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NCLEX- PN Practice Exam 8 (PM)
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Question 1
Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?
A
Pain associated with angina is confined to the chest area.
B
Pain associated with angina is relieved by rest.
C
Pain associated with myocardial infarction is referred to the left arm.
D
Pain associated with myocardial infarction is always more severe.
Question 1 Explanation:
Pain associated with angina is relieved by rest. Pain associated with angina can be referred to the jaw, the left arm, and the back. Pain from a myocardial infarction can be referred to areas other than the left arm.
Question 2
Which home remedy is suitable to relieve the itching associated with varicella?
A
Dusting the lesions with baby powder
B
Using cool compresses of normal saline
C
Applying a paste of baking soda and water
D
Applying gauze saturated in hydrogen peroxide
Question 2 Explanation:
Applying a paste of baking soda and water soothes the itching and helps to dry the vesicles. The use of baby powder is not recommended for either children. Hydrogen peroxide and saline will not relieve the itching and will prevent the vesicles from crusting.
Question 3
A client with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin?
A
Calcium gluconate
B
Aquamephyton
C
Methergine
D
Protamine sulfate
Question 3 Explanation:
Protamine sulfate is given to counteract the effects of enoxaprin as well as heparin. Calcium gluconate is given to counteract the effects of magnesium sulfate. Aquamephyton is given to counteract the effects of sodium warfarin. Methargine is given to increase uterine contractions following delivery.
Question 4
The nurse is assessing an infant with Hirschsprung’s disease. The nurse can expect the infant to:
A
Have a scaphoid-shaped abdomen
B
Exhibit clubbing of the fingers and toes
C
Weigh less than expected for height and age
D
Have hyperactive deep tendon reflexes
Question 4 Explanation:
The child with Hirschsprung’s disease will have a scaphoid or hollowed abdomen. Other answer choices do not apply to the condition; therefore, they are incorrect.
Question 5
A client with angina has an order for nitroglycerin ointment. Before applying the medication, the nurse should:
A
Obtain both a radial and an apical pulse
B
Remove the previously applied ointment
C
Tell the client he will experience pain relief in 15 minutes
D
Apply the ointment to the previous application
Question 5 Explanation:
The nurse should remove any remaining ointment before applying the medication again. Applying the ointment to the previous application is incorrect because it interferes with absorption. Obtaining both a radial and an apical pulse does not apply to the question of how to administer the medication; therefore, it is incorrect. Telling the client he will experience pain relief in 15 minutes is incorrect because the medication’s action is more immediate.
Question 6
The physician has prescribed supplemental iron for a prenatal client. The nurse should tell the client to take the medication with:
A
Water, to increase serum iron levels
B
Tomato juice, to increase absorption
C
Milk, to prevent stomach upset
D
Oatmeal, to prevent constipation
Question 6 Explanation:
Iron supplements should be taken with a source of vitamin C to promote absorption. Iron should not be taken with milk. High-fiber sources such as oatmeal prevent the absorption of iron. Water, to increase serum iron levels is an inaccurate statement; therefore, it is incorrect.
Question 7
The physician has ordered an external monitor for a laboring client. If the fetus is in the left occipital posterior (LOP) position, the nurse knows that the ultrasound transducer will be located:
A
Over the fetal abdomen
B
Over the fetal back
C
Near the umbilicus
D
Near the symphysis pubis
Question 7 Explanation:
In the left occipital posterior position, the heart sounds will be heard loudest through the fetal back. Other answer choices are incorrect locations.
Question 8
A 6-year-old is diagnosed with Legg-Calve Perthes disease of the right femur. An important part of the child’s care includes instructing the parents:
A
To prevent weight bearing on the affected leg
B
About exercises to strengthen affected muscles
C
About relaxation exercises to minimize pain in the joints
D
To increase the amount of dietary protein
Question 8 Explanation:
The child with Legg-Calve Perthes disease should be prevented from bearing weight on the affected extremity until revascularization has occurred.Increasing the amount of dietary protein is incorrect because it does not relate to the condition. Instructing about exercises to strengthen affected muscles and relaxation exercises to minimize pain in the joints are incorrect choices because the condition does not involve the muscles or the joints.
Question 9
The recommended time for administering Zantac (ranitidine) is:
A
At bedtime
B
After dinner
C
Midafternoon
D
Before breakfast
Question 9 Explanation:
Zantac (ranitidine) should be administered in one dose at bedtime or with meals. Other answer choices have incorrect times for dosing.
