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NCLEX Practice Exam for Health Promotion and Maintenance (PM)
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Question 1
When assessing a newborn whose mother consumed alcohol during the pregnancy, the nurse would assess for which of these clinical manifestations?
strong tongue thrust, short palpebral fissures, simean crease
Question 1 Explanation:
The nurse should anticipate that the infant may have fetal alcohol syndrome and should assess for signs and symptoms of it like wide-spaced eyes, smooth filtrum, flattened nose.
Question 2
The nurse is assessing a 4 month-old infant. Which motor skill would the nurse anticipate finding?
A
Hold a rattle
B
Wave “bye-bye”
C
Drink from a cup
D
Bang two blocks
Question 2 Explanation:
The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.
Question 3
The family of a 6 year-old with a fractured femur asks the nurse if the child’s height will be affected by the injury. Which statement is true concerning long bone fractures in children?
A
Growth problems will occur if the fracture involves the periosteum
B
Children usually heal very quickly, so growth problems are rare
C
Epiphyseal fractures often interrupt a child’s normal growth pattern
D
Adequate blood supply to the bone prevents growth delay after fractures
Question 3 Explanation:
Epiphyseal fractures often interrupt a child’s normal growth pattern
Question 4
Which technique would be best in caring for a client following receiving a diagnosis of a state IV tumor in the brain?
A
Asking the client if there is anything he or his family needs
B
Reminding the client that advances in technology are occurring everyday
C
Providing accurate information about the disease and treatment options
D
Offering the client pamphlets on support groups for brain cancer
Question 4 Explanation:
Providing information for the client is the best technique for a new diagnosis.
Question 5
What equipment would be necessary to complete an evaluation of cranial nerves 9 and 10 during a physical assessment?
A
An ophthalmoscope
B
A cotton ball
C
A pen light
D
A tongue depressor and flashlight
Question 5 Explanation:
Cranial nerves 9 and 10 are the glossopharyngeal and vagus nerves. The gag reflex would be evaluated.
Question 6
The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:
A
decreased size of the nose and ears.
B
neck wrinkles.
C
increased growth of facial hair.
D
pronounced wrinkles on the face.
Question 6 Explanation:
The nose and ears of the aging client actually become longer and broader. The chin line is also altered. Wrinkles on the face become more pronounced and tend to take on the general mood of the client over the years. For example laugh or frown wrinkles about the eyebrows, lips, cheeks, and outer edges of the eye orbit. The change in the androgen-estrogen ration causes an increase in growth of facial hair in most elder adults. The aging process shortens the platysma muscle, which contributes to neck wrinkles.
Question 7
All of the following characteristics would indicate to the nurse that an elder client might experience undesirable effects of medicines except:
A
decreased serum albumin
B
medications containing magnesium.
C
alcohol taken with medication.
D
increased oxidative enzyme levels.
Question 7 Explanation:
Oxidative enzyme levels decrease in the elderly, which affects the disposition of medication and can alter the therapeutic effects of medication. Alcohol has a smaller water distribution level in the elderly, resulting in higher blood alcohol levels. Alcohol also interacts with various drugs to either potentate or interfere with their effects. Magnesium is contained in a lot of medications elder clients routinely obtain over the counter. Magnesium toxicity is a real concern. Albumin is the major drug-binding protein. Decreased levels of serum albumin mean that higher levels of the drug remain free and that there are less therapeutic effects and increased drug interactions.
Question 8
While caring for a client, the nurse notes a pulsating mass in the client’s periumbilical area. Which of the following assessments is appropriate for the nurse to perform?
A
Measure the length of the mass
B
Auscultate the mass
C
Percuss the mass
D
Palpate the mass
Question 8 Explanation:
Auscultate the mass. Auscultation of the abdomen and finding a bruit will confirm the presence of an abdominal aneurysm and will form the basis of information given to the provider. The mass should not be palpated because of the risk of rupture.
Question 9
What question would be most important to ask a male client who is in for a digital rectal examination?
A
“Do you notice any burning with urination or any odor to the urine?”
B
“Have you noticed a change in the force of the urinary system?”
C
“Have you noticed a change in tolerance of certain foods in your diet?”
