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NCLEX- PN Practice Exam 6 (PM)
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Question 1
The nurse is teaching the parents of a newborn with osteogenesis imperfecta. The nurse should tell the parents:
A
That the baby will need daily calcium supplements
B
That the condition is a temporary one
C
That only the bones are affected by the disease
D
To lift the baby by the buttocks when diapering
Question 1 Explanation:
To prevent fractures, the parents should lift the baby by the buttocks rather than the ankles when diapering. Children with osteogenesis imperfecta have normal calcium and phosphorus levels. The condition is not temporary. The teeth and the sclera are also affected.
Question 2
The mother of a child with cystic fibrosis tells the nurse that her child makes "snoring" sounds when breathing. The nurse is aware that many children with cystic fibrosis have:
A
Septal deviations
B
Choanal atresia
C
Nasal polyps
D
Enlarged adenoids
Question 2 Explanation:
Children with cystic fibrosis are susceptible to chronic sinusitis and nasal polyps, which might require surgical removal. Choanal atresia is incorrect because it is a congenital condition in which there is a bony obstruction between the nares and the pharynx.Septal deviations and enlarged adenoids are not specific to the child with cystic fibrosis; therefore, they are incorrect.
Question 3
Which of the following pediatric clients is at greatest risk for latex allergy?
A
The child with a myelomeningocele
B
The child with coxa plana
C
The child with epispadias
D
The child with rheumatic fever
Question 3 Explanation:
The child with myelomenigocele is at greatest risk for the development of latex allergy because of repeated exposure to latex products during surgery and from numerous urinary catheterizations. Other answer choices are much less likely to be exposed to latex; therefore, they are incorrect.
Question 4
A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
A
Prilosec (omeprazole)
B
Lipitor (atorvastatin)
C
Premarin (conjugated estrogens)
D
Synthroid (levothyroxine)
Question 4 Explanation:
Lipid-lowering agents are contraindicated in the client with active liver disease. Other answer choices are incorrect because they are not contraindicated in the client with active liver disease.
Question 5
A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
A
After dinner
B
With breakfast
C
Before lunch
D
At bedtime
Question 5 Explanation:
Glucotrol XL is given once a day with breakfast. At bedtime is incorrect because the client would develop hypoglycemia while sleeping. Before lunch and after dinner are incorrect because the client would develop hypoglycemia later in the day or evening.
Question 6
The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
A
Visual disturbances, including diplopia
B
Cogwheel rigidity and loss of coordination
C
Progressive weakness that is worse at the day’s end
D
Ascending paralysis and loss of motor function
Question 6 Explanation:
The client with myasthenia develops progressive weakness that worsens during the day. Visual disturbances, including diplopia is incorrect because it refers to symptoms of multiple sclerosis. Ascending paralysis and loss of motor function is incorrect because it refers to symptoms of Guillain Barre syndrome. Cogwheel rigidity and loss of coordination is incorrect because it refers to Parkinson’s disease.
Question 7
The nurse is teaching the mother of a child with cystic fibrosis how to do postural drainage. The nurse should tell the mother to:
A
Do percussion after the child eats and at bedtime
B
Use the heel of her hand during percussion
C
Change the child’s position every 20 minutes
D
Use cupped hands during percussion
Question 7 Explanation:
The nurse or parent should use a cupped hand when performing chest percussion. Using the heel of her hand during percussion is incorrect because the hand should be cupped. The child’s position should be changed every 5–10 minutes and the whole session should be limited to 20 minutes. Percussion should be done before meals.
Question 8
A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?
A
High calorie, high carbohydrate, low protein
B
High calorie, low carbohydrate, high fat
C
High calorie, high protein, low fat
D
High calorie, high protein, high fat
Question 8 Explanation:
The suggested diet for the client with AIDS is one that is high calorie, high protein, and low fat. Clients with AIDS have a reduced tolerance to fat because of the disease as well as side effects from some antiviral medications; therefore, high fat diet are incorrect. The client needs a high-protein diet.
Question 9
The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
A
Oatmeal, apple juice, dry toast, and coffee
B
Cornflakes, whole milk, banana, and coffee
C
Pancakes, ham, tomato juice, and coffee
D
Scrambled eggs, bacon, toast, and coffee
Question 9 Explanation:
Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure.Cornflakes and whole milk are higher in sodium and are poor sources of fiber. Scrambled eggs, bacon,and ham are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
Question 10
A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
A
2 weeks
B
4 weeks
C
1 week
D
6 weeks
Question 10 Explanation:
Depot injections of Haldol are administered every 4 weeks. 1 week and 2 weeks are incorrect because the medication is still in the client’s system. 6 weeks is incorrect because the medication has been eliminated from the client’s system, which allows the symptoms of schizophrenia to return.
