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NCLEX- PN Practice Exam 7 (PM)
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Question 1
The nurse is providing dietary teaching for a client with gout. Which dietary selection is suitable for the client with gout?
A
Steak, baked potato, tossed salad
B
Stuffed crab, steamed rice, peas
C
Baked chicken, pasta salad, asparagus casserole
D
Broiled liver, macaroni and cheese, spinach
Question 1 Explanation:
Steak, baked potato, and tossed salad are lower in purine than the other choices. Liver, crab, and chicken are high in purine.
Question 2
The nurse is caring for a client with an ileostomy. The nurse should pay careful attention to care around the stoma because:
A
Stools are less watery and contain more solid matter.
B
Digestive enzymes cause skin breakdown.
C
The stoma will heal more slowly than expected.
D
It is difficult to fit the appliance to the stoma site.
Question 2 Explanation:
Stool from the ileostomy contains digestive enzymes that can cause severe skin breakdown.
Question 3
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:
A
Diarrhea
B
Anorexia
C
Weight gain
D
Constipation
Question 3 Explanation:
Overuse of magnesium-containing antacids results in diarrhea. Antacids containing calcium and aluminum cause constipation. Weight gain and anorexia are not associated with the use of magnesium antacids; therefore, they are incorrect.
Question 4
The nurse is preparing to give an oral potassium supplement. The nurse should:
A
Give the medication on an empty stomach
B
Give the medication without diluting it
C
Give the medication with water only
D
Give the medication with 4oz. of juice
Question 4 Explanation:
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. Other answer choices are incorrect because they cause gastric upset.
Question 5
A client with schizophrenia has been taking Thorazine (chlorpromazine) 200mg four times a day. Which finding should be reported to the doctor immediately?
A
The client complains of thirst
B
The client has gained 4 pounds in the past 2 months
C
The client naps throughout the day
D
The client complains of a sore throat
Question 5 Explanation:
The nurse should carefully monitor the client taking Thorazine for signs of infection that can quickly become overwhelming. Other answer choices are incorrect because they are expected side effects of the medication.
Question 6
The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:
A
Diarrhea
B
Tinnitus
C
Pruritis
D
Anorexia
Question 6 Explanation:
Tinnitus is a sign of aspirin toxicity. Other answer choices are not related to aspirin toxicity; therefore, they are incorrect.
Question 7
A child is hospitalized with a fractured femur involving the epiphysis. Epiphyseal fractures are serious because:
A
Bone marrow is lost through the fracture site.
B
Normal bone growth is affected.
C
Blood supply to the bone is obliterated.
D
Callus formation prevents bone healing.
Question 7 Explanation:
Growth plates located in the epiphysis can be damaged by epiphyseal fractures. Other answer choices are untrue statements; therefore, they are incorrect.
Question 8
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:
A
Produces a burning sensation when applied
B
Can alter the function of the thyroid
C
Produces a cooling sensation when applied
D
Will cause dark staining of the surrounding skin
Question 8 Explanation:
The client should receive pain medication 30 minutes before the application of Sulfamylon. Staining of the surrounding skin refers to silver nitrate. Produces a cooling sensation when applied refers to Silvadene. Can alter the function of the thyroid it refers to Betadine.
Question 9
A newborn has been diagnosed with exstrophy of the bladder. The nurse should position the newborn:
A
On either side
B
Supine
C
Prone
D
With the head elevated
Question 9 Explanation:
Placing the newborn in a side-lying position helps the urine to drain from the exposed bladder. Prone is incorrect because it would position the child on the exposed bladder. Supine and head elevated are incorrect because they would allow the urine to pool.
Question 10
The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true regarding collection of cultures for cytomegalovirus?
A
Accurate diagnosis depends on fresh specimens.
B
Collection of one specimen is sufficient.
C
Pregnant caregivers may obtain cultures
D
Stool cultures are preferred for definitive diagnosis.
Question 10 Explanation:
Fresh specimens are essential for accurate diagnosis of CMV.Urine, sputum, and oral swab are preferred. Pregnant caregivers should not be assigned to care for clients with suspected or known infection with CMV. A convalescent culture is obtained 2–4 weeks after diagnosis.
Question 11
The physician has ordered a low-potassium diet for a child with acute glomerulonephritis. Which snack is suitable for the child with potassium restrictions?
A
Bananas
B
Apricots
C
Raisins
D
Oranges
Question 11 Explanation:
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, are incorrect.