Question 10
The mother of a child with hemophilia asks the nurse which over-the-counter medication is suitable for her child’s joint discomfort. The nurse should tell the mother to purchase:
A
Naproxen (naprosyn)
B
Tylenol (acetaminophen)
C
Advil (ibuprofen)
D
Aspirin (acetylsalicytic acid)
Question 10 Explanation:
The nurse should recommend acetaminophen for the child’s joint discomfort because it will have no effect on the bleeding time. Other answer choices are all nonsteroidal anti-inflammatory medications that can prolong bleeding time; therefore, they are not suitable for the child with hemophilia.
Question 11
The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
A
"I need to eat more protein and fiber each day."
B
"I shouldn’t add salt when I am cooking."
C
"I need to drink at least a quart of milk a day."
D
"I need to reduce my daily intake to 1,200 calories a day."
Question 11 Explanation:
The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus. Other answer choices indicate that the client understands the nurse’s dietary teaching regarding obesity and hypertension; therefore, they are incorrect.
Question 12
The nurse is developing a bowel-retraining plan for a client with multiple sclerosis. Which measure is likely to be least helpful to the client:
A
Establishing a regular schedule for toileting
B
Elevating the toilet seat for easy access
C
Limiting fluid intake to 1000mL per day
D
Providing a high-roughage diet
Question 12 Explanation:
It would not be helpful to limit the fluid intake of a client during bowel retraining.
Question 13
An adolescent with borderline personality is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this client?
A
The client will leave group activities to pace when feeling anxious.
B
The client will remain in her room when feeling overwhelmed by sadness.
C
The client will request medication when feeling loss of emotional control.
D
The client will seek out a staff member to verbalize feelings of anger and sadness.
Question 13 Explanation:
Verbalizing feelings of anger and sadness to a staff member is an appropriate therapeutic goal for the client with a risk of self-directed violence. Answers "The client will remain in her room when feeling overwhelmed by sadness" and " The client will leave group activities to pace when feeling anxious" place the client in an isolated situation to deal with her feelings alone; therefore, they are incorrect. Answer "The client will request medication when feeling loss of emotional control" is incorrect because it does not allow the client to ventilate her feelings.
Question 14
A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client’s breakfast should be served within:
A
20 minutes
B
30 minutes
C
15 minutes
D
45 minutes
Question 14 Explanation:
The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular insulin.
Question 15
A client with oxylate renal calculi should be taught to avoid eating:
A
Pears
B
Strawberries
C
Apples
D
Oranges
Question 15 Explanation:
The client with oxylate renal calculi should avoid sources of oxylate, which include strawberries, rhubarb, and spinach. Other answer choices are incorrect because they are not sources of oxylate.
Question 16
A client develops tremors while withdrawing from alcohol. Which medication is routinely administered to lessen physiological effects of alcohol withdrawal?
A
Dolophine (methodone)
B
Antabuse (disulfiram)
C
Narcan (Naloxone)
D
Klonopin (clonazepam)
Question 16 Explanation:
Benzodiazepines such as clonazepam and lorazepam are given to the client withdrawing from alcohol. Methodone is given to the client withdrawing from opiates.Naloxone is an antidote for narcotic overdose. Disufiram is used in aversive therapy for alcohol addiction.
Question 17
The nurse is caring for a client who is unconscious following a fall. Which comment by the nurse will help the client become reoriented when he regains consciousness?
A
"You were in an accident that hurt your head. You are in the hospital."
B
"Can you tell me your name and where you are?"
C
"I know you are confused right now, but everything will be alright."
D
"I am your nurse and I will be taking care of you today."
Question 17 Explanation:
Telling the client what happened and where he is helps with reorientation. The statement "I am your nurse and I will be taking care of you today." does not explain what happened to the client; therefore, it is incorrect. The statement "Can you tell me your name and where you are?" is not helpful because the client regaining consciousness will not know where he is; therefore, the answer is incorrect. The nurse should not offer false reassurances, such as "everything will be alright"; therefore, it is incorrect.
Question 18
The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:
A
Ankle edema
B
Pulse deficits
C
Facial swelling
D
Diminished reflexes
Question 18 Explanation:
The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Pulse deficits is not related to the question; therefore, it is incorrect. Ankle edema is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, diminished reflexes is incorrect.
Question 19
A newborn male has been diagnosed with hypospadias with chordee. The nurse understands that the infant will have altered patterns of urination because:
A
The urinary meatus is on the dorsum of the penis.
