Question 2 Explanation:
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. The client might or might not require glasses following cataract surgery. Cataract surgery is pain free.
Question 3
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?
A
Providing small, frequent meals
B
Thoroughly cooking all foods
C
Forcing fluids
D
Offering yogurt and buttermilk between meals
Question 3 Explanation:
Providing small, frequent meals will improve the client’s appetite and help reduce nausea. Thoroughly cooking all foods is incorrect because it does not compensate for limited absorption. Foods and beverages containing live cultures are discouraged for the immune-compromised client; therefore, offering yogurt and buttermilk incorrect. Forcing fluids is incorrect because forcing fluids will not compensate for limited absorption of the intestine.
Question 4
A factory worker is brought to the nurse’s office after a metal fragment enters his right eye. The nurse should:
A
Cover both eyes and transport the client to the ER
B
Attempt to remove the metal with a cotton-tipped applicator
C
Cover the right eye with a sterile 4×4
D
Flush the eye for 10 minutes with running water
Question 4 Explanation:
The nurse should cover both of the client’s eyes and transport him immediately to the ER or the doctor’s office. Other answer choices are incorrect because they increase the risk of further damage to the eye.
Question 5
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:
A
3 p.m.
B
10 a.m.
C
5 a.m.
D
8 a.m.
Question 5 Explanation:
The client taking NPH insulin should have a snack midafternoon to prevent hypoglycemia. 8 a.m. and 10 a.m. are incorrect because the times are too early for symptoms of hypoglycemia. 5 a.m. is incorrect because the time is too late and the client would be in severe hypoglycemia.
Question 6
A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:
A
Document that the infection has completely cleared
B
Determine whether the ear infection has affected her hearing
C
Obtain a new prescription in case the infection recurs
D
Make sure that she has taken all the antibiotic
Question 6 Explanation:
The client should be assessed following completion of antibiotic therapy to determine whether the infection has cleared. Determine whether the ear infection has affected her hearing would be done if there are repeated instances of otitis media; therefore, it is incorrect. Make sure that she has taken all the antibiotic is incorrect because it will not determine whether the child has completed the medication. Obtain a new prescription in case the infection recurs is incorrect because the purpose of the recheck is to determine whether the infection is gone.
Question 7
Which of the following symptoms is associated with exacerbation of multiple sclerosis?
A
Diplopia
B
Seizures
C
Anorexia
D
Insomnia
Question 7 Explanation:
The most common sign associated with exacerbation of multiple sclerosis is double vision. Other answer choices are not associated with a diagnosis of multiple sclerosis; therefore, they are incorrect.
Question 8
According to Erickson’s stage of growth and development, the developmental task associated with middle childhood is:
A
Initiative
B
Industry
C
Independence
D
Trust
Question 8 Explanation:
According to Erikson’s Psychosocial Developmental Theory, the developmental task of middle childhood is industry versus inferiority. Trust is incorrect because it is the developmental task of infancy. Initiative is incorrect because it is the developmental task of the school-age child. Independence is incorrect because it is not one of Erikson’s developmental stages.
Question 9
Which of the following meal choices is suitable for a 6-month-old infant?
A
Apple juice, carrots, whole milk
B
Rice cereal, apple juice, formula
C
Melba toast, egg yolk, whole milk
D
Egg white, formula, and orange juice
Question 9 Explanation:
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.
Question 10
Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:
A
Apply an emollient to the baby’s skin to prevent drying
B
Wear a gown, gloves, and a mask while caring for the infant
C
Place the baby on enteric isolation
D
Offer the baby sterile water between feedings of formula
Question 10 Explanation:
Providing additional fluids will help the newborn eliminate excess bilirubin in the stool and urine. Oils and lotions should not be used with phototherapy. Physiologic jaundice is not associated with infection; therefore, wearing a gown, gloves, and a mask and placing the baby on enteric isolation are incorrect.
Question 11
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?
A
The client’s abdominal dressing is dry and intact.
B
The client’s abdomen is soft.
C
The client has active bowel sounds.
D
The client is able to swallow.
Question 11 Explanation:
Nasogastric suction decompresses the stomach and leaves the abdomen soft and nondistended. The client is able to swallow is incorrect because it does not relate to the effectiveness of the NG suction. The client has active bowel sounds is incorrect because it relates to peristalsis, not the effectiveness of the NG suction. The client’s abdominal dressing is dry and intact is incorrect because it relates to wound healing, not the effectiveness of the NG suction.