Question 12
The LPN is reviewing the lab results of an elderly client when she notes a specific gravity of 1.006. The nurse recognizes that:
A
The client has mild to moderate dehydration.
B
The client has a normal specific gravity.
C
The client has impaired renal function.
D
The client has diluted urine from fluid overload.
Question 12 Explanation:
The normal specific gravity is 1.005-1.030.
Question 13
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:
A
2L per minute
B
6L per minute
C
12L per minute
D
10L per minute
Question 13 Explanation:
With standing orders, the nurse can administer oxygen at 6L per minute via mask. 2L per minute is incorrect because the amount is too low to help the client with chest pain and shortness of breath. 10 L per minute and 12 L per minute have oxygen levels requiring a doctor’s order.
Question 14
Before administering a nasogastric feeding to a client hospitalized following a CVA, the nurse aspirates 40mL of residual. The nurse should:
A
Replace the aspirate and withhold the feeding
B
Discard the aspirate and begin the feeding
C
Replace the aspirate and administer the feeding
D
Discard the aspirate and withhold the feeding
Question 14 Explanation:
The nurse should replace the aspirate and administer the feeding because the amount aspirated was less than 50mL. The aspirate should not be discarded. The feeding should not be withheld.
Question 15
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:
A
4 capsules
B
1 capsule
C
2 capsules
D
3 capsules
Question 15 Explanation:
The nurse should administer two capsules. Other answer choices contain inaccurate amounts; therefore, they are incorrect.
Question 16
The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care, the nurse should:
A
Maintain strict intake and output
B
Administer the medication 30 minutes before meals
C
Check the pulse before giving the medication
D
Provide oral hygiene and gum care every shift
Question 16 Explanation:
Gingival hyperplasia is a side effect of Dilantin; therefore, the nurse should provide oral hygiene and gum care every shift. Other answer choices do not apply to the medication; therefore, they are incorrect.
Question 17
The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:
A
Anorexia
B
Diarrhea
C
Tinnitus
D
Pruritis
Question 17 Explanation:
Tinnitus is a sign of aspirin toxicity. Other answer choices are not related to aspirin toxicity; therefore, they are incorrect.
Question 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:
A
Place the baby supine with head elevated
B
Burp the baby after the feeding is completed
C
Feed the baby only when he is hungry
D
Burp the baby frequently throughout the feeding
Question 18 Explanation:
Burping the baby frequently throughout the feeding will help prevent gastric distention that contributes to esophageal reflux. Feeding the baby only when he is hungry and burping the baby after the feeding is completed are incorrect because they allow air to collect in the baby’s stomach, which contributes to reflux. Placing the baby supine with head elevated is incorrect because the baby should be placed side-lying with the head elevated, to prevent aspiration.
Question 19
A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:
A
Water only
B
Apple juice
C
Milk
D
Orange juice
Question 19 Explanation:
Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent source of ascorbic acid. The medication should be taken with orange juice or tomato juice. Iron should not be taken with milk because it interferes with absorption. Apple juice does not contain high amounts of ascorbic acid.
Question 20
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:
A
Prevent anemia
B
Prevent nausea
C
Promote relaxation
D
Increase neutrophil counts
Question 20 Explanation:
Zofran is given before chemotherapy to prevent nausea. Other answer choices are not associated with the medication; therefore, they are incorrect.
Question 21
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:
A
18%
B
27%
C
36%
D
45%
Question 21 Explanation:
Burn injury of the arm (9%), chest (9%), and head (9%) accounts for burns covering 27% of the total body surface area.
Question 22
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?
A
The head is 3cm smaller than the chest.
B
The head is 2cm larger than the chest.
C
The head and chest circumference are the same.
D
The head is 4cm larger than the chest.
Question 22 Explanation:
The head circumference of the normal newborn is approximately 33cm, while the chest circumference is 31cm. The head and chest are not the same circumference. The head is larger in circumference than the chest. The difference in head circumference and chest circumference is too great.
Question 23
The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
A
Pull the ear up and back
B
Pull the ear down and back
C
Pull the ear straight out
D
Leave the ear undisturbed
Question 23 Explanation:
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. Pullig the ear straight out and leaving the ear undisturbed are incorrect positions for administering ear drops.Pulling the ear up and back is used for administering ear drops to an adult client.
