NCLEX- PN Practice Exam 8

Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam.

Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.

Text Mode – Text version of the exam

1. A client with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin?

1. Calcium gluconate
2. Aquamephyton
3. Methergine
4. 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?

1. Taking part in a reality-orientation group
2. Participating in unit community goal setting
3. Going on a field trip with a group of clients
4. 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:

1. Advil (ibuprofen)
2. Tylenol (acetaminophen)
3. Aspirin (acetylsalicytic acid)
4. Naproxen (naprosyn)

4. Which home remedy is suitable to relieve the itching associated with varicella?

1. Dusting the lesions with baby powder
2. Applying gauze saturated in hydrogen peroxide
3. Using cool compresses of normal saline
4. 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:

1. The urinary meatus is on the dorsum of the penis.
2. The ureters will reflux urine into the kidneys.
3. The urinary meatus is on the top of the penis.
4. The bladder lies outside the abdominal cavity.

6. The recommended time for administering Zantac (ranitidine) is:

1. Before breakfast
2. Midafternoon
3. After dinner
4. At bedtime

7. Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?

1. Pain associated with angina is relieved by rest.
2. Pain associated with myocardial infarction is always more severe.
3. Pain associated with angina is confined to the chest area.
4. 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:

1. Limiting fluid intake to 1000mL per day
2. Providing a high-roughage diet
3. Elevating the toilet seat for easy access
4. 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?

1. “I can expect to see more problems with tinnitus if I eat a lot of dairy products.”
2. “I need to limit foods that taste salty or that contain a lot of sodium.”
3. “I can help control problems with vertigo if I avoid breads and cereals.”
4. “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:

1. Facial swelling
2. Pulse deficits
3. Ankle edema
4. 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?

1. The client will remain in her room when feeling overwhelmed by sadness.
2. The client will request medication when feeling loss of emotional control.
3. The client will leave group activities to pace when feeling anxious.
4. 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:

1. Apply the ointment to the previous application
2. Obtain both a radial and an apical pulse
3. Remove the previously applied ointment
4. 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?

1. “I am your nurse and I will be taking care of you today.”
2. “Can you tell me your name and where you are?”
3. “I know you are confused right now, but everything will be alright.”
4. “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:

1. Be unable to move the extremities
2. Be drowsy and prone to sleep
3. Remember events before the seizure
4. Have a drop in blood pressure

15. A client with oxylate renal calculi should be taught to avoid eating:

1. Strawberries
2. Oranges
3. Apples
4. 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:

1. To increase the amount of dietary protein
2. About exercises to strengthen affected muscles
3. About relaxation exercises to minimize pain in the joints
4. 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:

1. Weigh less than expected for height and age
2. Have a scaphoid-shaped abdomen
3. Exhibit clubbing of the fingers and toes
4. 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:

1. Milk, to prevent stomach upset
2. Tomato juice, to increase absorption
3. Oatmeal, to prevent constipation
4. 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?

1. “I need to reduce my daily intake to 1,200 calories a day.”
2. “I need to drink at least a quart of milk a day.”
3. “I shouldn’t add salt when I am cooking.”
4. “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:

1. Speech
2. Judgment
3. Endurance
4. 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:

1. Near the symphysis pubis
2. Near the umbilicus
3. Over the fetal back
4. 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?

1. Dolophine (methodone)
2. Klonopin (clonazepam)
3. Narcan (Naloxone)
4. 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:

1. 15 minutes
2. 20 minutes
3. 30 minutes
4. 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?

1. .5mL
2.  .6mL
3. .7mL
4.  .8mL

25. Which antibiotic is contraindicated for the treatment of infections in infants and young children?

1. Tetracyn (tetracycline)
2. Amoxil (amoxicillin)
3. Cefotan (cefotetan)
4. E-Mycin (erythromycin)

Answers and Rationales

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. Answer C is correct. The nurse should administer .7mL of the medication. Answers A, B, and D are incorrect because the dosage is incorrect.
25. 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.