B
The bladder lies outside the abdominal cavity.
C
The ureters will reflux urine into the kidneys.
D
The urinary meatus is on the top of the penis.
Question 19 Explanation:
The infant with hypospadias has altered patterns of urinary elimination caused by the location of the urinary meatus on the dorsum, or underside, of the penis. The ureters will reflux urine into the kidneys is incorrect because it refers to ureteral reflux.The urinary meatus is on the top of the penis is incorrect because it refers to epispadias. The bladder lies outside the abdominal cavity is incorrect because it refers to exstrophy of the bladder.
Question 20
The nurse is formulating a plan of care for a client with a cognitive disorder. Which activity is most appropriate for the client with confusion and short attention span?
A
Meeting with an assertiveness training group
B
Going on a field trip with a group of clients
C
Taking part in a reality-orientation group
D
Participating in unit community goal setting
Question 20 Explanation:
Participating in reality orientation is the most appropriate activity for the client who is confused. Other answer choices are incorrect because they are not suitable activities for a client who is confused.
Question 21
The nurse is providing dietary teaching for a client with Meniere’s disease. Which statement indicates that the client understands the role of diet in triggering her symptoms?
A
"I can help control problems with vertigo if I avoid breads and cereals."
B
"I need to eat fewer foods that are high in potassium, such as raisins and bananas."
C
"I need to limit foods that taste salty or that contain a lot of sodium."
D
"I can expect to see more problems with tinnitus if I eat a lot of dairy products."
Question 21 Explanation:
The client with Meniere’s disease should limit the intake of foods that contain sodium. Other answer choices have no relationship to the symptoms of Meniere’s disease; therefore, they are incorrect.
Question 22
A 10-year-old has an order for Demerol (meperidine) 35mg IM for pain. The medication is available as Demerol 50mg per ml. How much should the nurse administer?
A
.5mL
B
.6mL
C
.8mL
D
.7mL
Question 22 Explanation:
The nurse should administer .7mL of the medication. Other answer choices are incorrect because the dosage is incorrect.
Question 23
An elderly client is admitted to the psychiatric unit from the nursing home. Transfer information indicates that the client has become confused and disoriented, with behavioral problems. The client will also likely show a loss of ability in:
A
Judgment
B
Endurance
C
Balance
D
Speech
Question 23 Explanation:
Confusion, disorientation, behavioral changes, and alterations in judgment are early signs of dementia. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 24
Following a generalized seizure, the nurse can expect the client to:
A
Have a drop in blood pressure
B
Be unable to move the extremities
C
Remember events before the seizure
D
Be drowsy and prone to sleep
Question 24 Explanation:
Following a generalized seizure, the client frequently experiences drowsiness and postictal sleep. The client is able to move the extremities.The client can remember events before the seizure and the blood pressure is elevated.
Question 25
Which antibiotic is contraindicated for the treatment of infections in infants and young children?
A
Tetracyn (tetracycline)
B
Cefotan (cefotetan)
C
E-Mycin (erythromycin)
D
Amoxil (amoxicillin)
Question 25 Explanation:
Tetracycline is contraindicated for use in infants and young children because it stains the teeth and arrests bone development. Other answer choices are incorrect because they can be used to treat infections in infants and children.
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NCLEX- PN Practice Exam 8 (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 8 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:
A
Diminished reflexes
B
Pulse deficits
C
Facial swelling
D
Ankle edema
Question 1 Explanation:
The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Pulse deficits is not related to the question; therefore, it is incorrect. Ankle edema is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, diminished reflexes is incorrect.
Question 2
The nurse is assessing an infant with Hirschsprung’s disease. The nurse can expect the infant to:
A
Exhibit clubbing of the fingers and toes
B
Weigh less than expected for height and age
C
Have hyperactive deep tendon reflexes
D
Have a scaphoid-shaped abdomen
Question 2 Explanation:
The child with Hirschsprung’s disease will have a scaphoid or hollowed abdomen. Other answer choices do not apply to the condition; therefore, they are incorrect.
Question 3
Which antibiotic is contraindicated for the treatment of infections in infants and young children?
A
Amoxil (amoxicillin)
B
Tetracyn (tetracycline)
C
E-Mycin (erythromycin)
D
Cefotan (cefotetan)
Question 3 Explanation:
Tetracycline is contraindicated for use in infants and young children because it stains the teeth and arrests bone development. Other answer choices are incorrect because they can be used to treat infections in infants and children.