Question 11
The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25mL. The nurse should:
A
Give the medication in one injection in the dorsogluteal muscle
B
Divide the amount in two injections and give one in the ventrogluteal muscle and one in the vastus lateralis muscle
C
Give the medication in one injection in the ventrogluteal muscle
D
Divide the amount into two injections and administer in each vastus lateralis muscle
Question 11 Explanation:
No more than 1mL should be given in the vastus lateralis of the infant. Other answer choices are incorrect because the dorsogluteal and ventrogluteal muscles are not used for injections in the infant.
Question 12
The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?
A
Providing suckers and pinwheels to help strengthen tongue movement
B
Encouraging play with a video game to improve muscle coordination
C
Providing musical tapes to provide auditory training
D
Patching one of the eyes to strengthen the muscles
Question 12 Explanation:
The nurse can help ready the child with cerebral palsy for speech therapy by providing activities that help the child develop tongue control. Most children with cerebral palsy have visual and auditory difficulties that require glasses or hearing devices rather than rehabilitative training. Video games are not appropriate for the age or developmental level of the child with cerebral palsy.
Question 13
An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:
A
Skip breakfast but eat a larger lunch and dinner
B
Drink a glass of orange juice after adding a couple of teaspoons of sugar
C
Drink a glass of whole milk before going to sleep at night
D
Keep crackers at the bedside for eating before she arises
Question 13 Explanation:
Eating a carbohydrate source such as dry crackers or toast before arising helps alleviate symptoms of morning sickness. Drinking a glass of whole milk is incorrect because the additional fat might increase the client’s nausea. The client does not need to skip meals. Drinking a glass of orange juice after adding a couple of teaspoons of sugar is the treatment of hypoglycemia, not morning sickness; therefore, it is incorrect.
Question 14
Physician’s orders for a client with acute pancreatitis include the following: strict NPO, NG tube to low intermittent suction. The nurse recognizes that these interventions will:
A
Prevent secretion of gastric acid
B
Decrease the client’s need for insulin
C
Reduce the secretion of pancreatic enzymes
D
Eliminate the need for analgesia
Question 14 Explanation:
Placing the client on strict NPO status will stop the inflammatory process by reducing the secretion of pancreatic enzymes. The use of low, intermittent suction prevents release of secretion in the duodenum. Decreasing the client’s need for insulin is incorrect because the client requires exogenous insulin. Preventing secretion of gastric acid is incorrect because it does not prevent the secretion of gastric acid. Eliminating the need for analgesia is incorrect because it does not eliminate the need for analgesia.
Question 15
The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
A
The nurse cleans the stethoscope with alcohol and returns it to the exam room.
B
The nurse uses the stethoscope to assess the blood pressure of other assigned clients.
C
The nurse leaves the stethoscope in the client’s room for future use.
D
The nurse cleans the stethoscope with water, dries it, and returns it to the nurse’s station.
Question 15 Explanation:
The stethoscope should be left in the client’s room for future use. The stethoscope should not be returned to the exam room or the nurse’s station. The stethoscope should not be used to assess other clients.
Question 16
The physician has prescribed Cognex (tacrine) for a client with dementia. The nurse should monitor the client for adverse reactions, which include:
A
Hypoglycemia
B
Tinnitus
C
Jaundice
D
Urinary retention
Question 16 Explanation:
An adverse reaction to Cognex is drug-induced hepatitis. The nurse should monitor the client for signs of jaundice. Other answer choices are incorrect because they are not associated with the use of Cognex.
Question 17
An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?
A
The child should not play on his rocking horse.
B
Applying warm compresses to decrease pain.
C
The child will need a special diet to promote healing.
D
Diapering should be avoided for 1–2 weeks.
Question 17 Explanation:
The child will need to avoid straddle toys, swimming, and rough play until allowed by the surgeon. Other answer choices do not relate to the post-operative care of the child with hypospadias; therefore, they are incorrect.
Question 18
At the 6-week check-up, the mother asks when she can expect the baby to sleep all night. The nurse should tell the mother that most infants begin to sleep all night by age:
A
3–4 months
B
1 month
C
2 months
D
5–6 months
Question 18 Explanation:
Most infants begin nocturnal sleep lasting 9–11 hours by 3–4 months of age. 1 and 2 months are incorrect because the infant is still waking for nighttime feedings. 5–6 months is incorrect because it does not answer the question.
