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NCLEX- PN Practice Exam 3 (PM)
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Question 1
A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
A
Applies a heating pad to her feet
B
Uses an electric blanket at night
C
Dresses in extra layers of clothing
D
Takes a hot bath morning and evening
Question 1 Explanation:
Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns, making it incorrect. The client with hypothyroidism has dry skin, and a hot bath morning and evening would make her condition worse.
Question 2
The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia?
A
Numbness and tingling in the extremities
B
Difficulty in breathing after exertion
C
A faster-than-usual heart rate
D
Feelings of lightheadedness
Question 2 Explanation:
Numbness and tingling in the extremities is common in the client with pernicious anemia, but not those with other types of anemia. Other answer choices are incorrect because they are symptoms of all types of anemia.
Question 3
The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to:
A
Periodically lie prone without a neck pillow
B
Sleep on either side but keep his back straight
C
Sleep only in dorsal recumbent position
D
Rest in supine position with his head elevated
Question 3 Explanation:
Periodically lying in a prone position without a pillow will help prevent the flexion of the spine that occurs with Parkinson’s disease. Sleeping only in dorsal recumbent position and resting in supine position with his head elevated flex the spine; therefore, they are incorrect. Sleeping on either side but keep his back straight is not realistic because of position changes during sleep; therefore, it is incorrect.
Question 4
The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron?
A
Legumes
B
Tomatoes
C
Nuts
D
Dried fruits
Question 4 Explanation:
Tomatoes are a poor source of iron, although they are an excellent source of vitamin C, which increases iron absorption. Other answer choices are good sources of iron; therefore, they are incorrect.
Question 5
A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer?
A
A family history of laryngeal cancer
B
Frequent straining of the vocal cords
C
A history of alcohol and tobacco use
D
Chronic inhalation of noxious fumes
Question 5 Explanation:
A history of frequent alcohol and tobacco use is the most significant factor in the development of cancer of the larynx. Other answer choices are also factors in the development of laryngeal cancer, but they are not the most significant; therefore, they are incorrect.
Question 6
Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis?
A
Brushing the hair
B
Drinking a glass of juice
C
Brushing the teeth
D
Drinking a cup of coffee
Question 6 Explanation:
Holding a cup of coffee or hot chocolate helps to relieve the pain and stiffness of the hands. Other answer choices do not relieve the symptoms of rheumatoid arthritis; therefore, they are incorrect.
Question 7
The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client?
A
High calorie, low fat
B
Low calorie, low carbohydrate
C
High protein, high fat
D
Low protein, high carbohydrate
Question 7 Explanation:
The client recovering from pancreatitis needs a diet that is high in calories and low in fat. Other answer choices are incorrect because they can increase the client’s discomfort.
Question 8
An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
A
Bright red urine with many clots
B
Hourly urinary output of 40–50cc
C
Requests for pain med q 4 hrs.
D
Dark red urine with few clots
Question 8 Explanation:
Bright red bleeding with many clots indicates arterial bleeding that requires surgical intervention. Hourly urinary output of 40–50cc is within normal limits; therefore, it is incorrect. Dark red urine with few clots indicates venous bleeding, which can be managed by nursing intervention; therefore, it is incorrect. Requests for pain med q 4 hrs does not indicate excessive need for pain management that requires the doctor’s attention; therefore, it is incorrect.
Question 9
The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to:
A
Repeat words or phrases used by others
B
Speak using words that rhyme
C
Make up new words with new meanings
D
Include irrelevant details in conversation
Question 9 Explanation:
The client with echolalia repeats words or phrases used by others. Speaking using words that rhyme is incorrect because it refers to clang association. Including irrelevant details in conversation is incorrect because it refers to circumstantiality. Making up new words with new meanings is incorrect because it refers to neologisms.
Question 10
A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has:
A
Low blood pressure
B
Warm, flushed skin
C
Slow, regular pulse
D
Increased urination
Question 10 Explanation:
The client with acute adrenal crisis has symptoms of hypovolemia and shock; therefore, the blood pressure would be low. Slow, regular pulse is incorrect because the pulse would be rapid and irregular. Warm, flushed skin is incorrect because the skin would be cool and pale. Increased urination is incorrect because the urinary output would be decreased.