Question 12
A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client’s:
A
Movement of extremities
B
Urinary output
C
Gag reflex
D
Level of consciousness
Question 12 Explanation:
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. Level of consciousness is incorrect because conscious sedation is used. Urinary output and movement of extremities are not affected by the procedure; therefore, they are incorrect.
Question 13
The nurse should observe for side effects associated with the use of bronchodilators. A common side effect of bronchodilators is:
A
Ataxia
B
Nausea
C
Tinnitus
D
Hypotension
Question 13 Explanation:
A side effect of bronchodilators is nausea. Tinnitus and ataxia are not associated with bronchodilators; therefore, they are incorrect. Hypotension is incorrect because hypotension is a sign of toxicity, not a side effect.
Question 14
The primary purpose for using a CPM machine for the client with a total knee repair is to help:
A
Decrease the pain associated with early ambulation
B
Promote flexion of the artificial joint
C
Alleviate lactic acid production in the leg muscles
D
Prevent contractures
Question 14 Explanation:
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. Other answer choices do not describe the purpose of the CPM machine; therefore, they are incorrect.
Question 15
The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is:
A
Cyanosis of the hands and feet
B
The mottled appearance of the trunk
C
The presence of conjunctival hemorrhages
D
Respiratory rate of 20–28 per minute
Question 15 Explanation:
Although cyanosis of the hands and feet is common in the newborn, it accounts for an Apgar score of less than 10. The mottled appearance of the trunk suggests cooling, which is not scored by the Apgar. The presence of conjunctival hemorrhages is incorrect because conjunctival hemorrhages are not associated with the Apgar. Respiratory rate of 20–28 per minute is incorrect because it is within normal range as measured by the Apgar.
Question 16
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?
A
Alteration in O2 perfusion
B
Alteration in skin integrity
C
Alteration in comfort
D
Alteration in mobility
Question 16 Explanation:
The client with a detached retina will have limitations in mobility before and after surgery. Alteration in comfort is incorrect because a detached retina produces no pain or discomfort. Alteration in skin integrity and alteration in O2 perfusion do not apply to the client with a detached retina; therefore, they are incorrect.
Question 17
A 5-month-old infant is admitted to the ER with a temperature of 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:
A
Periorbital edema
B
Positive Babinski reflex
C
Negative scarf sign
D
Tenseness of the anterior fontanel
Question 17 Explanation:
Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Periorbital edema is incorrect because periorbital edema is not associated with meningitis. Positive Babinski reflex is incorrect because a positive Babinski reflex is normal in the infant. Negative scarf sign is incorrect because it relates to the preterm infant, not the infant with meningitis.
Question 18
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?
A
Providing the client with child-size utensils
B
Having a staff member remain with her for 1 hour after she eats
C
Weighing the client after she eats
D
Placing high-protein foods in the center of the client’s plate
Question 18 Explanation:
Having a staff member remain with the client for 1 hour after meals will help prevent self-induced vomiting. Weighing the client after she eats is incorrect because the client will weigh more after meals, which can undermine treatment. Placing high-protein foods in the center of the client’s plate is incorrect because the client will need a balanced diet and excess protein might not be well tolerated at first. Providing the client with child-size utensils is incorrect because it treats the client as a child rather than as an adult.
Question 19
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:
A
Laryngotracheobronchitis
B
Bronchiolitis
C
Strep throat
D
Epiglottitis
Question 19 Explanation:
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.
Question 20
Which of the following conditions is most likely related to the development of renal calculi?
A
Gout
B
Disc disease
C
Pancreatitis
D
Fractured femur
Question 20 Explanation:
Gout and renal calculi are the result of increased amounts of uric acid. Pancreatitis is incorrect because it does not contribute to renal calculi.Fractured femur and disc disease can result from decreased calcium levels. Renal calculi are the result of excess calcium.
Question 21
The nurse is caring for a client with detoxification from alcohol. Which medication is used in the treatment of alcohol withdrawal?