Question 24
The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
A
Withholding intake after midnight
B
Explaining that a small dose of radioactive isotope will be used
C
Giving an oral suspension of glucose 1 hour before the test
D
Telling the client that no special preparation is needed
Question 24 Explanation:
No special preparation is needed for the blood test for H. pylori. Withholding intake after midnight is incorrect because the client is not NPO before the test. Explaining that a small dose of radioactive isotope will be used is incorrect because it refers to preparation for the breath test. Giving an oral suspension of glucose 1 hour before the test is incorrect because glucose is not administered before the test.
Question 25
A client with pancreatitis has requested pain medication. Which pain medication is indicated for the client with pancreatitis?
A
Toradol (ketorolac)
B
Demerol (meperidine)
C
Codeine (codeine)
D
Morphine (morphine sulfate)
Question 25 Explanation:
To prevent spasms of the sphincter of Oddi, the client with pancreatitis should receive nonopiate analgesics for pain. 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.
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NCLEX- PN Practice Exam 7 (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 7 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
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:
A
Feed the baby only when he is hungry
B
Burp the baby frequently throughout the feeding
C
Burp the baby after the feeding is completed
D
Place the baby supine with head elevated
Question 1 Explanation:
Burping the baby frequently throughout the feeding will help prevent gastric distention that contributes to esophageal reflux. Feeding the baby only when he is hungry and burping the baby after the feeding is completed are incorrect because they allow air to collect in the baby’s stomach, which contributes to reflux. Placing the baby supine with head elevated is incorrect because the baby should be placed side-lying with the head elevated, to prevent aspiration.
Question 2
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:
A
36%
B
27%
C
18%
D
45%
Question 2 Explanation:
Burn injury of the arm (9%), chest (9%), and head (9%) accounts for burns covering 27% of the total body surface area.
Question 3
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:
A
10L per minute
B
6L per minute
C
12L per minute
D
2L per minute
Question 3 Explanation:
With standing orders, the nurse can administer oxygen at 6L per minute via mask. 2L per minute is incorrect because the amount is too low to help the client with chest pain and shortness of breath. 10 L per minute and 12 L per minute have oxygen levels requiring a doctor’s order.
Question 4
A newborn has been diagnosed with exstrophy of the bladder. The nurse should position the newborn:
A
With the head elevated
B
On either side
C
Prone
D
Supine
Question 4 Explanation:
Placing the newborn in a side-lying position helps the urine to drain from the exposed bladder. Prone is incorrect because it would position the child on the exposed bladder. Supine and head elevated are incorrect because they would allow the urine to pool.
Question 5
The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care, the nurse should:
A
Check the pulse before giving the medication
B
Provide oral hygiene and gum care every shift
C
Maintain strict intake and output
D
Administer the medication 30 minutes before meals
Question 5 Explanation:
Gingival hyperplasia is a side effect of Dilantin; therefore, the nurse should provide oral hygiene and gum care every shift. Other answer choices do not apply to the medication; therefore, they are incorrect.
Question 6
A client with pancreatitis has requested pain medication. Which pain medication is indicated for the client with pancreatitis?
A
Demerol (meperidine)
B
Codeine (codeine)
C
Toradol (ketorolac)
D
Morphine (morphine sulfate)
Question 6 Explanation:
To prevent spasms of the sphincter of Oddi, the client with pancreatitis should receive nonopiate analgesics for pain. 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.
Question 7
A child is hospitalized with a fractured femur involving the epiphysis. Epiphyseal fractures are serious because:
A
Blood supply to the bone is obliterated.
B
Bone marrow is lost through the fracture site.
C
Normal bone growth is affected.
D
Callus formation prevents bone healing.
Question 7 Explanation:
Growth plates located in the epiphysis can be damaged by epiphyseal fractures. Other answer choices are untrue statements; therefore, they are incorrect.
Question 8
The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true regarding collection of cultures for cytomegalovirus?
A
Accurate diagnosis depends on fresh specimens.
B
Collection of one specimen is sufficient.
C
Pregnant caregivers may obtain cultures
D
Stool cultures are preferred for definitive diagnosis.
Question 8 Explanation:
Fresh specimens are essential for accurate diagnosis of CMV.Urine, sputum, and oral swab are preferred. Pregnant caregivers should not be assigned to care for clients with suspected or known infection with CMV. A convalescent culture is obtained 2–4 weeks after diagnosis.
Question 9
The nurse is preparing to give an oral potassium supplement. The nurse should:
A
Give the medication with 4oz. of juice
B
Give the medication without diluting it
C
Give the medication on an empty stomach
D
Give the medication with water only
Question 9 Explanation:
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. Other answer choices are incorrect because they cause gastric upset.