Question 11
A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to:
A
Liquefy secretions and relieve laryngeal spasm
B
Provide a moist environment with oxygen at 30%
C
Prevent insensible water loss
D
Prevent dehydration and reduce fever
Question 11 Explanation:
The primary reason for placing a child with croup under a mist tent is to liquefy secretions and relieve laryngeal spasms. Preventing insensible water loss is incorrect because it does not prevent insensible water loss. Providing a moist environment with oxygen at 30% is incorrect because the oxygen concentration is too high. Preventing dehydration and reduce fever is incorrect because the mist tent does not prevent dehydration or reduce fever.
Question 12
A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of polymigratory arthritis?
A
Irregular movements of the extremities and facial grimacing
B
Painless swelling over the extensor surfaces of the joints
C
Faint areas of red demarcation over the back and abdomen
D
Swelling, inflammation, and effusion of the joints
Question 12 Explanation:
The child with polymigratory arthritis will exhibit swollen, painful joints. Painless swelling over the extensor surfaces of the joints is incorrect because it describes subcutaneous nodules. Faint areas of red demarcation over the back and abdomen is incorrect because it describes erythema marginatum. Irregular movements of the extremities and facial grimacing is incorrect because it describes Syndeham’s chorea.
Question 13
The physician has ordered Basalgel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include:
A
Confusion
B
Urinary retention
C
Diarrhea
D
Constipation
Question 13 Explanation:
Antacids containing aluminum and calcium tend to cause constipation. Urinary retention refers to the side effects of anticholinergic medications used to treat ulcers; therefore, it is incorrect. Diarrhea refers to antacids containing magnesium; therefore, it is incorrect. Confusion refers to dopamine antagonists used to treat ulcers; therefore, it is incorrect.
Question 14
Which diet is associated with an increased risk of colorectal cancer?
A
High fat, refined carbohydrates
B
Low carbohydrates, complex proteins
C
High protein, simple carbohydrates
D
Low protein, complex carbohydrates
Question 14 Explanation:
A diet that is high in fat and refined carbohydrates increases the risk of colorectal cancer. High fat content results in an increase in fecal bile acids, which facilitate carcinogenic changes. Refined carbohydrates increase the transit time of food through the gastrointestinal tract and increase the exposure time of the intestinal mucosa to cancer-causing substances. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 15
A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is:
A
Back pain that lessens when standing
B
Decreased urinary output
C
Pulsations in the periumbilical area
D
Loss of sensation in the lower extremities
Question 15 Explanation:
The client with an abdominal aortic aneurysm frequently complains of pulsations or "feeling my heart beat" in the abdomen. Loss of sensation in the lower extremities and decreased urinary output are incorrect because they occur with rupture of the aneurysm. Back pain that lessens when standing is incorrect because back pain is not affected by changes in position.
Question 16
A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms?
A
Cream of tomato soup and crackers
B
Tossed salad with oil and vinegar dressing
C
Baked potato with sour cream and chives
D
Mixed fruit and yogurt
Question 16 Explanation:
The symptoms of nontropical sprue and celiac are caused by the ingestion of gluten, which is found in wheat, oats, barley, and rye. Creamed soup and crackers contain gluten. Other answer choices do not contain gluten; therefore, they are incorrect.
Question 17
The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid:
A
Holding the infant
B
Providing a mobile
C
Offering a pacifier
D
Offering sterile water
Question 17 Explanation:
The nurse should avoid giving the infant a pacifier or bottle because sucking is not permitted. Holding the infant cradled in the arms, providing a mobile, and offering sterile water using a Breck feeder are permitted.
Question 18
A client with congestive heart failure has been receiving Digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
A
Stabilized weight
B
Increased urinary output
C
Increased pedal edema
D
Improved appetite
Question 18 Explanation:
Lanoxin slows and strengthens the contraction of the heart. An increase in urinary output shows that the medication is having a desired effect by eliminating excess fluid from the body. Stabilized weight is incorrect because the weight would decrease. Improved appetite might occur but is not directly related to the question; therefore, it is incorrect. Increased pedal edema is incorrect because pedal edema would decrease, not increase.
Question 19
Which play activity is best suited to the gross motor skills of the toddler?