D
“Do you notice polyuria in the AM?”
Question 9 Explanation:
This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.
Question 10
A 64 year-old client scheduled for surgery with a general anesthetic refuses to remove a set of dentures prior to leaving the unit for the operating room. What would be the most appropriate intervention by the nurse?
A
Explain to the client that the dentures must come out as they may get lost or broken in the operating room
B
Ask the client if the preference would be to remove the dentures in the operating room receiving area
C
Notify the anesthesia department and the surgeon of the client’s refusal
D
Ask the client if there are second thoughts about having the procedure
Question 10 Explanation:
Clients anticipating surgery may experience a variety of fears. This choice allows the client control over the situation and fosters the client’s sense of self-esteem and self-concept.
Question 11
When a client wishes to improve the appearance of their eyes by removing excess skin from the face and neck, the nurse should provide teaching regarding which of the following procedures?
A
Dermabrasion
B
Rhinoplasty
C
Rhytidectomy
D
Blepharoplasty
Question 11 Explanation:
Rhytidectomy is the procedure for removing excess skin from the face and neck. It is commonly called a face lift. Dermabrasion involves the spraying of a chemical to cause light freezing of the skin, which is then abraded with sandpaper or a revolving wire brush. It is used to remove facial scars, severe acne, and pigment from tattoos. Rhinoplasty is done to improve the appearance of the nose and involves reshaping the nasal skeleton and overlying skin. Blepharoplasty is the procedure that removes loose and protruding fat from the upper and lower eyelids.
Question 12
A client is admitted to the hospital with a history of confusion. The client has difficulty remembering recent events and becomes disoriented when away from home. Which statement would provide the bestreality orientation for this client?
A
"How are you today? Remember, you’re in the hospital.”
B
“Hello. My name is Elaine Jones and I am your nurse for today.”
C
“Good morning. You’re in the hospital. I am your nurse Elaine Jones.”
D
“Good morning. Do you remember where you are?”
Question 12 Explanation:
As cognitive ability declines, the nurse provides a calm, predictable environment for the client. This response establishes time, location and the caregivers name.
Question 13
When observing 4 year-old children playing in the hospital playroom, what activity would the nurse expect to see the children participating in?
A
Playing with their own toys along side with other children
B
Playing cooperatively with other preschoolers
C
Competitive board games with older children
D
Playing alone with hand held computer games
Question 13 Explanation:
Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.
Question 14
Which nursing approach would be most appropriate to use while administering an oral medication to a 4 month old?
A
Place medication in 45cc of formula
B
Place medication in a full bottle of formula
C
Place medication in an empty nipple
D
Place in supine position. Administer medication using a plastic syringe
Question 14 Explanation:
This is a convenient method for administering medications to an infant. Placing in supine position and administering medication using a plastic syringe is partially correct however, the infant is never placed in a reclining position during a procedure due to a potential aspiration.
Question 15
While the nurse is administering medications to a client, the client states “I do not want to take that medicine today.” Which of the following responses by the nurse would be best?
A
“That’s OK, its all right to skip your medication now and then.”
B
“Do you understand the consequences of refusing your prescribed treatment?”
C
“I will have to call your doctor and report this.”
D
“Is there a reason why you don’t want to take your medicine?”
Question 15 Explanation:
When a new problem is identified, it is important for the nurse to collect accurate assessment data. This is crucial to ensure that client needs are adequately identified in order to select the best nursing care approaches. The nurse should try to discover the reason for the refusal which may be that the client has developed untoward side effects.
Question 16
The nurse is teaching the parents of a 3 month-old infant about nutrition. What is the main source of fluids for an infant until about 12 months of age?
A
Fluoridated tap water
B
Dilute nonfat dry milk
C
Formula or breast milk
D
Warmed fruit juice
Question 16 Explanation:
Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.
Question 17
Which nursing intervention would be a priority during the care of a 2 month old after surgery?
A
Minimize stimuli for the infant
B
Demonstrate to the mother how she can assist with her infant’s care.
C
Restrain all extremities
D
Encourage stroking of the infant
Question 17 Explanation:
Tactile stimulation is imperative for an infant’s normal emotional development. After the trauma of surgery, sensory deprivation can cause failure to thrive.