Question 10
The nurse is caring for a client with an ileostomy. The nurse should pay careful attention to care around the stoma because:
A
Digestive enzymes cause skin breakdown.
B
Stools are less watery and contain more solid matter.
C
It is difficult to fit the appliance to the stoma site.
D
The stoma will heal more slowly than expected.
Question 10 Explanation:
Stool from the ileostomy contains digestive enzymes that can cause severe skin breakdown.
Question 11
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:
A
Anorexia
B
Diarrhea
C
Constipation
D
Weight gain
Question 11 Explanation:
Overuse of magnesium-containing antacids results in diarrhea. Antacids containing calcium and aluminum cause constipation. Weight gain and anorexia are not associated with the use of magnesium antacids; therefore, they are incorrect.
Question 12
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:
A
Prevent nausea
B
Prevent anemia
C
Increase neutrophil counts
D
Promote relaxation
Question 12 Explanation:
Zofran is given before chemotherapy to prevent nausea. Other answer choices are not associated with the medication; therefore, they are incorrect.
Question 13
A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:
A
Orange juice
B
Apple juice
C
Milk
D
Water only
Question 13 Explanation:
Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent source of ascorbic acid. The medication should be taken with orange juice or tomato juice. Iron should not be taken with milk because it interferes with absorption. Apple juice does not contain high amounts of ascorbic acid.
Question 14
The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
A
Telling the client that no special preparation is needed
B
Withholding intake after midnight
C
Giving an oral suspension of glucose 1 hour before the test
D
Explaining that a small dose of radioactive isotope will be used
Question 14 Explanation:
No special preparation is needed for the blood test for H. pylori. Withholding intake after midnight is incorrect because the client is not NPO before the test. Explaining that a small dose of radioactive isotope will be used is incorrect because it refers to preparation for the breath test. Giving an oral suspension of glucose 1 hour before the test is incorrect because glucose is not administered before the test.
Question 15
The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
A
Pull the ear down and back
B
Pull the ear up and back
C
Pull the ear straight out
D
Leave the ear undisturbed
Question 15 Explanation:
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. Pullig the ear straight out and leaving the ear undisturbed are incorrect positions for administering ear drops.Pulling the ear up and back is used for administering ear drops to an adult client.
Question 16
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:
A
Produces a burning sensation when applied
B
Will cause dark staining of the surrounding skin
C
Can alter the function of the thyroid
D
Produces a cooling sensation when applied
Question 16 Explanation:
The client should receive pain medication 30 minutes before the application of Sulfamylon. Staining of the surrounding skin refers to silver nitrate. Produces a cooling sensation when applied refers to Silvadene. Can alter the function of the thyroid it refers to Betadine.
Question 17
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?
A
The head is 4cm larger than the chest.
B
The head is 3cm smaller than the chest.
C
The head and chest circumference are the same.
D
The head is 2cm larger than the chest.
Question 17 Explanation:
The head circumference of the normal newborn is approximately 33cm, while the chest circumference is 31cm. The head and chest are not the same circumference. The head is larger in circumference than the chest. The difference in head circumference and chest circumference is too great.
Question 18
The nurse is providing dietary teaching for a client with gout. Which dietary selection is suitable for the client with gout?
A
Steak, baked potato, tossed salad
B
Broiled liver, macaroni and cheese, spinach
C
Baked chicken, pasta salad, asparagus casserole
D
Stuffed crab, steamed rice, peas
Question 18 Explanation:
Steak, baked potato, and tossed salad are lower in purine than the other choices. Liver, crab, and chicken are high in purine.
Question 19
Before administering a nasogastric feeding to a client hospitalized following a CVA, the nurse aspirates 40mL of residual. The nurse should:
A
Replace the aspirate and administer the feeding
B
Replace the aspirate and withhold the feeding
C
Discard the aspirate and withhold the feeding
D
Discard the aspirate and begin the feeding
Question 19 Explanation:
The nurse should replace the aspirate and administer the feeding because the amount aspirated was less than 50mL. The aspirate should not be discarded. The feeding should not be withheld.
Question 20
The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:
A
Diarrhea
B
Anorexia
C
Pruritis
D
Tinnitus
Question 20 Explanation:
Tinnitus is a sign of aspirin toxicity. Other answer choices are not related to aspirin toxicity; therefore, they are incorrect.