A
Ball
B
Coloring book and crayons
C
Swing set
D
Building cubes
Question 19 Explanation:
The toddler has gross motor skills suited to playing with a ball, which can be kicked forward or thrown overhand. Coloring book and crayons and building cubes are incorrect because they require fine motor skills. Swinging set is incorrect because the toddler lacks gross motor skills for play on the swing set.
Question 20
The nurse is caring for a client with systemic lupus erythematosis (SLE). The major complication associated with systemic lupus erythematosis is:
A
Nephritis
B
Cardiomegaly
C
Meningitis
D
Desquamation
Question 20 Explanation:
The major complication of SLE is lupus nephritis, which results in end-stage renal disease. SLE affects the musculoskeletal, integumentary, renal, nervous, and cardiovascular systems, but the major complication is renal involvement; therefore, cardiomegaly and meningitis are incorrect. Desquamation is incorrect because the SLE produces a "butterfly" rash, not desquamation.
Question 21
A client admitted to the psychiatric unit claims to be the Son of God and insists that he will not be kept away from his followers. The most likely explanation for the client’s delusion is:
A
A religious experience
B
Low self-esteem
C
Overwhelming anxiety
D
A stressful event
Question 21 Explanation:
Delusions of grandeur are associated with low self-esteem. A religious experience is incorrect because conversion is expressed as sensory or motor deficits. A stressful event and overwhelming anxiety can cause an increase in the client’s delusions but do not explain their purpose; therefore, they are incorrect.
Question 22
A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal:
A
Rapid pulse, constipation, and bulging eyes
B
Decreased body temperature, weight loss, and increased respirations
C
Slow pulse rate, weight loss, diarrhea, and cardiac failure
D
Weight gain, lethargy, slowed speech, and decreased respiratory rate
Question 22 Explanation:
Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations. Slow pulse rate, weight loss, diarrhea, cardiac failure ,decreased body temperature, weight loss, and increased respirations do not describe symptoms associated with myxedema; therefore, they are incorrect. Rapid pulse, constipation, and bulging eyes describes symptoms associated with Graves’s disease; therefore, it is incorrect.
Question 23
The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by:
A
Giving the medication with an antacid
B
Requesting an alternate form of the medication
C
Providing extra water with the medication
D
Giving the medication as ordered
Question 23 Explanation:
The client with esophageal varices can develop spontaneous bleeding from the mechanical irritation caused by taking capsules; therefore, the nurse should request the medication in a suspension. Giving the medication as ordered is incorrect because it does not best meet the client’s needs. Providing extra water with the medication is incorrect because it is not the best means of preventing bleeding. Giving the medication with an antacid is incorrect because the medications should not be given with milk or antacids.
Question 24
Which statement describes the contagious stage of varicella?
A
The contagious stage is from the onset of the rash until the rash disappears.
B
The contagious stage is 1 day before the onset of the rash until all the lesions are crusted.
C
The contagious stage lasts during the vesicular and crusting stages of the lesions.
D
The contagious stage is 1 day before the onset of the rash until the appearance of vesicles.
Question 24 Explanation:
The contagious stage of varicella begins 24 hours before the onset of the rash and lasts until all the lesions are crusted. Other answer choices are inaccurate regarding the time of contagion; therefore, they are incorrect.
Question 25
A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh:
A
25 pounds
B
14 pounds
C
30 pounds
D
18 pounds
Question 25 Explanation:
The infant’s birth weight should double by 6 months of age. Other answer choices are incorrect because they are greater than the expected weight gain by 6 months of age.
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Exam Mode
Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.
NCLEX- PN Practice Exam 3 (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 3 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
The physician has ordered Basalgel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include:
A
Diarrhea
B
Constipation
C
Confusion
D
Urinary retention
Question 1 Explanation:
Antacids containing aluminum and calcium tend to cause constipation. Urinary retention refers to the side effects of anticholinergic medications used to treat ulcers; therefore, it is incorrect. Diarrhea refers to antacids containing magnesium; therefore, it is incorrect. Confusion refers to dopamine antagonists used to treat ulcers; therefore, it is incorrect.
Question 2
A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
A
Uses an electric blanket at night
B
Takes a hot bath morning and evening
C
Dresses in extra layers of clothing
D
Applies a heating pad to her feet
Question 2 Explanation:
Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns, making it incorrect. The client with hypothyroidism has dry skin, and a hot bath morning and evening would make her condition worse.