Question 18
An 8.5 lb, 6 oz infant is delivered to a diabetic mother. Which nursing intervention would be implemented when the neonate becomes jittery and lethargic?
A
Place infant in a warmer
B
Administer oxygen
C
Administer insulin
D
Feed the infant glucose water (10%)
Question 18 Explanation:
After birth, the infant of a diabetic mother is often hypoglycemic.
Question 19
The nurse assesses a prolonged late deceleration of the fetal heart rate while the client is receiving oxytocin (Pitocin) IV to stimulate labor. The priority nursing intervention would be to:
A
Change the fluid to Ringer’s Lactate
B
Turn off the infusion
C
Turn the client to the left
D
Increase mainline IV rate
Question 19 Explanation:
Stopping the infusion will decrease contractions and possibly remove uterine pressure on the fetus, which is a possible cause of the deceleration.
Question 20
During the history, which information from a 21 year old client would indicate a risk for development of testicular cancer?
A
Measles
B
Hydrocele
C
Undescended testicle
D
Genital Herpes
Question 20 Explanation:
Undescended testicles make the client high risk for testicular cancer. Mumps, inguinal hernia in childhood, orchitis, and testicular cancer in the contra lateral testis are other predisposing factors.
Question 21
While performing a physical examination on a newborn, which assessment should be reported to the physician?
A
Head circumference of 40 cm
B
Acrocyanosis and edema of the scalp
C
Chest circumference of 32 cm
D
Heart rate of 160 and respirations of 40
Question 21 Explanation:
Average circumference of the head for a neonate ranges between 32 to 36 cm. An increase in size may indicate hydrocephaly or increased intracranial pressure.
Question 22
Which action by the mother of a preschooler would indicate a disturbed family interaction?
A
Tells her child that if he does not sit down and shut up she will leave him there.
B
Explains that the injection will burn like abee sting.
C
Tells her child that the injection can be given while he’s in her lap
D
Reassures child that it is acceptable to cry.
Question 22 Explanation:
Threatening a child with abandonment will destroy the child’s trust in his family
Question 23
Which of these statements, when made by the nurse, is most effective when communicating with a 4-year-old?
A
“Other children like having their blood pressure taken.”
B
“Anything you tell me is confidential.”
C
“Tell me where you hurt.”
D
“This will be like having a little stick in your arm.”
Question 23 Explanation:
Four-year-olds are egocentric and interested in having the focus on themselves. They will not be interested in what it feels like to other children. Preschoolers are concrete thinkers and would literally interpret any analogies so they are not helpful in explaining procedures. Assurance of confidential communication is most appropriate for the adolescent. In addition, confidentiality is not maintained if the child plans to harm themselves, harm someone else, or discloses abuse.
Question 24
The nurse is assessing a client who states her last menstrual period was March 17, and she has missed one period. She reports episodes of nausea and vomiting. Pregancy is confirmed by a urine test. What will the nurse calculate as the estimated date of delivery (EDD)?
A
February 21
B
December 24
C
May 15
D
November 8
Question 24 Explanation:
Naegele’s rule: add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery.
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Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.
NCLEX Practice Exam for Health Promotion and Maintenance (EM)
Choose the letter of the correct answer. You got 24 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed NCLEX Practice Exam for Health Promotion and Maintenance (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
When assessing a newborn whose mother consumed alcohol during the pregnancy, the nurse would assess for which of these clinical manifestations?
A
strong tongue thrust, short palpebral fissures, simean crease
The nurse should anticipate that the infant may have fetal alcohol syndrome and should assess for signs and symptoms of it like wide-spaced eyes, smooth filtrum, flattened nose.
Question 2
What question would be most important to ask a male client who is in for a digital rectal examination?
A
“Do you notice any burning with urination or any odor to the urine?”
B
“Do you notice polyuria in the AM?”
C
“Have you noticed a change in the force of the urinary system?”
D
“Have you noticed a change in tolerance of certain foods in your diet?”
Question 2 Explanation:
This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.
Question 3
A client is admitted to the hospital with a history of confusion. The client has difficulty remembering recent events and becomes disoriented when away from home. Which statement would provide the bestreality orientation for this client?