Question 4
The mother of a child with hemophilia asks the nurse which over-the-counter medication is suitable for her child’s joint discomfort. The nurse should tell the mother to purchase:
A
Naproxen (naprosyn)
B
Tylenol (acetaminophen)
C
Aspirin (acetylsalicytic acid)
D
Advil (ibuprofen)
Question 4 Explanation:
The nurse should recommend acetaminophen for the child’s joint discomfort because it will have no effect on the bleeding time. Other answer choices are all nonsteroidal anti-inflammatory medications that can prolong bleeding time; therefore, they are not suitable for the child with hemophilia.
Question 5
The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
A
"I need to eat more protein and fiber each day."
B
"I need to drink at least a quart of milk a day."
C
"I shouldn’t add salt when I am cooking."
D
"I need to reduce my daily intake to 1,200 calories a day."
Question 5 Explanation:
The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus. Other answer choices indicate that the client understands the nurse’s dietary teaching regarding obesity and hypertension; therefore, they are incorrect.
Question 6
An elderly client is admitted to the psychiatric unit from the nursing home. Transfer information indicates that the client has become confused and disoriented, with behavioral problems. The client will also likely show a loss of ability in:
A
Balance
B
Endurance
C
Speech
D
Judgment
Question 6 Explanation:
Confusion, disorientation, behavioral changes, and alterations in judgment are early signs of dementia. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 7
Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?
A
Pain associated with myocardial infarction is always more severe.
B
Pain associated with angina is confined to the chest area.
C
Pain associated with myocardial infarction is referred to the left arm.
D
Pain associated with angina is relieved by rest.
Question 7 Explanation:
Pain associated with angina is relieved by rest. Pain associated with angina can be referred to the jaw, the left arm, and the back. Pain from a myocardial infarction can be referred to areas other than the left arm.
Question 8
The nurse is caring for a client who is unconscious following a fall. Which comment by the nurse will help the client become reoriented when he regains consciousness?
A
"I am your nurse and I will be taking care of you today."
B
"I know you are confused right now, but everything will be alright."
C
"You were in an accident that hurt your head. You are in the hospital."
D
"Can you tell me your name and where you are?"
Question 8 Explanation:
Telling the client what happened and where he is helps with reorientation. The statement "I am your nurse and I will be taking care of you today." does not explain what happened to the client; therefore, it is incorrect. The statement "Can you tell me your name and where you are?" is not helpful because the client regaining consciousness will not know where he is; therefore, the answer is incorrect. The nurse should not offer false reassurances, such as "everything will be alright"; therefore, it is incorrect.
Question 9
The nurse is developing a bowel-retraining plan for a client with multiple sclerosis. Which measure is likely to be least helpful to the client:
A
Limiting fluid intake to 1000mL per day
B
Elevating the toilet seat for easy access
C
Providing a high-roughage diet
D
Establishing a regular schedule for toileting
Question 9 Explanation:
It would not be helpful to limit the fluid intake of a client during bowel retraining.
Question 10
An adolescent with borderline personality is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this client?
A
The client will seek out a staff member to verbalize feelings of anger and sadness.
B
The client will remain in her room when feeling overwhelmed by sadness.
C
The client will leave group activities to pace when feeling anxious.
D
The client will request medication when feeling loss of emotional control.
Question 10 Explanation:
Verbalizing feelings of anger and sadness to a staff member is an appropriate therapeutic goal for the client with a risk of self-directed violence. Answers "The client will remain in her room when feeling overwhelmed by sadness" and " The client will leave group activities to pace when feeling anxious" place the client in an isolated situation to deal with her feelings alone; therefore, they are incorrect. Answer "The client will request medication when feeling loss of emotional control" is incorrect because it does not allow the client to ventilate her feelings.
Question 11
The nurse is formulating a plan of care for a client with a cognitive disorder. Which activity is most appropriate for the client with confusion and short attention span?
A
Going on a field trip with a group of clients
B
Meeting with an assertiveness training group
C
Taking part in a reality-orientation group
D
Participating in unit community goal setting
Question 11 Explanation:
Participating in reality orientation is the most appropriate activity for the client who is confused. Other answer choices are incorrect because they are not suitable activities for a client who is confused.
Question 12
A client with oxylate renal calculi should be taught to avoid eating:
A
Pears
B
Apples
C
Oranges
D
Strawberries
Question 12 Explanation:
The client with oxylate renal calculi should avoid sources of oxylate, which include strawberries, rhubarb, and spinach. Other answer choices are incorrect because they are not sources of oxylate.