Question 3
The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to:
A
Include irrelevant details in conversation
B
Repeat words or phrases used by others
C
Speak using words that rhyme
D
Make up new words with new meanings
Question 3 Explanation:
The client with echolalia repeats words or phrases used by others. Speaking using words that rhyme is incorrect because it refers to clang association. Including irrelevant details in conversation is incorrect because it refers to circumstantiality. Making up new words with new meanings is incorrect because it refers to neologisms.
Question 4
A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of polymigratory arthritis?
A
Faint areas of red demarcation over the back and abdomen
B
Painless swelling over the extensor surfaces of the joints
C
Swelling, inflammation, and effusion of the joints
D
Irregular movements of the extremities and facial grimacing
Question 4 Explanation:
The child with polymigratory arthritis will exhibit swollen, painful joints. Painless swelling over the extensor surfaces of the joints is incorrect because it describes subcutaneous nodules. Faint areas of red demarcation over the back and abdomen is incorrect because it describes erythema marginatum. Irregular movements of the extremities and facial grimacing is incorrect because it describes Syndeham’s chorea.
Question 5
Which play activity is best suited to the gross motor skills of the toddler?
A
Coloring book and crayons
B
Building cubes
C
Swing set
D
Ball
Question 5 Explanation:
The toddler has gross motor skills suited to playing with a ball, which can be kicked forward or thrown overhand. Coloring book and crayons and building cubes are incorrect because they require fine motor skills. Swinging set is incorrect because the toddler lacks gross motor skills for play on the swing set.
Question 6
A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to:
A
Prevent insensible water loss
B
Provide a moist environment with oxygen at 30%
C
Prevent dehydration and reduce fever
D
Liquefy secretions and relieve laryngeal spasm
Question 6 Explanation:
The primary reason for placing a child with croup under a mist tent is to liquefy secretions and relieve laryngeal spasms. Preventing insensible water loss is incorrect because it does not prevent insensible water loss. Providing a moist environment with oxygen at 30% is incorrect because the oxygen concentration is too high. Preventing dehydration and reduce fever is incorrect because the mist tent does not prevent dehydration or reduce fever.
Question 7
Which statement describes the contagious stage of varicella?
A
The contagious stage lasts during the vesicular and crusting stages of the lesions.
B
The contagious stage is from the onset of the rash until the rash disappears.
C
The contagious stage is 1 day before the onset of the rash until all the lesions are crusted.
D
The contagious stage is 1 day before the onset of the rash until the appearance of vesicles.
Question 7 Explanation:
The contagious stage of varicella begins 24 hours before the onset of the rash and lasts until all the lesions are crusted. Other answer choices are inaccurate regarding the time of contagion; therefore, they are incorrect.
Question 8
The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to:
A
Rest in supine position with his head elevated
B
Sleep on either side but keep his back straight
C
Periodically lie prone without a neck pillow
D
Sleep only in dorsal recumbent position
Question 8 Explanation:
Periodically lying in a prone position without a pillow will help prevent the flexion of the spine that occurs with Parkinson’s disease. Sleeping only in dorsal recumbent position and resting in supine position with his head elevated flex the spine; therefore, they are incorrect. Sleeping on either side but keep his back straight is not realistic because of position changes during sleep; therefore, it is incorrect.
Question 9
The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by:
A
Giving the medication as ordered
B
Providing extra water with the medication
C
Giving the medication with an antacid
D
Requesting an alternate form of the medication
Question 9 Explanation:
The client with esophageal varices can develop spontaneous bleeding from the mechanical irritation caused by taking capsules; therefore, the nurse should request the medication in a suspension. Giving the medication as ordered is incorrect because it does not best meet the client’s needs. Providing extra water with the medication is incorrect because it is not the best means of preventing bleeding. Giving the medication with an antacid is incorrect because the medications should not be given with milk or antacids.
Question 10
A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has:
A
Warm, flushed skin
B
Slow, regular pulse
C
Increased urination
D
Low blood pressure
Question 10 Explanation:
The client with acute adrenal crisis has symptoms of hypovolemia and shock; therefore, the blood pressure would be low. Slow, regular pulse is incorrect because the pulse would be rapid and irregular. Warm, flushed skin is incorrect because the skin would be cool and pale. Increased urination is incorrect because the urinary output would be decreased.
Question 11
The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron?