Question 19
The physician has ordered Stadol (butorphanol) for a post-operative client. The nurse knows that the medication is having its intended effect if the client:
A
States that he is feeling less nauseated
B
Is asleep 30 minutes after the injection
C
Has an increased urinary output
D
Asks for extra servings on his meal tray
Question 19 Explanation:
Stadol reduces the perception of pain, which allows the post-operative client to rest. Relief of pain generally results in less nausea, but it is not the intended effect of the medication.
Question 20
The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:
A
Didronel (etidronate)
B
Atropine (atropine sulfate)
C
Tensilon (edrophonium)
D
Prostigmine (neostigmine)
Question 20 Explanation:
Protigmine is used to treat clients with myasthenia gravis. Atropine (atropine sulfate) is incorrect because it is used to reverse the effects of neostigmine. Didronel (etidronate) is incorrect because the drug is unrelated to the treatment of myasthenia gravis. Tensilon (edrophonium) is incorrect because it is the test for myasthenia gravis.
Question 21
A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents?
A
Tuck a disposable diaper beneath the cast at the perineal opening
B
Provide crayons and a coloring book for play activity
C
Keep the bed flat, with a small pillow beneath the cast
D
Increase her intake of high-calorie foods for healing
Question 21 Explanation:
Tucking a disposable diaper at the perineal opening will help prevent soiling of the cast by urine and stool. Keeping the bed flat, with a small pillow beneath the cast is incorrect because the head of the bed should be elevated. Providing crayons and a coloring book for play activity is incorrect because the child can place the crayons beneath the cast, causing pressure areas to develop. Increasing her intake of high-calorie foods for healing is incorrect because the child does not need high-calorie foods that would cause weight gain while she is immobilized by the cast.
Question 22
The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:
A
The medication is given one time daily every other day.
B
The medication will be needed throughout the child’s lifetime.
C
The medication schedule can be arranged to allow for drug holidays.
D
The medication will be needed only during times of rapid growth.
Question 22 Explanation:
The medication will be needed throughout the child’s lifetime. Other answer questions contain inaccurate statements; therefore, they are incorrect.
Question 23
When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
A
Orange-tinged urine containing particles of calculi
B
Cherry-red urine that gradually becomes clearer
C
Dark red urine that becomes cloudy in appearance
D
Dark, smoky-colored urine with high specific gravity
Question 23 Explanation:
Following extracorporeal lithotripsy, the urine will appear cherry red in color but will gradually change to clear urine. The urine will be red, not orange. The urine will be not be dark red or cloudy in appearance.Dark, smoky-colored urine with high specific gravity is incorrect because it describes the urinary output of the client with acute glomerulonephritis.
Question 24
The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?
A
Coolness and discoloration of the digits
B
Complaints of pain
C
Difficulty moving the digits
D
Temperature of 100°F
Question 24 Explanation:
Coolness and discoloration of the reimplanted digits indicates compromised circulation, which should be reported immediately to the physician. The temperature should be monitored, but the client would receive antibiotics to prevent infection. Complaints of pain and difficulty moving the digits are expected following amputation and reimplantation; therefore, they are incorrect.
Question 25
A client with diverticulitis is admitted with nausea, vomiting, and dehydration. Which finding suggests a complication of diverticulitis?
A
Boardlike abdomen
B
Abdominal distention
C
Low-grade fever
D
Pain in the left lower quadrant
Question 25 Explanation:
A rigid or boardlike abdomen is suggestive of peritonitis, which is a complication of diverticulitis. Other answer choices are common findings in diverticulitis; therefore, they are incorrect.
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NCLEX- PN Practice Exam 6 (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 6 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents?
A
Keep the bed flat, with a small pillow beneath the cast
B
Tuck a disposable diaper beneath the cast at the perineal opening
C
Increase her intake of high-calorie foods for healing
D
Provide crayons and a coloring book for play activity
Question 1 Explanation:
Tucking a disposable diaper at the perineal opening will help prevent soiling of the cast by urine and stool. Keeping the bed flat, with a small pillow beneath the cast is incorrect because the head of the bed should be elevated. Providing crayons and a coloring book for play activity is incorrect because the child can place the crayons beneath the cast, causing pressure areas to develop. Increasing her intake of high-calorie foods for healing is incorrect because the child does not need high-calorie foods that would cause weight gain while she is immobilized by the cast.
Question 2
A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
A
Lipitor (atorvastatin)
B
Prilosec (omeprazole)
C
Premarin (conjugated estrogens)
D
Synthroid (levothyroxine)
Question 2 Explanation:
Lipid-lowering agents are contraindicated in the client with active liver disease. Other answer choices are incorrect because they are not contraindicated in the client with active liver disease.
Question 3
Which of the following pediatric clients is at greatest risk for latex allergy?