A
Romazicon (flumazenil)
B
Dolophine (methodone)
C
Ativan (lorazepam)
D
Antabuse (disulfiram)
Question 21 Explanation:
Benzodiazepines are ordered for the client in alcohol withdrawal to prevent delirium tremens. Antabuse (disulfiram) is incorrect because it is a medication used in aversive therapy to maintain sobriety.Romazicon (flumazenil) is incorrect because it is used for the treatment of benzodiazepine overdose. Dolophine (methodone) is incorrect because it is the treatment for opiate withdrawal.
Question 22
The nurse is teaching the client with insulin-dependent diabetes the signs of hypoglycemia. Which of the following signs is associated with hypoglycemia?
A
Tremulousness
B
Nausea
C
Flushed skin
D
Slow pulse
Question 22 Explanation:
Tremulousness is an early sign of hypoglycemia. Other answer choices are incorrect because they are symptoms of hyperglycemia.
Question 23
The treatment protocol for a client with acute lymphatic leukemia includes prednisone, methotrexate, and cimetadine. The purpose of the cimetadine is to:
A
Enhance the effectiveness of methotrexate
B
Promote peristalsis
C
Decrease the secretion of pancreatic enzymes
D
Prevent a common side effect of prednisone
Question 23 Explanation:
A common side effect of prednisone is gastric ulcers. Cimetadine is given to help prevent the development of ulcers. Other answer choices do not relate to the use of cimetadine; therefore, they are incorrect.
Question 24
The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephotic syndrome. The nurse should:
A
Encourage the client to drink extra fluids
B
Request a low-protein diet for the client
C
Provide additional warmth for swollen, inflamed joints
D
Bathe the client using only mild soap and water
Question 24 Explanation:
The client taking Cytoxan should increase his fluid intake to prevent hemorrhagic cystitis. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 25
The LPN is preparing to administer an injection of vitamin K to the newborn. The nurse should administer the injection in the:
A
Vastus lateralis muscle
B
Deltoid muscle
C
Dorsogluteal muscle
D
Rectus femoris muscle
Question 25 Explanation:
The nurse should administer the injection in the vastus lateralis muscle. Rectus femoris muscle and deltoid muscle are not as well developed in the newborn; therefore, they are incorrect. Answer dorsogluteal muscle is incorrect because the dorsogluteal muscle is not used for IM injections until the child is 3 years of age.
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NCLEX- PN Practice Exam 2 (EM)
Choose the letter of the correct answer. You got 25 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed NCLEX- PN Practice Exam 2 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Which of the following meal choices is suitable for a 6-month-old infant?
A
Melba toast, egg yolk, whole milk
B
Rice cereal, apple juice, formula
C
Apple juice, carrots, whole milk
D
Egg white, formula, and orange juice
Question 1 Explanation:
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.
Question 2
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?
A
Thoroughly cooking all foods
B
Providing small, frequent meals
C
Offering yogurt and buttermilk between meals
D
Forcing fluids
Question 2 Explanation:
Providing small, frequent meals will improve the client’s appetite and help reduce nausea. Thoroughly cooking all foods is incorrect because it does not compensate for limited absorption. Foods and beverages containing live cultures are discouraged for the immune-compromised client; therefore, offering yogurt and buttermilk incorrect. Forcing fluids is incorrect because forcing fluids will not compensate for limited absorption of the intestine.
Question 3
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?
A
Providing the client with child-size utensils
B
Having a staff member remain with her for 1 hour after she eats
C
Placing high-protein foods in the center of the client’s plate
D
Weighing the client after she eats
Question 3 Explanation:
Having a staff member remain with the client for 1 hour after meals will help prevent self-induced vomiting. Weighing the client after she eats is incorrect because the client will weigh more after meals, which can undermine treatment. Placing high-protein foods in the center of the client’s plate is incorrect because the client will need a balanced diet and excess protein might not be well tolerated at first. Providing the client with child-size utensils is incorrect because it treats the client as a child rather than as an adult.
Question 4
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?
A
The client’s abdomen is soft.
B
The client is able to swallow.
C
The client’s abdominal dressing is dry and intact.
D
The client has active bowel sounds.
Question 4 Explanation:
Nasogastric suction decompresses the stomach and leaves the abdomen soft and nondistended. The client is able to swallow is incorrect because it does not relate to the effectiveness of the NG suction. The client has active bowel sounds is incorrect because it relates to peristalsis, not the effectiveness of the NG suction. The client’s abdominal dressing is dry and intact is incorrect because it relates to wound healing, not the effectiveness of the NG suction.