A
Legumes
B
Tomatoes
C
Nuts
D
Dried fruits
Question 11 Explanation:
Tomatoes are a poor source of iron, although they are an excellent source of vitamin C, which increases iron absorption. Other answer choices are good sources of iron; therefore, they are incorrect.
Question 12
A client admitted to the psychiatric unit claims to be the Son of God and insists that he will not be kept away from his followers. The most likely explanation for the client’s delusion is:
A
A stressful event
B
Low self-esteem
C
Overwhelming anxiety
D
A religious experience
Question 12 Explanation:
Delusions of grandeur are associated with low self-esteem. A religious experience is incorrect because conversion is expressed as sensory or motor deficits. A stressful event and overwhelming anxiety can cause an increase in the client’s delusions but do not explain their purpose; therefore, they are incorrect.
Question 13
Which diet is associated with an increased risk of colorectal cancer?
A
Low carbohydrates, complex proteins
B
Low protein, complex carbohydrates
C
High fat, refined carbohydrates
D
High protein, simple carbohydrates
Question 13 Explanation:
A diet that is high in fat and refined carbohydrates increases the risk of colorectal cancer. High fat content results in an increase in fecal bile acids, which facilitate carcinogenic changes. Refined carbohydrates increase the transit time of food through the gastrointestinal tract and increase the exposure time of the intestinal mucosa to cancer-causing substances. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 14
The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia?
A
Feelings of lightheadedness
B
Difficulty in breathing after exertion
C
A faster-than-usual heart rate
D
Numbness and tingling in the extremities
Question 14 Explanation:
Numbness and tingling in the extremities is common in the client with pernicious anemia, but not those with other types of anemia. Other answer choices are incorrect because they are symptoms of all types of anemia.
Question 15
A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer?
A
Chronic inhalation of noxious fumes
B
Frequent straining of the vocal cords
C
A family history of laryngeal cancer
D
A history of alcohol and tobacco use
Question 15 Explanation:
A history of frequent alcohol and tobacco use is the most significant factor in the development of cancer of the larynx. Other answer choices are also factors in the development of laryngeal cancer, but they are not the most significant; therefore, they are incorrect.
Question 16
A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal:
A
Rapid pulse, constipation, and bulging eyes
B
Weight gain, lethargy, slowed speech, and decreased respiratory rate
C
Slow pulse rate, weight loss, diarrhea, and cardiac failure
D
Decreased body temperature, weight loss, and increased respirations
Question 16 Explanation:
Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations. Slow pulse rate, weight loss, diarrhea, cardiac failure ,decreased body temperature, weight loss, and increased respirations do not describe symptoms associated with myxedema; therefore, they are incorrect. Rapid pulse, constipation, and bulging eyes describes symptoms associated with Graves’s disease; therefore, it is incorrect.
Question 17
The nurse is caring for a client with systemic lupus erythematosis (SLE). The major complication associated with systemic lupus erythematosis is:
A
Meningitis
B
Cardiomegaly
C
Desquamation
D
Nephritis
Question 17 Explanation:
The major complication of SLE is lupus nephritis, which results in end-stage renal disease. SLE affects the musculoskeletal, integumentary, renal, nervous, and cardiovascular systems, but the major complication is renal involvement; therefore, cardiomegaly and meningitis are incorrect. Desquamation is incorrect because the SLE produces a "butterfly" rash, not desquamation.
Question 18
A client with congestive heart failure has been receiving Digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
A
Stabilized weight
B
Increased pedal edema
C
Increased urinary output
D
Improved appetite
Question 18 Explanation:
Lanoxin slows and strengthens the contraction of the heart. An increase in urinary output shows that the medication is having a desired effect by eliminating excess fluid from the body. Stabilized weight is incorrect because the weight would decrease. Improved appetite might occur but is not directly related to the question; therefore, it is incorrect. Increased pedal edema is incorrect because pedal edema would decrease, not increase.
Question 19
A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms?
A
Mixed fruit and yogurt
B
Tossed salad with oil and vinegar dressing
C
Cream of tomato soup and crackers
D
Baked potato with sour cream and chives
Question 19 Explanation:
The symptoms of nontropical sprue and celiac are caused by the ingestion of gluten, which is found in wheat, oats, barley, and rye. Creamed soup and crackers contain gluten. Other answer choices do not contain gluten; therefore, they are incorrect.