A
“Hello. My name is Elaine Jones and I am your nurse for today.”
B
"How are you today? Remember, you’re in the hospital.”
C
“Good morning. You’re in the hospital. I am your nurse Elaine Jones.”
D
“Good morning. Do you remember where you are?”
Question 3 Explanation:
As cognitive ability declines, the nurse provides a calm, predictable environment for the client. This response establishes time, location and the caregivers name.
Question 4
During the history, which information from a 21 year old client would indicate a risk for development of testicular cancer?
A
Undescended testicle
B
Hydrocele
C
Genital Herpes
D
Measles
Question 4 Explanation:
Undescended testicles make the client high risk for testicular cancer. Mumps, inguinal hernia in childhood, orchitis, and testicular cancer in the contra lateral testis are other predisposing factors.
Question 5
Which nursing approach would be most appropriate to use while administering an oral medication to a 4 month old?
A
Place medication in 45cc of formula
B
Place in supine position. Administer medication using a plastic syringe
C
Place medication in a full bottle of formula
D
Place medication in an empty nipple
Question 5 Explanation:
This is a convenient method for administering medications to an infant. Placing in supine position and administering medication using a plastic syringe is partially correct however, the infant is never placed in a reclining position during a procedure due to a potential aspiration.
Question 6
The nurse assesses a prolonged late deceleration of the fetal heart rate while the client is receiving oxytocin (Pitocin) IV to stimulate labor. The priority nursing intervention would be to:
A
Change the fluid to Ringer’s Lactate
B
Increase mainline IV rate
C
Turn off the infusion
D
Turn the client to the left
Question 6 Explanation:
Stopping the infusion will decrease contractions and possibly remove uterine pressure on the fetus, which is a possible cause of the deceleration.
Question 7
When observing 4 year-old children playing in the hospital playroom, what activity would the nurse expect to see the children participating in?
A
Playing cooperatively with other preschoolers
B
Competitive board games with older children
C
Playing alone with hand held computer games
D
Playing with their own toys along side with other children
Question 7 Explanation:
Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.
Question 8
Which nursing intervention would be a priority during the care of a 2 month old after surgery?
A
Demonstrate to the mother how she can assist with her infant’s care.
B
Minimize stimuli for the infant
C
Encourage stroking of the infant
D
Restrain all extremities
Question 8 Explanation:
Tactile stimulation is imperative for an infant’s normal emotional development. After the trauma of surgery, sensory deprivation can cause failure to thrive.
Question 9
The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:
A
increased growth of facial hair.
B
pronounced wrinkles on the face.
C
neck wrinkles.
D
decreased size of the nose and ears.
Question 9 Explanation:
The nose and ears of the aging client actually become longer and broader. The chin line is also altered. Wrinkles on the face become more pronounced and tend to take on the general mood of the client over the years. For example laugh or frown wrinkles about the eyebrows, lips, cheeks, and outer edges of the eye orbit. The change in the androgen-estrogen ration causes an increase in growth of facial hair in most elder adults. The aging process shortens the platysma muscle, which contributes to neck wrinkles.
Question 10
An 8.5 lb, 6 oz infant is delivered to a diabetic mother. Which nursing intervention would be implemented when the neonate becomes jittery and lethargic?
A
Administer oxygen
B
Administer insulin
C
Feed the infant glucose water (10%)
D
Place infant in a warmer
Question 10 Explanation:
After birth, the infant of a diabetic mother is often hypoglycemic.
Question 11
All of the following characteristics would indicate to the nurse that an elder client might experience undesirable effects of medicines except:
A
decreased serum albumin
B
medications containing magnesium.
C
increased oxidative enzyme levels.
D
alcohol taken with medication.
Question 11 Explanation:
Oxidative enzyme levels decrease in the elderly, which affects the disposition of medication and can alter the therapeutic effects of medication. Alcohol has a smaller water distribution level in the elderly, resulting in higher blood alcohol levels. Alcohol also interacts with various drugs to either potentate or interfere with their effects. Magnesium is contained in a lot of medications elder clients routinely obtain over the counter. Magnesium toxicity is a real concern. Albumin is the major drug-binding protein. Decreased levels of serum albumin mean that higher levels of the drug remain free and that there are less therapeutic effects and increased drug interactions.
