NCLEX- PN Practice Exam 7

1. The physician has ordered a low-potassium diet for a child with acute glomerulonephritis. Which snack is suitable for the child with potassium restrictions?

1. Raisins
2. Oranges
3. Apricots
4. Bananas

2. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:

1. Withholding intake after midnight
2. Telling the client that no special preparation is needed
3. Explaining that a small dose of radioactive isotope will be used
4. Giving an oral suspension of glucose 1 hour before the test

3. The nurse is preparing to give an oral potassium supplement. The nurse should:

1. Give the medication without diluting it
2. Give the medication with 4oz. of juice
3. Give the medication with water only
4. Give the medication on an empty stomach

4. The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true regarding collection of cultures for cytomegalovirus?

1. Stool cultures are preferred for definitive diagnosis.
2. Pregnant caregivers may obtain cultures.
3. Collection of one specimen is sufficient.
4. Accurate diagnosis depends on fresh specimens.

5. A pediatric client with burns to the hands and arms has dressing changes with Sulfamylon (mafenide acetate) cream. The nurse is aware that the medication:

1. Will cause dark staining of the surrounding skin
2. Produces a cooling sensation when applied
3. Can alter the function of the thyroid
4. Produces a burning sensation when applied

6. The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care, the nurse should:

1. Maintain strict intake and output
2. Check the pulse before giving the medication
3. Administer the medication 30 minutes before meals
4. Provide oral hygiene and gum care every shift

7. A client receiving chemotherapy for breast cancer has an order for Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of the chemotherapy. The purpose of the medication is to:

1. Prevent anemia
2. Promote relaxation
3. Prevent nausea
4. Increase neutrophil counts

8. The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:

1. Pull the ear down and back
2. Pull the ear straight out
3. Pull the ear up and back
4. Leave the ear undisturbed

9. A client with schizophrenia has been taking Thorazine (chlorpromazine) 200mg four times a day. Which finding should be reported to the doctor immediately?

1. The client complains of thirst
2. The client has gained 4 pounds in the past 2 months
3.  The client complains of a sore throat
4.  The client naps throughout the day

10. A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:

1. Orange juice
2. Water only
3. Milk
4. Apple juice

11. A client is admitted with burns of the right arm, chest, and head. According to the Rule of Nines, the percent of burn injury is:

1. 18%
2. 27%
3. 36%
4. 45%

12. A client who was admitted with chest pain and shortness of breath has a standing order for oxygen via mask. Standing orders for oxygen mean that the nurse can apply oxygen at:

1. 2L per minute
2. 6L per minute
3. 10L per minute
4. 12L per minute

13. The nurse is caring for a client with an ileostomy. The nurse should pay careful attention to care around the stoma because:

1. Digestive enzymes cause skin breakdown.
2. Stools are less watery and contain more solid matter.
3. The stoma will heal more slowly than expected.
4. It is difficult to fit the appliance to the stoma site.

14. The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:

1. Anorexia
2. Diarrhea
3. Tinnitus
4. Pruritis

15. A client is admitted to the emergency room with symptoms of delirium tremens. After admitting the client to a private room, the priority nursing intervention is to:

1. Obtain a history of his alcohol use
2. Provide seizure precautions
3. Keep the room cool and dark
4. Administer thiamine and zinc

16. The nurse is providing dietary teaching for a client with gout. Which dietary selection is suitable for the client with gout?

1. Broiled liver, macaroni and cheese, spinach
2. Stuffed crab, steamed rice, peas
3. Baked chicken, pasta salad, asparagus casserole
4. Steak, baked potato, tossed salad

17. A newborn has been diagnosed with exstrophy of the bladder. The nurse should position the newborn:

1. Prone
2. Supine
3. On either side
4. With the head elevated

18. The mother of a 3-month-old with esophageal reflux asks the nurse what she can do to lessen the baby’s reflux. The nurse should tell the mother to:

1. Feed the baby only when he is hungry
2. Burp the baby after the feeding is completed
3. Place the baby supine with head elevated
4. Burp the baby frequently throughout the feeding

19. A child is hospitalized with a fractured femur involving the epiphysis. Epiphyseal fractures are serious because:

1. Bone marrow is lost through the fracture site.
2. Normal bone growth is affected.
3. Blood supply to the bone is obliterated.
4. Callus formation prevents bone healing.