A
The child with a myelomeningocele
B
The child with rheumatic fever
C
The child with coxa plana
D
The child with epispadias
Question 3 Explanation:
The child with myelomenigocele is at greatest risk for the development of latex allergy because of repeated exposure to latex products during surgery and from numerous urinary catheterizations. Other answer choices are much less likely to be exposed to latex; therefore, they are incorrect.
Question 4
The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
A
Oatmeal, apple juice, dry toast, and coffee
B
Cornflakes, whole milk, banana, and coffee
C
Scrambled eggs, bacon, toast, and coffee
D
Pancakes, ham, tomato juice, and coffee
Question 4 Explanation:
Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure.Cornflakes and whole milk are higher in sodium and are poor sources of fiber. Scrambled eggs, bacon,and ham are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
Question 5
A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
A
After dinner
B
With breakfast
C
Before lunch
D
At bedtime
Question 5 Explanation:
Glucotrol XL is given once a day with breakfast. At bedtime is incorrect because the client would develop hypoglycemia while sleeping. Before lunch and after dinner are incorrect because the client would develop hypoglycemia later in the day or evening.
Question 6
The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
A
Cogwheel rigidity and loss of coordination
B
Ascending paralysis and loss of motor function
C
Progressive weakness that is worse at the day’s end
D
Visual disturbances, including diplopia
Question 6 Explanation:
The client with myasthenia develops progressive weakness that worsens during the day. Visual disturbances, including diplopia is incorrect because it refers to symptoms of multiple sclerosis. Ascending paralysis and loss of motor function is incorrect because it refers to symptoms of Guillain Barre syndrome. Cogwheel rigidity and loss of coordination is incorrect because it refers to Parkinson’s disease.
Question 7
Physician’s orders for a client with acute pancreatitis include the following: strict NPO, NG tube to low intermittent suction. The nurse recognizes that these interventions will:
A
Reduce the secretion of pancreatic enzymes
B
Prevent secretion of gastric acid
C
Eliminate the need for analgesia
D
Decrease the client’s need for insulin
Question 7 Explanation:
Placing the client on strict NPO status will stop the inflammatory process by reducing the secretion of pancreatic enzymes. The use of low, intermittent suction prevents release of secretion in the duodenum. Decreasing the client’s need for insulin is incorrect because the client requires exogenous insulin. Preventing secretion of gastric acid is incorrect because it does not prevent the secretion of gastric acid. Eliminating the need for analgesia is incorrect because it does not eliminate the need for analgesia.
Question 8
When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
A
Dark red urine that becomes cloudy in appearance
B
Cherry-red urine that gradually becomes clearer
C
Orange-tinged urine containing particles of calculi
D
Dark, smoky-colored urine with high specific gravity
Question 8 Explanation:
Following extracorporeal lithotripsy, the urine will appear cherry red in color but will gradually change to clear urine. The urine will be red, not orange. The urine will be not be dark red or cloudy in appearance.Dark, smoky-colored urine with high specific gravity is incorrect because it describes the urinary output of the client with acute glomerulonephritis.
Question 9
A client with diverticulitis is admitted with nausea, vomiting, and dehydration. Which finding suggests a complication of diverticulitis?
A
Boardlike abdomen
B
Low-grade fever
C
Pain in the left lower quadrant
D
Abdominal distention
Question 9 Explanation:
A rigid or boardlike abdomen is suggestive of peritonitis, which is a complication of diverticulitis. Other answer choices are common findings in diverticulitis; therefore, they are incorrect.
Question 10
The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:
A
The medication is given one time daily every other day.
B
The medication will be needed throughout the child’s lifetime.
C
The medication will be needed only during times of rapid growth.
D
The medication schedule can be arranged to allow for drug holidays.
Question 10 Explanation:
The medication will be needed throughout the child’s lifetime. Other answer questions contain inaccurate statements; therefore, they are incorrect.
Question 11
A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
A
6 weeks
B
1 week
C
2 weeks
D
4 weeks
Question 11 Explanation:
Depot injections of Haldol are administered every 4 weeks. 1 week and 2 weeks are incorrect because the medication is still in the client’s system. 6 weeks is incorrect because the medication has been eliminated from the client’s system, which allows the symptoms of schizophrenia to return.
Question 12
The physician has prescribed Cognex (tacrine) for a client with dementia. The nurse should monitor the client for adverse reactions, which include:
A
Jaundice
B
Tinnitus
C
Hypoglycemia
D
Urinary retention
Question 12 Explanation:
An adverse reaction to Cognex is drug-induced hepatitis. The nurse should monitor the client for signs of jaundice. Other answer choices are incorrect because they are not associated with the use of Cognex.