Question 12
When a client wishes to improve the appearance of their eyes by removing excess skin from the face and neck, the nurse should provide teaching regarding which of the following procedures?
A
Blepharoplasty
B
Dermabrasion
C
Rhytidectomy
D
Rhinoplasty
Question 12 Explanation:
Rhytidectomy is the procedure for removing excess skin from the face and neck. It is commonly called a face lift. Dermabrasion involves the spraying of a chemical to cause light freezing of the skin, which is then abraded with sandpaper or a revolving wire brush. It is used to remove facial scars, severe acne, and pigment from tattoos. Rhinoplasty is done to improve the appearance of the nose and involves reshaping the nasal skeleton and overlying skin. Blepharoplasty is the procedure that removes loose and protruding fat from the upper and lower eyelids.
Question 13
The nurse is assessing a 4 month-old infant. Which motor skill would the nurse anticipate finding?
A
Bang two blocks
B
Drink from a cup
C
Wave “bye-bye”
D
Hold a rattle
Question 13 Explanation:
The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.
Question 14
A 64 year-old client scheduled for surgery with a general anesthetic refuses to remove a set of dentures prior to leaving the unit for the operating room. What would be the most appropriate intervention by the nurse?
A
Ask the client if the preference would be to remove the dentures in the operating room receiving area
B
Explain to the client that the dentures must come out as they may get lost or broken in the operating room
C
Notify the anesthesia department and the surgeon of the client’s refusal
D
Ask the client if there are second thoughts about having the procedure
Question 14 Explanation:
Clients anticipating surgery may experience a variety of fears. This choice allows the client control over the situation and fosters the client’s sense of self-esteem and self-concept.
Question 15
The family of a 6 year-old with a fractured femur asks the nurse if the child’s height will be affected by the injury. Which statement is true concerning long bone fractures in children?
A
Adequate blood supply to the bone prevents growth delay after fractures
B
Children usually heal very quickly, so growth problems are rare
C
Epiphyseal fractures often interrupt a child’s normal growth pattern
D
Growth problems will occur if the fracture involves the periosteum
Question 15 Explanation:
Epiphyseal fractures often interrupt a child’s normal growth pattern
Question 16
While caring for a client, the nurse notes a pulsating mass in the client’s periumbilical area. Which of the following assessments is appropriate for the nurse to perform?
A
Percuss the mass
B
Auscultate the mass
C
Palpate the mass
D
Measure the length of the mass
Question 16 Explanation:
Auscultate the mass. Auscultation of the abdomen and finding a bruit will confirm the presence of an abdominal aneurysm and will form the basis of information given to the provider. The mass should not be palpated because of the risk of rupture.
Question 17
What equipment would be necessary to complete an evaluation of cranial nerves 9 and 10 during a physical assessment?
A
An ophthalmoscope
B
A tongue depressor and flashlight
C
A pen light
D
A cotton ball
Question 17 Explanation:
Cranial nerves 9 and 10 are the glossopharyngeal and vagus nerves. The gag reflex would be evaluated.
Question 18
While the nurse is administering medications to a client, the client states “I do not want to take that medicine today.” Which of the following responses by the nurse would be best?
A
“That’s OK, its all right to skip your medication now and then.”
B
“Is there a reason why you don’t want to take your medicine?”
C
“Do you understand the consequences of refusing your prescribed treatment?”
D
“I will have to call your doctor and report this.”
Question 18 Explanation:
When a new problem is identified, it is important for the nurse to collect accurate assessment data. This is crucial to ensure that client needs are adequately identified in order to select the best nursing care approaches. The nurse should try to discover the reason for the refusal which may be that the client has developed untoward side effects.
Question 19
Which technique would be best in caring for a client following receiving a diagnosis of a state IV tumor in the brain?
A
Reminding the client that advances in technology are occurring everyday
B
Asking the client if there is anything he or his family needs
C
Providing accurate information about the disease and treatment options
D
Offering the client pamphlets on support groups for brain cancer
Question 19 Explanation:
Providing information for the client is the best technique for a new diagnosis.