20. Before administering a nasogastric feeding to a client hospitalized following a CVA, the nurse aspirates 40mL of residual. The nurse should:

1. Replace the aspirate and administer the feeding
2. Discard the aspirate and withhold the feeding
3. Discard the aspirate and begin the feeding
4. Replace the aspirate and withhold the feeding

21. A client has an order for Dilantin (phenytoin) .2g orally twice a day. The medication is available in 100mg capsules. For the morning medication, the nurse should administer:

1. 1 capsule
2. 2 capsules
3. 3 capsules
4. 4 capsules

22. The LPN is reviewing the lab results of an elderly client when she notes a specific gravity of 1.006. The nurse recognizes that:

1. The client has impaired renal function.
2. The client has a normal specific gravity.
3. The client has mild to moderate dehydration.
4. The client has diluted urine from fluid overload.

23. A client with pancreatitis has requested pain medication. Which pain medication is indicated for the client with pancreatitis?

1. Demerol (meperidine)
2.  Toradol (ketorolac)
3. Morphine (morphine sulfate)
4.  Codeine (codeine)

24. A client with a hiatal hernia has been taking magnesium hydroxide for relief of heartburn. Overuse of magnesium-based antacids can cause the client to have:

1.  Constipation
2.  Weight gain
3.  Anorexia
4.  Diarrhea

25. When performing a newborn assessment, the nurse measures the circumference of the neonate’s head and chest. Which assessment finding is expected in the normal newborn?

1. The head and chest circumference are the same.
2. The head is 2cm larger than the chest.
3. The head is 3cm smaller than the chest.
4. The head is 4cm larger than the chest.