Question 13
The nurse is teaching the mother of a child with cystic fibrosis how to do postural drainage. The nurse should tell the mother to:
A
Use the heel of her hand during percussion
B
Change the child’s position every 20 minutes
C
Do percussion after the child eats and at bedtime
D
Use cupped hands during percussion
Question 13 Explanation:
The nurse or parent should use a cupped hand when performing chest percussion. Using the heel of her hand during percussion is incorrect because the hand should be cupped. The child’s position should be changed every 5–10 minutes and the whole session should be limited to 20 minutes. Percussion should be done before meals.
Question 14
At the 6-week check-up, the mother asks when she can expect the baby to sleep all night. The nurse should tell the mother that most infants begin to sleep all night by age:
A
5–6 months
B
3–4 months
C
2 months
D
1 month
Question 14 Explanation:
Most infants begin nocturnal sleep lasting 9–11 hours by 3–4 months of age. 1 and 2 months are incorrect because the infant is still waking for nighttime feedings. 5–6 months is incorrect because it does not answer the question.
Question 15
A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?
A
High calorie, high carbohydrate, low protein
B
High calorie, low carbohydrate, high fat
C
High calorie, high protein, low fat
D
High calorie, high protein, high fat
Question 15 Explanation:
The suggested diet for the client with AIDS is one that is high calorie, high protein, and low fat. Clients with AIDS have a reduced tolerance to fat because of the disease as well as side effects from some antiviral medications; therefore, high fat diet are incorrect. The client needs a high-protein diet.
Question 16
The physician has ordered Stadol (butorphanol) for a post-operative client. The nurse knows that the medication is having its intended effect if the client:
A
Asks for extra servings on his meal tray
B
Is asleep 30 minutes after the injection
C
Has an increased urinary output
D
States that he is feeling less nauseated
Question 16 Explanation:
Stadol reduces the perception of pain, which allows the post-operative client to rest. Relief of pain generally results in less nausea, but it is not the intended effect of the medication.
Question 17
The mother of a child with cystic fibrosis tells the nurse that her child makes "snoring" sounds when breathing. The nurse is aware that many children with cystic fibrosis have:
A
Choanal atresia
B
Enlarged adenoids
C
Septal deviations
D
Nasal polyps
Question 17 Explanation:
Children with cystic fibrosis are susceptible to chronic sinusitis and nasal polyps, which might require surgical removal. Choanal atresia is incorrect because it is a congenital condition in which there is a bony obstruction between the nares and the pharynx.Septal deviations and enlarged adenoids are not specific to the child with cystic fibrosis; therefore, they are incorrect.
Question 18
The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
A
The nurse cleans the stethoscope with water, dries it, and returns it to the nurse’s station.
B
The nurse uses the stethoscope to assess the blood pressure of other assigned clients.
C
The nurse leaves the stethoscope in the client’s room for future use.
D
The nurse cleans the stethoscope with alcohol and returns it to the exam room.
Question 18 Explanation:
The stethoscope should be left in the client’s room for future use. The stethoscope should not be returned to the exam room or the nurse’s station. The stethoscope should not be used to assess other clients.
Question 19
An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?
A
Diapering should be avoided for 1–2 weeks.
B
The child should not play on his rocking horse.
C
The child will need a special diet to promote healing.
D
Applying warm compresses to decrease pain.
Question 19 Explanation:
The child will need to avoid straddle toys, swimming, and rough play until allowed by the surgeon. Other answer choices do not relate to the post-operative care of the child with hypospadias; therefore, they are incorrect.
Question 20
The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25mL. The nurse should:
A
Give the medication in one injection in the dorsogluteal muscle
B
Give the medication in one injection in the ventrogluteal muscle
C
Divide the amount in two injections and give one in the ventrogluteal muscle and one in the vastus lateralis muscle
D
Divide the amount into two injections and administer in each vastus lateralis muscle
Question 20 Explanation:
No more than 1mL should be given in the vastus lateralis of the infant. Other answer choices are incorrect because the dorsogluteal and ventrogluteal muscles are not used for injections in the infant.
Question 21
The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?
A
Patching one of the eyes to strengthen the muscles
B
Encouraging play with a video game to improve muscle coordination
C
Providing musical tapes to provide auditory training
D
Providing suckers and pinwheels to help strengthen tongue movement
Question 21 Explanation:
The nurse can help ready the child with cerebral palsy for speech therapy by providing activities that help the child develop tongue control. Most children with cerebral palsy have visual and auditory difficulties that require glasses or hearing devices rather than rehabilitative training. Video games are not appropriate for the age or developmental level of the child with cerebral palsy.