Question 20
A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is:
A
Pulsations in the periumbilical area
B
Decreased urinary output
C
Back pain that lessens when standing
D
Loss of sensation in the lower extremities
Question 20 Explanation:
The client with an abdominal aortic aneurysm frequently complains of pulsations or "feeling my heart beat" in the abdomen. Loss of sensation in the lower extremities and decreased urinary output are incorrect because they occur with rupture of the aneurysm. Back pain that lessens when standing is incorrect because back pain is not affected by changes in position.
Question 21
A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh:
A
30 pounds
B
14 pounds
C
25 pounds
D
18 pounds
Question 21 Explanation:
The infant’s birth weight should double by 6 months of age. Other answer choices are incorrect because they are greater than the expected weight gain by 6 months of age.
Question 22
Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis?
A
Brushing the hair
B
Drinking a glass of juice
C
Brushing the teeth
D
Drinking a cup of coffee
Question 22 Explanation:
Holding a cup of coffee or hot chocolate helps to relieve the pain and stiffness of the hands. Other answer choices do not relieve the symptoms of rheumatoid arthritis; therefore, they are incorrect.
Question 23
An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
A
Bright red urine with many clots
B
Requests for pain med q 4 hrs.
C
Dark red urine with few clots
D
Hourly urinary output of 40–50cc
Question 23 Explanation:
Bright red bleeding with many clots indicates arterial bleeding that requires surgical intervention. Hourly urinary output of 40–50cc is within normal limits; therefore, it is incorrect. Dark red urine with few clots indicates venous bleeding, which can be managed by nursing intervention; therefore, it is incorrect. Requests for pain med q 4 hrs does not indicate excessive need for pain management that requires the doctor’s attention; therefore, it is incorrect.
Question 24
The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client?
A
High calorie, low fat
B
Low calorie, low carbohydrate
C
High protein, high fat
D
Low protein, high carbohydrate
Question 24 Explanation:
The client recovering from pancreatitis needs a diet that is high in calories and low in fat. Other answer choices are incorrect because they can increase the client’s discomfort.
Question 25
The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid:
A
Offering a pacifier
B
Providing a mobile
C
Offering sterile water
D
Holding the infant
Question 25 Explanation:
The nurse should avoid giving the infant a pacifier or bottle because sucking is not permitted. Holding the infant cradled in the arms, providing a mobile, and offering sterile water using a Breck feeder are permitted.
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1. The nurse is caring for a client with systemic lupus erythematosis (SLE). The major complication associated with systemic lupus erythematosis is:
Nephritis
Cardiomegaly
Desquamation
Meningitis
2. Which diet is associated with an increased risk of colorectal cancer?
Low protein, complex carbohydrates
High protein, simple carbohydrates
High fat, refined carbohydrates
Low carbohydrates, complex proteins
3. The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid:
Holding the infant
Offering a pacifier
Providing a mobile
Offering sterile water
4. The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by:
Giving the medication as ordered
Providing extra water with the medication
Giving the medication with an antacid
Requesting an alternate form of the medication
5. The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron?
Tomatoes
Legumes
Dried fruits
Nuts
6. The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to:
Periodically lie prone without a neck pillow
Sleep only in dorsal recumbent position
Rest in supine position with his head elevated
Sleep on either side but keep his back straight
7. The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client?
Low calorie, low carbohydrate
High calorie, low fat
High protein, high fat
Low protein, high carbohydrate
8. A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
Uses an electric blanket at night
Dresses in extra layers of clothing
Applies a heating pad to her feet
Takes a hot bath morning and evening
9. A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer?
A family history of laryngeal cancer
Chronic inhalation of noxious fumes
Frequent straining of the vocal cords
A history of alcohol and tobacco use
10. The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia?
Difficulty in breathing after exertion
Numbness and tingling in the extremities
A faster-than-usual heart rate
Feelings of lightheadedness
11. The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to:
Speak using words that rhyme
Repeat words or phrases used by others
Include irrelevant details in conversation
Make up new words with new meanings
12. Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis?