Answers and Rationales

1. Answer C is correct. Apricots are low in potassium; therefore, it is a suitable snack of the client on a potassium-restricted diet. Raisins, oranges, and bananas are all good sources of potassium; therefore, answers A, B, and C are incorrect.
2. Answer B is correct. No special preparation is needed for the blood test for H. pylori. Answer A is incorrect because the client is not NPO before the test. Answer C is incorrect because it refers to preparation for the breath test. Answer D is incorrect because glucose is not administered before the test.
3. Answer B is correct. Oral potassium supplements should be given in at least 4oz. of juice or other liquid, to prevent gastric upset and to disguise the unpleasant taste. Answers A, C, and D are incorrect because they cause gastric upset.
4. Answer D is correct. Fresh specimens are essential for accurate diagnosis of CMV. Answer A is incorrect because cultures of urine, sputum, and oral swab are preferred. Answer B is incorrect because pregnant caregivers should not be assigned to care for clients with suspected or known infection with CMV. Answer C is incorrect because a convalescent culture is obtained 2–4 weeks after diagnosis.
5. Answer D is correct. The client should receive pain medication 30 minutes before the application of Sulfamylon. Answer A is incorrect because it refers to silver nitrate. Answer B is incorrect because it refers to Silvadene. Answer C is incorrect because it refers to Betadine.
6. Answer D is correct. Gingival hyperplasia is a side effect of Dilantin; therefore, the nurse should provide oral hygiene and gum care every shift. Answers A, B, and C do not apply to the medication; therefore, they are incorrect.
7.  Answer C is correct. Zofran is given before chemotherapy to prevent nausea. Answers A, B, and D are not associated with the medication; therefore, they are incorrect.
8. Answer A is correct. When administering ear drops to a child under 3 years of age, the nurse should pull the ear down and back to straighten the ear canal. Answers B and D are incorrect positions for administering ear drops. Answer C is used for administering ear drops to an adult client.
9. Answer C is correct. The nurse should carefully monitor the client taking Thorazine for signs of infection that can quickly become overwhelming. Answers A, B, and C are incorrect because they are expected side effects of the medication.
10. Answer A is correct. Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent source of ascorbic acid. Answer B is incorrect because the medication should be taken with orange juice or tomato juice. Answer C is incorrect because iron should not be taken with milk because it interferes with absorption. Answer D is incorrect because apple juice does not contain high amounts of ascorbic acid.
11. Answer B is correct. Burn injury of the arm (9%), chest (9%), and head (9%) accounts for burns covering 27% of the total body surface area. Answers A, C, and D are incorrect percentages.
12. Answer B is correct. With standing orders, the nurse can administer oxygen at 6L per minute via mask. Answer A is incorrect because the amount is too low to help the client with chest pain and shortness of breath. Answers C and D have oxygen levels requiring a doctor’s order.
13. Answer A is correct. Stool from the ileostomy contains digestive enzymes that can cause severe skin breakdown. Answer B contains contradictory information; therefore, it is incorrect. Answers C and D contain inaccurate statements; therefore, they are incorrect.
14. Answer C is correct. Tinnitus is a sign of aspirin toxicity. Answers A, B, and D are not related to aspirin toxicity; therefore, they are incorrect.
15. Answer B is correct. The client with delirium tremens has an increased risk for seizures; therefore, the nurse should provide seizure precautions. Answer A is not a priority in the client’s care; therefore, it is incorrect. Answer C is incorrect because the client should be kept in a dimly lit, not dark, room. Answer D is incorrect because thiamine and multivitamins are given to prevent Wernicke’s encephalopathy, not delirium tremens.
16. Answer D is correct. Steak, baked potato, and tossed salad are lower in purine than the other choices. Liver, crab, and chicken are high in purine; therefore, answers A, B, and C are incorrect.
17. Answer C is correct. Placing the newborn in a side-lying position helps the urine to drain from the exposed bladder. Answer A is incorrect because it would position the child on the exposed bladder. Answers B and D are incorrect because they would allow the urine to pool.
18. Answer D is correct. Burping the baby frequently throughout the feeding will help prevent gastric distention that contributes to esophageal reflux. Answers A and B are incorrect because they allow air to collect in the baby’s stomach, which contributes to reflux. Answer C is incorrect because the baby should be placed side-lying with the head elevated, to prevent aspiration.
19. Answer B is correct. Growth plates located in the epiphysis can be damaged by epiphyseal fractures. Answers A, B, and C are untrue statements; therefore, they are incorrect.
20. Answer A is correct. The nurse should replace the aspirate and administer the feeding because the amount aspirated was less than 50mL. Answers B and C are incorrect because the aspirate should not be discarded. Answer D is incorrect because the feeding should not be withheld.
21. Answer B is correct. The nurse should administer two capsules. Answers A, C, and D contain inaccurate amounts; therefore, they are incorrect.
22. Answer B is correct. The normal specific gravity is 1.005-1.030. Answers A, C, and D are inaccurate statements; therefore, they are incorrect.
23. Answer A is correct. To prevent spasms of the sphincter of Oddi, the client with pancreatitis should receive nonopiate analgesics for pain. Answer B is incorrect because the client with pancreatitis might be prone to bleed; therefore, Toradol is not a drug of choice for pain control. Morphine and codeine, opiate analgesics, are contraindicated for the client with pancreatitis; therefore, answers C and D are incorrect.
24. Answer D is correct. Overuse of magnesium-containing antacids results in diarrhea. Antacids containing calcium and aluminum cause constipation; therefore, answer A is incorrect. Answers B and C are not associated with the use of magnesium antacids; therefore, they are incorrect.
25. Answer B is correct. The head circumference of the normal newborn is approximately 33cm, while the chest circumference is 31cm. Answer A is incorrect because the head and chest are not the same circumference. Answer C is incorrect because the head is larger in circumference than the chest. Answer D is incorrect because the difference in head circumference and chest circumference is too great.