Question 20
The nurse is assessing a client who states her last menstrual period was March 17, and she has missed one period. She reports episodes of nausea and vomiting. Pregancy is confirmed by a urine test. What will the nurse calculate as the estimated date of delivery (EDD)?
A
May 15
B
December 24
C
February 21
D
November 8
Question 20 Explanation:
Naegele’s rule: add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery.
Question 21
Which action by the mother of a preschooler would indicate a disturbed family interaction?
A
Reassures child that it is acceptable to cry.
B
Tells her child that if he does not sit down and shut up she will leave him there.
C
Explains that the injection will burn like abee sting.
D
Tells her child that the injection can be given while he’s in her lap
Question 21 Explanation:
Threatening a child with abandonment will destroy the child’s trust in his family
Question 22
Which of these statements, when made by the nurse, is most effective when communicating with a 4-year-old?
A
“Tell me where you hurt.”
B
“Other children like having their blood pressure taken.”
C
“Anything you tell me is confidential.”
D
“This will be like having a little stick in your arm.”
Question 22 Explanation:
Four-year-olds are egocentric and interested in having the focus on themselves. They will not be interested in what it feels like to other children. Preschoolers are concrete thinkers and would literally interpret any analogies so they are not helpful in explaining procedures. Assurance of confidential communication is most appropriate for the adolescent. In addition, confidentiality is not maintained if the child plans to harm themselves, harm someone else, or discloses abuse.
Question 23
The nurse is teaching the parents of a 3 month-old infant about nutrition. What is the main source of fluids for an infant until about 12 months of age?
A
Warmed fruit juice
B
Formula or breast milk
C
Fluoridated tap water
D
Dilute nonfat dry milk
Question 23 Explanation:
Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.
Question 24
While performing a physical examination on a newborn, which assessment should be reported to the physician?
A
Heart rate of 160 and respirations of 40
B
Chest circumference of 32 cm
C
Acrocyanosis and edema of the scalp
D
Head circumference of 40 cm
Question 24 Explanation:
Average circumference of the head for a neonate ranges between 32 to 36 cm. An increase in size may indicate hydrocephaly or increased intracranial pressure.
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Text Mode – Text version of the exam
1. What equipment would be necessary to complete an evaluation of cranial nerves 9 and 10 during a physical assessment?
A cotton ball
A pen light
An ophthalmoscope
A tongue depressor and flashlight
2. Which technique would be best in caring for a client following receiving a diagnosis of a state IV tumor in the brain?
Offering the client pamphlets on support groups for brain cancer
Asking the client if there is anything he or his family needs
Reminding the client that advances in technology are occurring everyday
Providing accurate information about the disease and treatment options
3. An 8.5 lb, 6 oz infant is delivered to a diabetic mother. Which nursing intervention would be implemented when the neonate becomes jittery and lethargic?
Administer insulin
Administer oxygen
Feed the infant glucose water (10%)
Place infant in a warmer
4. What question would be most important to ask a male client who is in for a digital rectal examination?
“Have you noticed a change in the force of the urinary system?”
“Have you noticed a change in tolerance of certain foods in your diet?”
“Do you notice polyuria in the AM?”
“Do you notice any burning with urination or any odor to the urine?”
5. The nurse assesses a prolonged late deceleration of the fetal heart rate while the client is receiving oxytocin (Pitocin) IV to stimulate labor. The priority nursing intervention would be to:
Turn off the infusion
Turn the client to the left
Change the fluid to Ringer’s Lactate
Increase mainline IV rate
6. Which nursing approach would be most appropriate to use while administering an oral medication to a 4 month old?
Place medication in 45cc of formula
Place medication in an empty nipple
Place medication in a full bottle of formula
Place in supine position. Administer medication using a plastic syringe
7. Which nursing intervention would be a priority during the care of a 2 month old after surgery?
Minimize stimuli for the infant
Restrain all extremities
Encourage stroking of the infant
Demonstrate to the mother how she can assist with her infant’s care.
8. While performing a physical examination on a newborn, which assessment should be reported to the physician?
Head circumference of 40 cm
Chest circumference of 32 cm
Acrocyanosis and edema of the scalp
Heart rate of 160 and respirations of 40
9. Which action by the mother of a preschooler would indicate a disturbed family interaction?
Tells her child that if he does not sit down and shut up she will leave him there.