Question 13
A client develops tremors while withdrawing from alcohol. Which medication is routinely administered to lessen physiological effects of alcohol withdrawal?
A
Klonopin (clonazepam)
B
Dolophine (methodone)
C
Antabuse (disulfiram)
D
Narcan (Naloxone)
Question 13 Explanation:
Benzodiazepines such as clonazepam and lorazepam are given to the client withdrawing from alcohol. Methodone is given to the client withdrawing from opiates.Naloxone is an antidote for narcotic overdose. Disufiram is used in aversive therapy for alcohol addiction.
Question 14
The physician has ordered an external monitor for a laboring client. If the fetus is in the left occipital posterior (LOP) position, the nurse knows that the ultrasound transducer will be located:
A
Over the fetal abdomen
B
Over the fetal back
C
Near the symphysis pubis
D
Near the umbilicus
Question 14 Explanation:
In the left occipital posterior position, the heart sounds will be heard loudest through the fetal back. Other answer choices are incorrect locations.
Question 15
A 10-year-old has an order for Demerol (meperidine) 35mg IM for pain. The medication is available as Demerol 50mg per ml. How much should the nurse administer?
A
.6mL
B
.5mL
C
.8mL
D
.7mL
Question 15 Explanation:
The nurse should administer .7mL of the medication. Other answer choices are incorrect because the dosage is incorrect.
Question 16
A client with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin?
A
Protamine sulfate
B
Aquamephyton
C
Methergine
D
Calcium gluconate
Question 16 Explanation:
Protamine sulfate is given to counteract the effects of enoxaprin as well as heparin. Calcium gluconate is given to counteract the effects of magnesium sulfate. Aquamephyton is given to counteract the effects of sodium warfarin. Methargine is given to increase uterine contractions following delivery.
Question 17
The recommended time for administering Zantac (ranitidine) is:
A
After dinner
B
Midafternoon
C
At bedtime
D
Before breakfast
Question 17 Explanation:
Zantac (ranitidine) should be administered in one dose at bedtime or with meals. Other answer choices have incorrect times for dosing.
Question 18
Following a generalized seizure, the nurse can expect the client to:
A
Be drowsy and prone to sleep
B
Have a drop in blood pressure
C
Remember events before the seizure
D
Be unable to move the extremities
Question 18 Explanation:
Following a generalized seizure, the client frequently experiences drowsiness and postictal sleep. The client is able to move the extremities.The client can remember events before the seizure and the blood pressure is elevated.
Question 19
Which home remedy is suitable to relieve the itching associated with varicella?
A
Applying gauze saturated in hydrogen peroxide
B
Dusting the lesions with baby powder
C
Using cool compresses of normal saline
D
Applying a paste of baking soda and water
Question 19 Explanation:
Applying a paste of baking soda and water soothes the itching and helps to dry the vesicles. The use of baby powder is not recommended for either children. Hydrogen peroxide and saline will not relieve the itching and will prevent the vesicles from crusting.
Question 20
A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client’s breakfast should be served within:
A
45 minutes
B
15 minutes
C
30 minutes
D
20 minutes
Question 20 Explanation:
The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular insulin.
Question 21
The nurse is providing dietary teaching for a client with Meniere’s disease. Which statement indicates that the client understands the role of diet in triggering her symptoms?
A
"I can help control problems with vertigo if I avoid breads and cereals."
B
"I need to limit foods that taste salty or that contain a lot of sodium."
C
"I need to eat fewer foods that are high in potassium, such as raisins and bananas."
D
"I can expect to see more problems with tinnitus if I eat a lot of dairy products."
Question 21 Explanation:
The client with Meniere’s disease should limit the intake of foods that contain sodium. Other answer choices have no relationship to the symptoms of Meniere’s disease; therefore, they are incorrect.
Question 22
A 6-year-old is diagnosed with Legg-Calve Perthes disease of the right femur. An important part of the child’s care includes instructing the parents:
A
To prevent weight bearing on the affected leg
B
About relaxation exercises to minimize pain in the joints
C
About exercises to strengthen affected muscles
D
To increase the amount of dietary protein
Question 22 Explanation:
The child with Legg-Calve Perthes disease should be prevented from bearing weight on the affected extremity until revascularization has occurred.Increasing the amount of dietary protein is incorrect because it does not relate to the condition. Instructing about exercises to strengthen affected muscles and relaxation exercises to minimize pain in the joints are incorrect choices because the condition does not involve the muscles or the joints.