Question 5
Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:
A
Wear a gown, gloves, and a mask while caring for the infant
B
Apply an emollient to the baby’s skin to prevent drying
C
Place the baby on enteric isolation
D
Offer the baby sterile water between feedings of formula
Question 5 Explanation:
Providing additional fluids will help the newborn eliminate excess bilirubin in the stool and urine. Oils and lotions should not be used with phototherapy. Physiologic jaundice is not associated with infection; therefore, wearing a gown, gloves, and a mask and placing the baby on enteric isolation are incorrect.
Question 6
The nurse is teaching the client with insulin-dependent diabetes the signs of hypoglycemia. Which of the following signs is associated with hypoglycemia?
A
Tremulousness
B
Slow pulse
C
Flushed skin
D
Nausea
Question 6 Explanation:
Tremulousness is an early sign of hypoglycemia. Other answer choices are incorrect because they are symptoms of hyperglycemia.
Question 7
A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client’s:
A
Gag reflex
B
Movement of extremities
C
Urinary output
D
Level of consciousness
Question 7 Explanation:
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. Level of consciousness is incorrect because conscious sedation is used. Urinary output and movement of extremities are not affected by the procedure; therefore, they are incorrect.
Question 8
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:
A
Epiglottitis
B
Laryngotracheobronchitis
C
Bronchiolitis
D
Strep throat
Question 8 Explanation:
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.
Question 9
The nurse is caring for a client with detoxification from alcohol. Which medication is used in the treatment of alcohol withdrawal?
A
Dolophine (methodone)
B
Antabuse (disulfiram)
C
Romazicon (flumazenil)
D
Ativan (lorazepam)
Question 9 Explanation:
Benzodiazepines are ordered for the client in alcohol withdrawal to prevent delirium tremens. Antabuse (disulfiram) is incorrect because it is a medication used in aversive therapy to maintain sobriety.Romazicon (flumazenil) is incorrect because it is used for the treatment of benzodiazepine overdose. Dolophine (methodone) is incorrect because it is the treatment for opiate withdrawal.
Question 10
The nurse should observe for side effects associated with the use of bronchodilators. A common side effect of bronchodilators is:
A
Tinnitus
B
Nausea
C
Hypotension
D
Ataxia
Question 10 Explanation:
A side effect of bronchodilators is nausea. Tinnitus and ataxia are not associated with bronchodilators; therefore, they are incorrect. Hypotension is incorrect because hypotension is a sign of toxicity, not a side effect.
Question 11
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:
A
3 p.m.
B
10 a.m.
C
8 a.m.
D
5 a.m.
Question 11 Explanation:
The client taking NPH insulin should have a snack midafternoon to prevent hypoglycemia. 8 a.m. and 10 a.m. are incorrect because the times are too early for symptoms of hypoglycemia. 5 a.m. is incorrect because the time is too late and the client would be in severe hypoglycemia.
Question 12
Which instruction should be included in the discharge teaching for the client with cataract surgery?
A
Over-the-counter eyedrops can be used to treat redness and irritation.
B
The eye shield should be worn at night.
C
It will be necessary to wear special cataract glasses.
D
A prescription for medication to control post-operative pain will be needed.
Question 12 Explanation:
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. The client might or might not require glasses following cataract surgery. Cataract surgery is pain free.
Question 13
The treatment protocol for a client with acute lymphatic leukemia includes prednisone, methotrexate, and cimetadine. The purpose of the cimetadine is to:
A
Prevent a common side effect of prednisone
B
Promote peristalsis
C
Decrease the secretion of pancreatic enzymes
D
Enhance the effectiveness of methotrexate
Question 13 Explanation:
A common side effect of prednisone is gastric ulcers. Cimetadine is given to help prevent the development of ulcers. Other answer choices do not relate to the use of cimetadine; therefore, they are incorrect.
Question 14
A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:
A
Make sure that she has taken all the antibiotic
B
Document that the infection has completely cleared
C
Determine whether the ear infection has affected her hearing
D
Obtain a new prescription in case the infection recurs
Question 14 Explanation:
The client should be assessed following completion of antibiotic therapy to determine whether the infection has cleared. Determine whether the ear infection has affected her hearing would be done if there are repeated instances of otitis media; therefore, it is incorrect. Make sure that she has taken all the antibiotic is incorrect because it will not determine whether the child has completed the medication. Obtain a new prescription in case the infection recurs is incorrect because the purpose of the recheck is to determine whether the infection is gone.