Question 22
The nurse is teaching the parents of a newborn with osteogenesis imperfecta. The nurse should tell the parents:
A
That only the bones are affected by the disease
B
To lift the baby by the buttocks when diapering
C
That the condition is a temporary one
D
That the baby will need daily calcium supplements
Question 22 Explanation:
To prevent fractures, the parents should lift the baby by the buttocks rather than the ankles when diapering. Children with osteogenesis imperfecta have normal calcium and phosphorus levels. The condition is not temporary. The teeth and the sclera are also affected.
Question 23
The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?
A
Difficulty moving the digits
B
Temperature of 100°F
C
Coolness and discoloration of the digits
D
Complaints of pain
Question 23 Explanation:
Coolness and discoloration of the reimplanted digits indicates compromised circulation, which should be reported immediately to the physician. The temperature should be monitored, but the client would receive antibiotics to prevent infection. Complaints of pain and difficulty moving the digits are expected following amputation and reimplantation; therefore, they are incorrect.
Question 24
An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:
A
Drink a glass of whole milk before going to sleep at night
B
Skip breakfast but eat a larger lunch and dinner
C
Drink a glass of orange juice after adding a couple of teaspoons of sugar
D
Keep crackers at the bedside for eating before she arises
Question 24 Explanation:
Eating a carbohydrate source such as dry crackers or toast before arising helps alleviate symptoms of morning sickness. Drinking a glass of whole milk is incorrect because the additional fat might increase the client’s nausea. The client does not need to skip meals. Drinking a glass of orange juice after adding a couple of teaspoons of sugar is the treatment of hypoglycemia, not morning sickness; therefore, it is incorrect.
Question 25
The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:
A
Didronel (etidronate)
B
Prostigmine (neostigmine)
C
Atropine (atropine sulfate)
D
Tensilon (edrophonium)
Question 25 Explanation:
Protigmine is used to treat clients with myasthenia gravis. Atropine (atropine sulfate) is incorrect because it is used to reverse the effects of neostigmine. Didronel (etidronate) is incorrect because the drug is unrelated to the treatment of myasthenia gravis. Tensilon (edrophonium) is incorrect because it is the test for myasthenia gravis.
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1. The physician has ordered Stadol (butorphanol) for a post-operative client. The nurse knows that the medication is having its intended effect if the client:
Is asleep 30 minutes after the injection
Asks for extra servings on his meal tray
Has an increased urinary output
States that he is feeling less nauseated
2. The mother of a child with cystic fibrosis tells the nurse that her child makes “snoring” sounds when breathing. The nurse is aware that many children with cystic fibrosis have:
Choanal atresia
Nasal polyps
Septal deviations
Enlarged adenoids
3. A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
Prilosec (omeprazole)
Synthroid (levothyroxine)
Premarin (conjugated estrogens)
Lipitor (atorvastatin)
4. The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
Cornflakes, whole milk, banana, and coffee
Scrambled eggs, bacon, toast, and coffee
Oatmeal, apple juice, dry toast, and coffee
Pancakes, ham, tomato juice, and coffee
5. An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?
The child should not play on his rocking horse.
Applying warm compresses to decrease pain.
Diapering should be avoided for 1–2 weeks.
The child will need a special diet to promote healing.
6. An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:
Keep crackers at the bedside for eating before she arises
Drink a glass of whole milk before going to sleep at night
Skip breakfast but eat a larger lunch and dinner
Drink a glass of orange juice after adding a couple of teaspoons of sugar
7. The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
The nurse leaves the stethoscope in the client’s room for future use.
The nurse cleans the stethoscope with alcohol and returns it to the exam room.
The nurse uses the stethoscope to assess the blood pressure of other assigned clients.
The nurse cleans the stethoscope with water, dries it, and returns it to the nurse’s station.
8. The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:
The medication will be needed only during times of rapid growth.
The medication will be needed throughout the child’s lifetime.
The medication schedule can be arranged to allow for drug holidays.
The medication is given one time daily every other day.
9. A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
At bedtime
With breakfast
Before lunch
After dinner
10. The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
Visual disturbances, including diplopia
Ascending paralysis and loss of motor function
Cogwheel rigidity and loss of coordination
Progressive weakness that is worse at the day’s end
11. The nurse is teaching the parents of a newborn with osteogenesis imperfecta. The nurse should tell the parents:
That the baby will need daily calcium supplements
To lift the baby by the buttocks when diapering
That the condition is a temporary one
That only the bones are affected by the disease
12. Physician’s orders for a client with acute pancreatitis include the following: strict NPO, NG tube to low intermittent suction. The nurse recognizes that these interventions will:
Reduce the secretion of pancreatic enzymes
Decrease the client’s need for insulin
Prevent secretion of gastric acid
Eliminate the need for analgesia
13. A client with diverticulitis is admitted with nausea, vomiting, and dehydration. Which finding suggests a complication of diverticulitis?