Question 23
The physician has prescribed supplemental iron for a prenatal client. The nurse should tell the client to take the medication with:
A
Oatmeal, to prevent constipation
B
Water, to increase serum iron levels
C
Milk, to prevent stomach upset
D
Tomato juice, to increase absorption
Question 23 Explanation:
Iron supplements should be taken with a source of vitamin C to promote absorption. Iron should not be taken with milk. High-fiber sources such as oatmeal prevent the absorption of iron. Water, to increase serum iron levels is an inaccurate statement; therefore, it is incorrect.
Question 24
A client with angina has an order for nitroglycerin ointment. Before applying the medication, the nurse should:
A
Obtain both a radial and an apical pulse
B
Tell the client he will experience pain relief in 15 minutes
C
Remove the previously applied ointment
D
Apply the ointment to the previous application
Question 24 Explanation:
The nurse should remove any remaining ointment before applying the medication again. Applying the ointment to the previous application is incorrect because it interferes with absorption. Obtaining both a radial and an apical pulse does not apply to the question of how to administer the medication; therefore, it is incorrect. Telling the client he will experience pain relief in 15 minutes is incorrect because the medication’s action is more immediate.
Question 25
A newborn male has been diagnosed with hypospadias with chordee. The nurse understands that the infant will have altered patterns of urination because:
A
The urinary meatus is on the dorsum of the penis.
B
The urinary meatus is on the top of the penis.
C
The ureters will reflux urine into the kidneys.
D
The bladder lies outside the abdominal cavity.
Question 25 Explanation:
The infant with hypospadias has altered patterns of urinary elimination caused by the location of the urinary meatus on the dorsum, or underside, of the penis. The ureters will reflux urine into the kidneys is incorrect because it refers to ureteral reflux.The urinary meatus is on the top of the penis is incorrect because it refers to epispadias. The bladder lies outside the abdominal cavity is incorrect because it refers to exstrophy of the bladder.
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1. A client with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin?
Calcium gluconate
Aquamephyton
Methergine
Protamine sulfate
2. The nurse is formulating a plan of care for a client with a cognitive disorder. Which activity is most appropriate for the client with confusion and short attention span?
Taking part in a reality-orientation group
Participating in unit community goal setting
Going on a field trip with a group of clients
Meeting with an assertiveness training group
3. The mother of a child with hemophilia asks the nurse which over-the-counter medication is suitable for her child’s joint discomfort. The nurse should tell the mother to purchase:
Advil (ibuprofen)
Tylenol (acetaminophen)
Aspirin (acetylsalicytic acid)
Naproxen (naprosyn)
4. Which home remedy is suitable to relieve the itching associated with varicella?
Dusting the lesions with baby powder
Applying gauze saturated in hydrogen peroxide
Using cool compresses of normal saline
Applying a paste of baking soda and water
5. A newborn male has been diagnosed with hypospadias with chordee. The nurse understands that the infant will have altered patterns of urination because:
The urinary meatus is on the dorsum of the penis.
The ureters will reflux urine into the kidneys.
The urinary meatus is on the top of the penis.
The bladder lies outside the abdominal cavity.
6. The recommended time for administering Zantac (ranitidine) is:
Before breakfast
Midafternoon
After dinner
At bedtime
7. Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?
Pain associated with angina is relieved by rest.
Pain associated with myocardial infarction is always more severe.
Pain associated with angina is confined to the chest area.
Pain associated with myocardial infarction is referred to the left arm.
8. The nurse is developing a bowel-retraining plan for a client with multiple sclerosis. Which measure is likely to be least helpful to the client:
Limiting fluid intake to 1000mL per day
Providing a high-roughage diet
Elevating the toilet seat for easy access
Establishing a regular schedule for toileting
9. The nurse is providing dietary teaching for a client with Meniere’s disease. Which statement indicates that the client understands the role of diet in triggering her symptoms?
“I can expect to see more problems with tinnitus if I eat a lot of dairy products.”
“I need to limit foods that taste salty or that contain a lot of sodium.”
“I can help control problems with vertigo if I avoid breads and cereals.”
“I need to eat fewer foods that are high in potassium, such as raisins and bananas.”
10. The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:
Facial swelling
Pulse deficits
Ankle edema
Diminished reflexes
11. An adolescent with borderline personality is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this client?
The client will remain in her room when feeling overwhelmed by sadness.