Brushing the teeth
Drinking a glass of juice
Drinking a cup of coffee
Brushing the hair
13. A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh:
14 pounds
18 pounds
25 pounds
30 pounds
14. A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms?
Tossed salad with oil and vinegar dressing
Baked potato with sour cream and chives
Cream of tomato soup and crackers
Mixed fruit and yogurt
15. A client with congestive heart failure has been receiving Digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
Increased urinary output
Stabilized weight
Improved appetite
Increased pedal edema
16. Which play activity is best suited to the gross motor skills of the toddler?
Coloring book and crayons
Ball
Building cubes
Swing set
17. The physician has ordered Basalgel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include:
Constipation
Urinary retention
Diarrhea
Confusion
18. A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is:
Loss of sensation in the lower extremities
Back pain that lessens when standing
Decreased urinary output
Pulsations in the periumbilical area
19. A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has:
Low blood pressure
Slow, regular pulse
Warm, flushed skin
Increased urination
20. An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
Hourly urinary output of 40–50cc
Bright red urine with many clots
Dark red urine with few clots
Requests for pain med q 4 hrs.
21. A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of polymigratory arthritis?
Irregular movements of the extremities and facial grimacing
Painless swelling over the extensor surfaces of the joints
Faint areas of red demarcation over the back and abdomen
Swelling, inflammation, and effusion of the joints
22. A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to:
Prevent insensible water loss
Provide a moist environment with oxygen at 30%
Prevent dehydration and reduce fever
Liquefy secretions and relieve laryngeal spasm
23. A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal:
Slow pulse rate, weight loss, diarrhea, and cardiac failure
Weight gain, lethargy, slowed speech, and decreased respiratory rate
Rapid pulse, constipation, and bulging eyes
Decreased body temperature, weight loss, and increased respirations
24. Which statement describes the contagious stage of varicella?
The contagious stage is 1 day before the onset of the rash until the appearance of vesicles.
The contagious stage lasts during the vesicular and crusting stages of the lesions.
The contagious stage is from the onset of the rash until the rash disappears.
The contagious stage is 1 day before the onset of the rash until all the lesions are crusted.
25. A client admitted to the psychiatric unit claims to be the Son of God and insists that he will not be kept away from his followers. The most likely explanation for the client’s delusion is:
A religious experience
A stressful event
Low self-esteem
Overwhelming anxiety
Answers and Rationales
Answer A is correct. The major complication of SLE is lupus nephritis, which results in end-stage renal disease. SLE affects the musculoskeletal, integumentary, renal, nervous, and cardiovascular systems, but the major complication is renal involvement; therefore, answers B and D are incorrect. Answer C is incorrect because the SLE produces a “butterfly” rash, not desquamation.
Answer C is correct. A diet that is high in fat and refined carbohydrates increases the risk of colorectal cancer. High fat content results in an increase in fecal bile acids, which facilitate carcinogenic changes. Refined carbohydrates increase the transit time of food through the gastrointestinal tract and increase the exposure time of the intestinal mucosa to cancer-causing substances. Answers A, B, and D do not relate to the question; therefore, they are incorrect.
Answer B is correct. The nurse should avoid giving the infant a pacifier or bottle because sucking is not permitted. Holding the infant cradled in the arms, providing a mobile, and offering sterile water using a Breck feeder are permitted; therefore, answers A, C, and D are incorrect.
Answer D is correct. The client with esophageal varices can develop spontaneous bleeding from the mechanical irritation caused by taking capsules; therefore, the nurse should request the medication in a suspension. Answer A is incorrect because it does not best meet the client’s needs. Answer B is incorrect because it is not the best means of preventing bleeding. Answer C is incorrect because the medications should not be given with milk or antacids.
Answer A is correct. Tomatoes are a poor source of iron, although they are an excellent source of vitamin C, which increases iron absorption. Answers B, C, and D are good sources of iron; therefore, they are incorrect.
Answer A is correct. Periodically lying in a prone position without a pillow will help prevent the flexion of the spine that occurs with Parkinson’s disease. Answers B and C flex the spine; therefore, they are incorrect. Answer D is not realistic because of position changes during sleep; therefore, it is incorrect.
Answer B is correct. The client recovering from pancreatitis needs a diet that is high in calories and low in fat. Answers A, C, and D are incorrect because they can increase the client’s discomfort.
Answer B is correct. Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns, making answers A and C incorrect. Answer D is incorrect because the client with hypothyroidism has dry skin, and a hot bath morning and evening would make her condition worse.