Explains that the injection will burn like abee sting.
Tells her child that the injection can be given while he’s in her lap
Reassures child that it is acceptable to cry.
10. During the history, which information from a 21 year old client would indicate a risk for development of testicular cancer?
Genital Herpes
Hydrocele
Measles
Undescended testicle
11. While caring for a client, the nurse notes a pulsating mass in the client’s periumbilical area. Which of the following assessments is appropriate for the nurse to perform?
Measure the length of the mass
Auscultate the mass
Percuss the mass
Palpate the mass
12. When observing 4 year-old children playing in the hospital playroom, what activity would the nurse expect to see the children participating in?
Competitive board games with older children
Playing with their own toys along side with other children
Playing alone with hand held computer games
Playing cooperatively with other preschoolers
13. The nurse is teaching the parents of a 3 month-old infant about nutrition. What is the main source of fluids for an infant until about 12 months of age?
Formula or breast milk
Dilute nonfat dry milk
Warmed fruit juice
Fluoridated tap water
14. While the nurse is administering medications to a client, the client states “I do not want to take that medicine today.” Which of the following responses by the nurse would be best?
“That’s OK, its all right to skip your medication now and then.”
“I will have to call your doctor and report this.”
“Is there a reason why you don’t want to take your medicine?”
“Do you understand the consequences of refusing your prescribed treatment?”
15. The nurse is assessing a 4 month-old infant. Which motor skill would the nurse anticipate finding?
Hold a rattle
Bang two blocks
Drink from a cup
Wave “bye-bye”
16. The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:
pronounced wrinkles on the face.
decreased size of the nose and ears.
increased growth of facial hair.
neck wrinkles.
17. All of the following characteristics would indicate to the nurse that an elder client might experience undesirable effects of medicines except:
increased oxidative enzyme levels.
alcohol taken with medication.
medications containing magnesium.
decreased serum albumin.
18. When assessing a newborn whose mother consumed alcohol during the pregnancy, the nurse would assess for which of these clinical manifestations?
wide-spaced eyes, smooth filtrum, flattened nose
strong tongue thrust, short palpebral fissures, simean crease
19. Which of these statements, when made by the nurse, is most effective when communicating with a 4-year-old?
“Tell me where you hurt.”
“Other children like having their blood pressure taken.”
“This will be like having a little stick in your arm.”
“Anything you tell me is confidential.”
20. A 64 year-old client scheduled for surgery with a general anesthetic refuses to remove a set of dentures prior to leaving the unit for the operating room. What would be the most appropriate intervention by the nurse?
Explain to the client that the dentures must come out as they may get lost or broken in the operating room
Ask the client if there are second thoughts about having the procedure
Notify the anesthesia department and the surgeon of the client’s refusal
Ask the client if the preference would be to remove the dentures in the operating room receiving area
21. The nurse is assessing a client who states her last menstrual period was March 17, and she has missed one period. She reports episodes of nausea and vomiting. Pregancy is confirmed by a urine test. What will the nurse calculate as the estimated date of delivery (EDD)?
November 8
May 15
February 21
December 24
22. The family of a 6 year-old with a fractured femur asks the nurse if the child’s height will be affected by the injury. Which statement is true concerning long bone fractures in children?
Growth problems will occur if the fracture involves the periosteum
Epiphyseal fractures often interrupt a child’s normal growth pattern
Children usually heal very quickly, so growth problems are rare
Adequate blood supply to the bone prevents growth delay after fractures
23. A client is admitted to the hospital with a history of confusion. The client has difficulty remembering recent events and becomes disoriented when away from home. Which statement would provide the bestreality orientation for this client?
“Good morning. Do you remember where you are?”
“Hello. My name is Elaine Jones and I am your nurse for today.”
“How are you today? Remember, you’re in the hospital.”
“Good morning. You’re in the hospital. I am your nurse Elaine Jones.”
24. When a client wishes to improve the appearance of their eyes by removing excess skin from the face and neck, the nurse should provide teaching regarding which of the following procedures?