The client will request medication when feeling loss of emotional control.
The client will leave group activities to pace when feeling anxious.
The client will seek out a staff member to verbalize feelings of anger and sadness.
12. A client with angina has an order for nitroglycerin ointment. Before applying the medication, the nurse should:
Apply the ointment to the previous application
Obtain both a radial and an apical pulse
Remove the previously applied ointment
Tell the client he will experience pain relief in 15 minutes
13. The nurse is caring for a client who is unconscious following a fall. Which comment by the nurse will help the client become reoriented when he regains consciousness?
“I am your nurse and I will be taking care of you today.”
“Can you tell me your name and where you are?”
“I know you are confused right now, but everything will be alright.”
“You were in an accident that hurt your head. You are in the hospital.”
14. Following a generalized seizure, the nurse can expect the client to:
Be unable to move the extremities
Be drowsy and prone to sleep
Remember events before the seizure
Have a drop in blood pressure
15. A client with oxylate renal calculi should be taught to avoid eating:
Strawberries
Oranges
Apples
Pears
16. A 6-year-old is diagnosed with Legg-Calve Perthes disease of the right femur. An important part of the child’s care includes instructing the parents:
To increase the amount of dietary protein
About exercises to strengthen affected muscles
About relaxation exercises to minimize pain in the joints
To prevent weight bearing on the affected leg
17. The nurse is assessing an infant with Hirschsprung’s disease. The nurse can expect the infant to:
Weigh less than expected for height and age
Have a scaphoid-shaped abdomen
Exhibit clubbing of the fingers and toes
Have hyperactive deep tendon reflexes
18. The physician has prescribed supplemental iron for a prenatal client. The nurse should tell the client to take the medication with:
Milk, to prevent stomach upset
Tomato juice, to increase absorption
Oatmeal, to prevent constipation
Water, to increase serum iron levels
19. The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
“I need to reduce my daily intake to 1,200 calories a day.”
“I need to drink at least a quart of milk a day.”
“I shouldn’t add salt when I am cooking.”
“I need to eat more protein and fiber each day.”
20. An elderly client is admitted to the psychiatric unit from the nursing home. Transfer information indicates that the client has become confused and disoriented, with behavioral problems. The client will also likely show a loss of ability in:
Speech
Judgment
Endurance
Balance
21. The physician has ordered an external monitor for a laboring client. If the fetus is in the left occipital posterior (LOP) position, the nurse knows that the ultrasound transducer will be located:
Near the symphysis pubis
Near the umbilicus
Over the fetal back
Over the fetal abdomen
22. A client develops tremors while withdrawing from alcohol. Which medication is routinely administered to lessen physiological effects of alcohol withdrawal?
Dolophine (methodone)
Klonopin (clonazepam)
Narcan (Naloxone)
Antabuse (disulfiram)
23. A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client’s breakfast should be served within:
15 minutes
20 minutes
30 minutes
45 minutes
24. A 10-year-old has an order for Demerol (meperidine) 35mg IM for pain. The medication is available as Demerol 50mg per ml. How much should the nurse administer?
.5mL
.6mL
.7mL
.8mL
25. Which antibiotic is contraindicated for the treatment of infections in infants and young children?
Tetracyn (tetracycline)
Amoxil (amoxicillin)
Cefotan (cefotetan)
E-Mycin (erythromycin)
Answers and Rationales
Answer D is correct. Protamine sulfate is given to counteract the effects of enoxaprin as well as heparin. Calcium gluconate is given to counteract the effects of magnesium sulfate; therefore, answer A is incorrect. Answer B is incorrect because aquamephyton is given to counteract the effects of sodium warfarin. Answer C is incorrect because methargine is given to increase uterine contractions following delivery.
Answer A is correct. Participating in reality orientation is the most appropriate activity for the client who is confused. Answers B, C, and D are incorrect because they are not suitable activities for a client who is confused.
Answer B is correct. The nurse should recommend acetaminophen for the child’s joint discomfort because it will have no effect on the bleeding time. Answers A, C, and D are all nonsteroidal anti-inflammatory medications that can prolong bleeding time; therefore, they are not suitable for the child with hemophilia.
Answer D is correct. Applying a paste of baking soda and water soothes the itching and helps to dry the vesicles. The use of baby powder is not recommended for either children; therefore, answer A is incorrect. Answers B and C are incorrect because hydrogen peroxide and saline will not relieve the itching and will prevent the vesicles from crusting.