Question 15
Which of the following conditions is most likely related to the development of renal calculi?
A
Disc disease
B
Gout
C
Pancreatitis
D
Fractured femur
Question 15 Explanation:
Gout and renal calculi are the result of increased amounts of uric acid. Pancreatitis is incorrect because it does not contribute to renal calculi.Fractured femur and disc disease can result from decreased calcium levels. Renal calculi are the result of excess calcium.
Question 16
Which of the following symptoms is associated with exacerbation of multiple sclerosis?
A
Insomnia
B
Seizures
C
Anorexia
D
Diplopia
Question 16 Explanation:
The most common sign associated with exacerbation of multiple sclerosis is double vision. Other answer choices are not associated with a diagnosis of multiple sclerosis; therefore, they are incorrect.
Question 17
The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephotic syndrome. The nurse should:
A
Provide additional warmth for swollen, inflamed joints
B
Request a low-protein diet for the client
C
Encourage the client to drink extra fluids
D
Bathe the client using only mild soap and water
Question 17 Explanation:
The client taking Cytoxan should increase his fluid intake to prevent hemorrhagic cystitis. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 18
The LPN is preparing to administer an injection of vitamin K to the newborn. The nurse should administer the injection in the:
A
Dorsogluteal muscle
B
Rectus femoris muscle
C
Vastus lateralis muscle
D
Deltoid muscle
Question 18 Explanation:
The nurse should administer the injection in the vastus lateralis muscle. Rectus femoris muscle and deltoid muscle are not as well developed in the newborn; therefore, they are incorrect. Answer dorsogluteal muscle is incorrect because the dorsogluteal muscle is not used for IM injections until the child is 3 years of age.
Question 19
The primary purpose for using a CPM machine for the client with a total knee repair is to help:
A
Prevent contractures
B
Alleviate lactic acid production in the leg muscles
C
Decrease the pain associated with early ambulation
D
Promote flexion of the artificial joint
Question 19 Explanation:
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. Other answer choices do not describe the purpose of the CPM machine; therefore, they are incorrect.
Question 20
A 5-month-old infant is admitted to the ER with a temperature of 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:
A
Tenseness of the anterior fontanel
B
Negative scarf sign
C
Positive Babinski reflex
D
Periorbital edema
Question 20 Explanation:
Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Periorbital edema is incorrect because periorbital edema is not associated with meningitis. Positive Babinski reflex is incorrect because a positive Babinski reflex is normal in the infant. Negative scarf sign is incorrect because it relates to the preterm infant, not the infant with meningitis.
Question 21
A factory worker is brought to the nurse’s office after a metal fragment enters his right eye. The nurse should:
A
Cover the right eye with a sterile 4×4
B
Attempt to remove the metal with a cotton-tipped applicator
C
Cover both eyes and transport the client to the ER
D
Flush the eye for 10 minutes with running water
Question 21 Explanation:
The nurse should cover both of the client’s eyes and transport him immediately to the ER or the doctor’s office. Other answer choices are incorrect because they increase the risk of further damage to the eye.
Question 22
According to Erickson’s stage of growth and development, the developmental task associated with middle childhood is:
A
Initiative
B
Industry
C
Trust
D
Independence
Question 22 Explanation:
According to Erikson’s Psychosocial Developmental Theory, the developmental task of middle childhood is industry versus inferiority. Trust is incorrect because it is the developmental task of infancy. Initiative is incorrect because it is the developmental task of the school-age child. Independence is incorrect because it is not one of Erikson’s developmental stages.
Question 23
The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is:
A
Respiratory rate of 20–28 per minute
B
The presence of conjunctival hemorrhages
C
Cyanosis of the hands and feet
D
The mottled appearance of the trunk
Question 23 Explanation:
Although cyanosis of the hands and feet is common in the newborn, it accounts for an Apgar score of less than 10. The mottled appearance of the trunk suggests cooling, which is not scored by the Apgar. The presence of conjunctival hemorrhages is incorrect because conjunctival hemorrhages are not associated with the Apgar. Respiratory rate of 20–28 per minute is incorrect because it is within normal range as measured by the Apgar.