Pain in the left lower quadrant
Boardlike abdomen
Low-grade fever
Abdominal distention
14. The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:
Prostigmine (neostigmine)
Atropine (atropine sulfate)
Didronel (etidronate)
Tensilon (edrophonium)
15. A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?
High calorie, high protein, high fat
High calorie, high carbohydrate, low protein
High calorie, low carbohydrate, high fat
High calorie, high protein, low fat
16. The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?
Patching one of the eyes to strengthen the muscles
Providing suckers and pinwheels to help strengthen tongue movement
Providing musical tapes to provide auditory training
Encouraging play with a video game to improve muscle coordination
17. At the 6-week check-up, the mother asks when she can expect the baby to sleep all night. The nurse should tell the mother that most infants begin to sleep all night by age:
1 month
2 months
3–4 months
5–6 months
18. Which of the following pediatric clients is at greatest risk for latex allergy?
The child with a myelomeningocele
The child with epispadias
The child with coxa plana
The child with rheumatic fever
19. The nurse is teaching the mother of a child with cystic fibrosis how to do postural drainage. The nurse should tell the mother to:
Use the heel of her hand during percussion
Change the child’s position every 20 minutes
Do percussion after the child eats and at bedtime
Use cupped hands during percussion
20. The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25mL. The nurse should:
Divide the amount into two injections and administer in each vastus lateralis muscle
Give the medication in one injection in the dorsogluteal muscle
Divide the amount in two injections and give one in the ventrogluteal muscle and one in the vastus lateralis muscle
Give the medication in one injection in the ventrogluteal muscle
21. A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
1 week
2 weeks
4 weeks
6 weeks
22. A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents?
Keep the bed flat, with a small pillow beneath the cast
Provide crayons and a coloring book for play activity
Increase her intake of high-calorie foods for healing
Tuck a disposable diaper beneath the cast at the perineal opening
23. The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?
Temperature of 100°F
Coolness and discoloration of the digits
Complaints of pain
Difficulty moving the digits
24. When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
Cherry-red urine that gradually becomes clearer
Orange-tinged urine containing particles of calculi
Dark red urine that becomes cloudy in appearance
Dark, smoky-colored urine with high specific gravity
25. The physician has prescribed Cognex (tacrine) for a client with dementia. The nurse should monitor the client for adverse reactions, which include:
Hypoglycemia
Jaundice
Urinary retention
Tinnitus
Answers and Rationales
Answer A is correct. Stadol reduces the perception of pain, which allows the post-operative client to rest. Answers B and C are not affected by the medication; therefore, they are incorrect. Relief of pain generally results in less nausea, but it is not the intended effect of the medication; therefore, answer D is incorrect.
Answer B is correct. Children with cystic fibrosis are susceptible to chronic sinusitis and nasal polyps, which might require surgical removal. Answer A is incorrect because it is a congenital condition in which there is a bony obstruction between the nares and the pharynx. Answers C and D are not specific to the child with cystic fibrosis; therefore, they are incorrect.
Answer D is correct. Lipid-lowering agents are contraindicated in the client with active liver disease. Answers A, B, and C are incorrect because they are not contraindicated in the client with active liver disease.
Answer C is correct. Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure. Answer A is incorrect because cornflakes and whole milk are higher in sodium and are poor sources of fiber. Answers B and D are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
Answer A is correct. The child will need to avoid straddle toys, swimming, and rough play until allowed by the surgeon. Answers B, C, and D do not relate to the post-operative care of the child with hypospadias; therefore, they are incorrect.
Answer A is correct. Eating a carbohydrate source such as dry crackers or toast before arising helps alleviate symptoms of morning sickness. Answer B is incorrect because the additional fat might increase the client’s nausea. Answer C is incorrect because the client does not need to skip meals. Answer D is the treatment of hypoglycemia, not morning sickness; therefore, it is incorrect.
Answer A is correct. The stethoscope should be left in the client’s room for future use. The stethoscope should not be returned to the exam room or the nurse’s station; therefore, answers B and D are incorrect. The stethoscope should not be used to assess other clients; therefore, answer C is incorrect.
Answer B is correct. The medication will be needed throughout the child’s lifetime. Answers A, C, and D contain inaccurate statements; therefore, they are incorrect.
Answer B is correct. Glucotrol XL is given once a day with breakfast. Answer A is incorrect because the client would develop hypoglycemia while sleeping. Answers C and D are incorrect because the client would develop hypoglycemia later in the day or evening.