Answer A is correct. The infant with hypospadias has altered patterns of urinary elimination caused by the location of the urinary meatus on the dorsum, or underside, of the penis. Answer B is incorrect because it refers to ureteral reflux. Answer C is incorrect because it refers to epispadias. Answer D is incorrect because it refers to exstrophy of the bladder.
Answer D is correct. Zantac (ranitidine) should be administered in one dose at bedtime or with meals. Answers A, B, and C have incorrect times for dosing.
Answer A is correct. Pain associated with angina is relieved by rest. Answer B is incorrect because it is not a true statement. Answer C is incorrect because pain associated with angina can be referred to the jaw, the left arm, and the back. Answer D is incorrect because pain from a myocardial infarction can be referred to areas other than the left arm.
Answer A is correct. It would not be helpful to limit the fluid intake of a client during bowel retraining. Answers B, C, and D would help the client; therefore, they are incorrect answers.
Answer B is correct. The client with Meniere’s disease should limit the intake of foods that contain sodium. Answers A, C, and D have no relationship to the symptoms of Meniere’s disease; therefore, they are incorrect.
Answer A is correct. The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Answer B is not related to the question; therefore, it is incorrect. Answer C is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, answer D is incorrect.
Answer D is correct. Verbalizing feelings of anger and sadness to a staff member is an appropriate therapeutic goal for the client with a risk of self-directed violence. Answers A and C place the client in an isolated situation to deal with her feelings alone; therefore, they are incorrect. Answer B is incorrect because it does not allow the client to ventilate her feelings.
Answer C is correct. The nurse should remove any remaining ointment before applying the medication again. Answer A is incorrect because it interferes with absorption. Answer B does not apply to the question of how to administer the medication; therefore, it is incorrect. Answer D is incorrect because the medication’s action is more immediate.
Answer D is correct. Telling the client what happened and where he is helps with reorientation. Answer A does not explain what happened to the client; therefore, it is incorrect. Answer B is not helpful because the client regaining consciousness will not know where he is; therefore, the answer is incorrect. The nurse should not offer false reassurances, such as “everything will be alright”; therefore, answer C is incorrect.
Answer B is correct. Following a generalized seizure, the client frequently experiences drowsiness and postictal sleep. Answer A is incorrect because the client is able to move the extremities. Answer C is incorrect because the client can remember events before the seizure. Answer D is incorrect because the blood pressure is elevated.
Answer A is correct. The client with oxylate renal calculi should avoid sources of oxylate, which include strawberries, rhubarb, and spinach. Answers B, C, and D are incorrect because they are not sources of oxylate.
Answer D is correct. The child with Legg-Calve Perthes disease should be prevented from bearing weight on the affected extremity until revascularization has occurred. Answer A is incorrect because it does not relate to the condition. Answers B and C are incorrect choices because the condition does not involve the muscles or the joints.
Answer B is correct. The child with Hirschsprung’s disease will have a scaphoid or hollowed abdomen. Answers A, C, and D do not apply to the condition; therefore, they are incorrect.
Answer B is correct. Iron supplements should be taken with a source of vitamin C to promote absorption. Answer A is incorrect because iron should not be taken with milk. Answer C is incorrect because high-fiber sources prevent the absorption of iron. Answer D is an inaccurate statement; therefore, it is incorrect.
Answer A is correct. The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus. Answers B, C, and D indicate that the client understands the nurse’s dietary teaching regarding obesity and hypertension; therefore, they are incorrect.
Answer B is correct. Confusion, disorientation, behavioral changes, and alterations in judgment are early signs of dementia. Answers A, C, and D do not relate to the question; therefore, they are incorrect.
Answer C is correct. In the left occipital posterior position, the heart sounds will be heard loudest through the fetal back. Answers A, B, and D are incorrect locations.
Answer B is correct. Benzodiazepines such as clonazepam and lorazepam are given to the client withdrawing from alcohol. Answer A is incorrect because methodone is given to the client withdrawing from opiates. Answer C is incorrect because naloxone is an antidote for narcotic overdose. Answer D is incorrect because disufiram is used in aversive therapy for alcohol addiction.
Answer C is correct. The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular insulin.
Answer C is correct. The nurse should administer .7mL of the medication. Answers A, B, and D are incorrect because the dosage is incorrect.
Answer A is correct. Tetracycline is contraindicated for use in infants and young children because it stains the teeth and arrests bone development. Answers B, C, and D are incorrect because they can be used to treat infections in infants and children.