Question 21
The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:
A
Tinnitus
B
Diarrhea
C
Pruritis
D
Anorexia
Question 21 Explanation:
Tinnitus is a sign of aspirin toxicity. Other answer choices are not related to aspirin toxicity; therefore, they are incorrect.
Question 22
The physician has ordered a low-potassium diet for a child with acute glomerulonephritis. Which snack is suitable for the child with potassium restrictions?
A
Oranges
B
Apricots
C
Raisins
D
Bananas
Question 22 Explanation:
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, are incorrect.
Question 23
The LPN is reviewing the lab results of an elderly client when she notes a specific gravity of 1.006. The nurse recognizes that:
A
The client has impaired renal function.
B
The client has mild to moderate dehydration.
C
The client has a normal specific gravity.
D
The client has diluted urine from fluid overload.
Question 23 Explanation:
The normal specific gravity is 1.005-1.030.
Question 24
A client with schizophrenia has been taking Thorazine (chlorpromazine) 200mg four times a day. Which finding should be reported to the doctor immediately?
A
The client naps throughout the day
B
The client complains of thirst
C
The client has gained 4 pounds in the past 2 months
D
The client complains of a sore throat
Question 24 Explanation:
The nurse should carefully monitor the client taking Thorazine for signs of infection that can quickly become overwhelming. Other answer choices are incorrect because they are expected side effects of the medication.
Question 25
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:
A
4 capsules
B
2 capsules
C
1 capsule
D
3 capsules
Question 25 Explanation:
The nurse should administer two capsules. Other answer choices contain inaccurate amounts; therefore, they are incorrect.
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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?
Raisins
Oranges
Apricots
Bananas
2. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
Withholding intake after midnight
Telling the client that no special preparation is needed
Explaining that a small dose of radioactive isotope will be used
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:
Give the medication without diluting it
Give the medication with 4oz. of juice
Give the medication with water only
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?
Stool cultures are preferred for definitive diagnosis.
Pregnant caregivers may obtain cultures.
Collection of one specimen is sufficient.
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:
Will cause dark staining of the surrounding skin
Produces a cooling sensation when applied
Can alter the function of the thyroid
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:
Maintain strict intake and output
Check the pulse before giving the medication
Administer the medication 30 minutes before meals
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:
Prevent anemia
Promote relaxation
Prevent nausea
Increase neutrophil counts
8. The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
Pull the ear down and back
Pull the ear straight out
Pull the ear up and back
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?
The client complains of thirst
The client has gained 4 pounds in the past 2 months
The client complains of a sore throat
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:
Orange juice
Water only
Milk
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:
18%
27%
36%
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:
2L per minute
6L per minute
10L per minute
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:
Digestive enzymes cause skin breakdown.
Stools are less watery and contain more solid matter.
The stoma will heal more slowly than expected.
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:
Anorexia
Diarrhea
Tinnitus
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:
Obtain a history of his alcohol use
Provide seizure precautions
Keep the room cool and dark
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?
Broiled liver, macaroni and cheese, spinach
Stuffed crab, steamed rice, peas
Baked chicken, pasta salad, asparagus casserole
Steak, baked potato, tossed salad
17. A newborn has been diagnosed with exstrophy of the bladder. The nurse should position the newborn:
Prone
Supine
On either side
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:
Feed the baby only when he is hungry
Burp the baby after the feeding is completed
Place the baby supine with head elevated
Burp the baby frequently throughout the feeding
19. A child is hospitalized with a fractured femur involving the epiphysis. Epiphyseal fractures are serious because:
Bone marrow is lost through the fracture site.
Normal bone growth is affected.
Blood supply to the bone is obliterated.
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:
Replace the aspirate and administer the feeding
Discard the aspirate and withhold the feeding
Discard the aspirate and begin the feeding
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 capsule
2 capsules
3 capsules
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:
The client has impaired renal function.
The client has a normal specific gravity.
The client has mild to moderate dehydration.
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?
Demerol (meperidine)
Toradol (ketorolac)
Morphine (morphine sulfate)
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:
Constipation
Weight gain
Anorexia
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?
The head and chest circumference are the same.
The head is 2cm larger than the chest.
The head is 3cm smaller than the chest.
The head is 4cm larger than the chest.
Answers and Rationales
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Answer B is correct. The nurse should administer two capsules. Answers A, C, and D contain inaccurate amounts; therefore, they are incorrect.
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.
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.
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.
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