Answer D is correct. The client with myasthenia develops progressive weakness that worsens during the day. Answer A is incorrect because it refers to symptoms of multiple sclerosis. Answer B is incorrect because it refers to symptoms of Guillain Barre syndrome. Answer C is incorrect because it refers to Parkinson’s disease.
Answer B is correct. To prevent fractures, the parents should lift the baby by the buttocks rather than the ankles when diapering. Answer A is incorrect because children with osteogenesis imperfecta have normal calcium and phosphorus levels. Answer C is incorrect because the condition is not temporary. Answer D is incorrect because the teeth and the sclera are also affected.
Answer A is correct. Placing the client on strict NPO status will stop the inflammatory process by reducing the secretion of pancreatic enzymes. The use of low, intermittent suction prevents release of secretion in the duodenum. Answer B is incorrect because the client requires exogenous insulin. Answer C is incorrect because it does not prevent the secretion of gastric acid. Answer D is incorrect because it does not eliminate the need for analgesia.
Answer B is correct. A rigid or boardlike abdomen is suggestive of peritonitis, which is a complication of diverticulitis. Answers A, C, and D are common findings in diverticulitis; therefore, they are incorrect.
Answer A is correct. Protigmine is used to treat clients with myasthenia gravis. Answer B is incorrect because it is used to reverse the effects of neostigmine. Answer C is incorrect because the drug is unrelated to the treatment of myasthenia gravis. Answer D is incorrect because it is the test for myasthenia gravis.
Answer D is correct. The suggested diet for the client with AIDS is one that is high calorie, high protein, and low fat. Clients with AIDS have a reduced tolerance to fat because of the disease as well as side effects from some antiviral medications; therefore, answers A and C are incorrect. Answer B is incorrect because the client needs a high-protein diet.
Answer B is correct. The nurse can help ready the child with cerebral palsy for speech therapy by providing activities that help the child develop tongue control. Most children with cerebral palsy have visual and auditory difficulties that require glasses or hearing devices rather than rehabilitative training; therefore, answers A and C are incorrect. Answer D is incorrect because video games are not appropriate for the age or developmental level of the child with cerebral palsy.
Answer C is correct. Most infants begin nocturnal sleep lasting 9–11 hours by 3–4 months of age. Answers A and B are incorrect because the infant is still waking for nighttime feedings. Answer D is incorrect because it does not answer the question.
Answer A is correct. The child with myelomenigocele is at greatest risk for the development of latex allergy because of repeated exposure to latex products during surgery and from numerous urinary catheterizations. Answers B, C, and D are much less likely to be exposed to latex; therefore, they are incorrect.
Answer D is correct. The nurse or parent should use a cupped hand when performing chest percussion. Answer A is incorrect because the hand should be cupped. Answer B is incorrect because the child’s position should be changed every 5–10 minutes and the whole session should be limited to 20 minutes. Answer C is incorrect because chest percussion should be done before meals.
Answer A is correct. No more than 1mL should be given in the vastus lateralis of the infant. Answers B, C, and D are incorrect because the dorsogluteal and ventrogluteal muscles are not used for injections in the infant.
Answer C is correct. Depot injections of Haldol are administered every 4 weeks. Answers A and B are incorrect because the medication is still in the client’s system. Answer D is incorrect because the medication has been eliminated from the client’s system, which allows the symptoms of schizophrenia to return.
Answer D is correct. Tucking a disposable diaper at the perineal opening will help prevent soiling of the cast by urine and stool. Answer A is incorrect because the head of the bed should be elevated. Answer B is incorrect because the child can place the crayons beneath the cast, causing pressure areas to develop. Answer C is incorrect because the child does not need high-calorie foods that would cause weight gain while she is immobilized by the cast.
Answer B is correct. Coolness and discoloration of the reimplanted digits indicates compromised circulation, which should be reported immediately to the physician. The temperature should be monitored, but the client would receive antibiotics to prevent infection; therefore, answer A is incorrect. Answers C and D are expected following amputation and reimplantation; therefore, they are incorrect.
Answer A is correct. Following extracorporeal lithotripsy, the urine will appear cherry red in color but will gradually change to clear urine. Answer B is incorrect because the urine will be red, not orange. Answer C is incorrect because the urine will be not be dark red or cloudy in appearance. Answer D is incorrect because it describes the urinary output of the client with acute glomerulonephritis.
Answer B is correct. An adverse reaction to Cognex is drug-induced hepatitis. The nurse should monitor the client for signs of jaundice. Answers A, C, and D are incorrect because they are not associated with the use of Cognex.