Question 24
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?
A
Alteration in O2 perfusion
B
Alteration in mobility
C
Alteration in skin integrity
D
Alteration in comfort
Question 24 Explanation:
The client with a detached retina will have limitations in mobility before and after surgery. Alteration in comfort is incorrect because a detached retina produces no pain or discomfort. Alteration in skin integrity and alteration in O2 perfusion do not apply to the client with a detached retina; therefore, they are incorrect.
Question 25
Which of the following statements reflects Kohlberg’s theory of the moral development of the preschool-age child?
A
Pleasing others is viewed as good behavior.
B
Showing respect for parents is seen as important.
C
Behavior is determined by consequences.
D
Obeying adults is seen as correct behavior.
Question 25 Explanation:
According to Kohlberg, in the preconventional stage of development, the behavior of the preschool child is determined by the consequences of the behavior. Other answer choices describe other stages of moral development; therefore, they are incorrect.
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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:
Level of consciousness
Gag reflex
Urinary output
Movement of extremities
2. Which instruction should be included in the discharge teaching for the client with cataract surgery?
Over-the-counter eyedrops can be used to treat redness and irritation.
The eye shield should be worn at night.
It will be necessary to wear special cataract glasses.
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:
Strep throat
Epiglottitis
Laryngotracheobronchitis
Bronchiolitis
4. Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:
Offer the baby sterile water between feedings of formula
Apply an emollient to the baby’s skin to prevent drying
Wear a gown, gloves, and a mask while caring for the infant
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?
Weighing the client after she eats
Having a staff member remain with her for 1 hour after she eats
Placing high-protein foods in the center of the client’s plate
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:
Trust
Initiative
Independence
Industry
7. The nurse should observe for side effects associated with the use of bronchodilators. A common side effect of bronchodilators is:
Tinnitus
Nausea
Ataxia
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:
The mottled appearance of the trunk
The presence of conjunctival hemorrhages
Cyanosis of the hands and feet
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:
Periorbital edema
Tenseness of the anterior fontanel
Positive Babinski reflex
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?
The client’s abdomen is soft.
The client is able to swallow.
The client has active bowel sounds.
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?
Tremulousness
Slow pulse
Nausea
Flushed skin
12. Which of the following symptoms is associated with exacerbation of multiple sclerosis?
Anorexia
Seizures
Diplopia
Insomnia
13. Which of the following conditions is most likely related to the development of renal calculi?
Gout
Pancreatitis
Fractured femur
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?
Thoroughly cooking all foods
Offering yogurt and buttermilk between meals
Forcing fluids
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:
Decrease the secretion of pancreatic enzymes
Enhance the effectiveness of methotrexate
Promote peristalsis
Prevent a common side effect of prednisone
16. Which of the following meal choices is suitable for a 6-month-old infant?
Egg white, formula, and orange juice
Apple juice, carrots, whole milk
Rice cereal, apple juice, formula
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:
Rectus femoris muscle
Vastus lateralis muscle
Deltoid muscle
Dorsogluteal muscle
18. The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephotic syndrome. The nurse should:
Encourage the client to drink extra fluids
Request a low-protein diet for the client
Bathe the client using only mild soap and water
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?
Antabuse (disulfiram)
Romazicon (flumazenil)
Dolophine (methodone)
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:
8 a.m.
10 a.m.
3 p.m.
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?
Alteration in comfort
Alteration in mobility
Alteration in skin integrity
Alteration in O2 perfusion
22. The primary purpose for using a CPM machine for the client with a total knee repair is to help:
Prevent contractures
Promote flexion of the artificial joint
Decrease the pain associated with early ambulation
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?
Obeying adults is seen as correct behavior.
Showing respect for parents is seen as important.
Pleasing others is viewed as good behavior.
Behavior is determined by consequences.
24. A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:
Determine whether the ear infection has affected her hearing
Make sure that she has taken all the antibiotic
Document that the infection has completely cleared
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:
Cover the right eye with a sterile 4×4
Attempt to remove the metal with a cotton-tipped applicator
Flush the eye for 10 minutes with running water
Cover both eyes and transport the client to the ER
Answers and Rationales
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Answer A is correct. Tremulousness is an early sign of hypoglycemia. Answers B, C, and D are incorrect because they are symptoms of hyperglycemia.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.