Dermabrasion
Rhinoplasty
Blepharoplasty
Rhytidectomy
Answers and Rationales
Answer D. Cranial nerves 9 and 10 are the glossopharyngeal and vagus nerves. The gag reflex would be evaluated.
Answer D. Providing information for the client is the best technique for a new diagnosis.
Answer C. After birth, the infant of a diabetic mother is often hypoglycemic.
Answer A. This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.
Answer A. Stopping the infusion will decrease contractions and possibly remove uterine pressure on the fetus, which is a possible cause of the deceleration.
Answer B. This is a convenient method for administering medications to an infant. Option D is partially correct however, the infant is never placed in a reclining position during a procedure due to a potential aspiration.
Answer C. Tactile stimulation is imperative for an infant’s normal emotional development. After the trauma of surgery, sensory deprivation can cause failure to thrive.
Answer A. Average circumference of the head for a neonate ranges between 32 to 36 cm. An increase in size may indicate hydrocephaly or increased intracranial pressure.
Answer A. Threatening a child with abandonment will destroy the child’s trust in his family.
Answer D. Undescended testicles make the client high risk for testicular cancer. Mumps, inguinal hernia in childhood, orchitis, and testicular cancer in the contra lateral testis are other predisposing factors.
Answer B. Auscultate the mass. Auscultation of the abdomen and finding a bruit will confirm the presence of an abdominal aneurysm and will form the basis of information given to the provider. The mass should not be palpated because of the risk of rupture.
Answer D. Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.
Answer A. Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.
Answer C. When a new problem is identified, it is important for the nurse to collect accurate assessment data. This is crucial to ensure that client needs are adequately identified in order to select the best nursing care approaches. The nurse should try to discover the reason for the refusal which may be that the client has developed untoward side effects.
Answer A. The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.
Answer B. The nose and ears of the aging client actually become longer and broader. The chin line is also altered. Wrinkles on the face become more pronounced and tend to take on the general mood of the client over the years. For example laugh or frown wrinkles about the eyebrows, lips, cheeks, and outer edges of the eye orbit. The change in the androgen-estrogen ration causes an increase in growth of facial hair in most elder adults. The aging process shortens the platysma muscle, which contributes to neck wrinkles.
Answer A. Oxidative enzyme levels decrease in the elderly, which affects the disposition of medication and can alter the therapeutic effects of medication. Alcohol has a smaller water distribution level in the elderly, resulting in higher blood alcohol levels. Alcohol also interacts with various drugs to either potentate or interfere with their effects. Magnesium is contained in a lot of medications elder clients routinely obtain over the counter. Magnesium toxicity is a real concern. Albumin is the major drug-binding protein. Decreased levels of serum albumin mean that higher levels of the drug remain free and that there are less therapeutic effects and increased drug interactions.
Answer A. The nurse should anticipate that the infant may have fetal alcohol syndrome and should assess for signs and symptoms of it. These include the characteristics listed in choice A.
Answer A. Four-year-olds are egocentric and interested in having the focus on themselves. They will not be interested in what it feels like to other children. Preschoolers are concrete thinkers and would literally interpret any analogies so they are not helpful in explaining procedures. Assurance of confidential communication is most appropriate for the adolescent. In addition, confidentiality is not maintained if the child plans to harm themselves, harm someone else, or discloses abuse.
Answer D. Clients anticipating surgery may experience a variety of fears. This choice allows the client control over the situation and fosters the client’s sense of self-esteem and self-concept.
Answer D. Naegele’s rule: add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery.
Answer B. Epiphyseal fractures often interrupt a child’s normal growth pattern
Answer is D. As cognitive ability declines, the nurse provides a calm, predictable environment for the client. This response establishes time, location and the caregivers name.
Answer D. Rhytidectomy is the procedure for removing excess skin from the face and neck. It is commonly called a face lift. Dermabrasion involves the spraying of a chemical to cause light freezing of the skin, which is then abraded with sandpaper or a revolving wire brush. It is used to remove facial scars, severe acne, and pigment from tattoos. Rhinoplasty is done to improve the appearance of the nose and involves reshaping the nasal skeleton and overlying skin. Blepharoplasty is the procedure that removes loose and protruding fat from the upper and lower eyelids.