Answer D is correct. A history of frequent alcohol and tobacco use is the most significant factor in the development of cancer of the larynx. Answers A, B, and C are also factors in the development of laryngeal cancer, but they are not the most significant; therefore, they are incorrect.
Answer B is correct. Numbness and tingling in the extremities is common in the client with pernicious anemia, but not those with other types of anemia. Answers A, C, and D are incorrect because they are symptoms of all types of anemia.
Answer B is correct. The client with echolalia repeats words or phrases used by others. Answer A is incorrect because it refers to clang association. Answer C is incorrect because it refers to circumstantiality. Answer D is incorrect because it refers to neologisms.
Answer C is correct. Holding a cup of coffee or hot chocolate helps to relieve the pain and stiffness of the hands. Answers A, B, and D do not relieve the symptoms of rheumatoid arthritis; therefore, they are incorrect.
Answer A is correct. The infant’s birth weight should double by 6 months of age. Answers B, C, and D are incorrect because they are greater than the expected weight gain by 6 months of age.
Answer C is correct. The symptoms of nontropical sprue and celiac are caused by the ingestion of gluten, which is found in wheat, oats, barley, and rye. Creamed soup and crackers contain gluten. Answers A, B, and D do not contain gluten; therefore, they are incorrect.
Answer A is correct. Lanoxin slows and strengthens the contraction of the heart. An increase in urinary output shows that the medication is having a desired effect by eliminating excess fluid from the body. Answer B is incorrect because the weight would decrease. Answer C might occur but is not directly related to the question; therefore, it is incorrect. Answer D is incorrect because pedal edema would decrease, not increase.
Answer B is correct. The toddler has gross motor skills suited to playing with a ball, which can be kicked forward or thrown overhand. Answers A and C are incorrect because they require fine motor skills. Answer D is incorrect because the toddler lacks gross motor skills for play on the swing set.
Answer A is correct. Antacids containing aluminum and calcium tend to cause constipation. Answer A refers to the side effects of anticholinergic medications used to treat ulcers; therefore, it is incorrect. Answer C refers to antacids containing magnesium; therefore, it is incorrect. Answer D refers to dopamine antagonists used to treat ulcers; therefore, it is incorrect.
Answer D is correct. The client with an abdominal aortic aneurysm frequently complains of pulsations or “feeling my heart beat” in the abdomen. Answers A and C are incorrect because they occur with rupture of the aneurysm. Answer B is incorrect because back pain is not affected by changes in position.
Answer A is correct. The client with acute adrenal crisis has symptoms of hypovolemia and shock; therefore, the blood pressure would be low. Answer B is incorrect because the pulse would be rapid and irregular. Answer C is incorrect because the skin would be cool and pale. Answer D is incorrect because the urinary output would be decreased.
Answer B is correct. Bright red bleeding with many clots indicates arterial bleeding that requires surgical intervention. Answer A is within normal limits; therefore, it is incorrect. Answer C indicates venous bleeding, which can be managed by nursing intervention; therefore, it is incorrect. Answer D does not indicate excessive need for pain management that requires the doctor’s attention; therefore, it is incorrect.
Answer D is correct. The child with polymigratory arthritis will exhibit swollen, painful joints. Answer B is incorrect because it describes subcutaneous nodules. Answer C is incorrect because it describes erythema marginatum. Answer A is incorrect because it describes Syndeham’s chorea.
Answer D is correct. The primary reason for placing a child with croup under a mist tent is to liquefy secretions and relieve laryngeal spasms. Answer A is incorrect because it does not prevent insensible water loss. Answer B is incorrect because the oxygen concentration is too high. Answer C is incorrect because the mist tent does not prevent dehydration or reduce fever.
Answer B is correct. Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations. Answers A and D do not describe symptoms associated with myxedema; therefore, they are incorrect. Answer C describes symptoms associated with Graves’s disease; therefore, it is incorrect.
Answer D is correct. The contagious stage of varicella begins 24 hours before the onset of the rash and lasts until all the lesions are crusted. Answers A, B, and C are inaccurate regarding the time of contagion; therefore, they are incorrect.
Answer C is correct. Delusions of grandeur are associated with low self-esteem. Answer A is incorrect because conversion is expressed as sensory or motor deficits. Answers B and C can cause an increase in the client’s delusions but do not explain their purpose; therefore, they are incorrect.