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NCLEX Practice Exam for Health Promotion and Maintenance (PM)
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Question 1
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
Epiphyseal fractures often interrupt a child’s normal growth pattern
B
Growth problems will occur if the fracture involves the periosteum
C
Adequate blood supply to the bone prevents growth delay after fractures
D
Children usually heal very quickly, so growth problems are rare
Question 1 Explanation:
Epiphyseal fractures often interrupt a child’s normal growth pattern
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
“Have you noticed a change in tolerance of certain foods in your diet?”
C
“Do you notice polyuria in the AM?”
D
“Have you noticed a change in the force of the urinary system?”
Question 2 Explanation:
This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.
Question 3
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
Turn off the infusion
B
Turn the client to the left
C
Change the fluid to Ringer’s Lactate
D
Increase mainline IV rate
Question 3 Explanation:
Stopping the infusion will decrease contractions and possibly remove uterine pressure on the fetus, which is a possible cause of the deceleration.
Question 4
When assessing a newborn whose mother consumed alcohol during the pregnancy, the nurse would assess for which of these clinical manifestations?
A
wide-spaced eyes, smooth filtrum, flattened nose
B
negative Babinski sign, hyperreflexia, deafness
C
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 5
All of the following characteristics would indicate to the nurse that an elder client might experience undesirable effects of medicines except:
A
alcohol taken with medication.
B
decreased serum albumin
C
increased oxidative enzyme levels.
D
medications containing magnesium.
Question 5 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 6
Which of these statements, when made by the nurse, is most effective when communicating with a 4-year-old?
A
“This will be like having a little stick in your arm.”
B
“Anything you tell me is confidential.”
C
“Tell me where you hurt.”
D
“Other children like having their blood pressure taken.”
Question 6 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 7
The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:
A
neck wrinkles.
B
decreased size of the nose and ears.
C
increased growth of facial hair.
D
pronounced wrinkles on the face.
Question 7 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 8
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 8 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 9
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
Dilute nonfat dry milk
B
Formula or breast milk
C
Warmed fruit juice
D
Fluoridated tap water
Question 9 Explanation:
Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.
Question 10
What equipment would be necessary to complete an evaluation of cranial nerves 9 and 10 during a physical assessment?
A
A cotton ball
B
An ophthalmoscope
C
A tongue depressor and flashlight
D
A pen light
Question 10 Explanation:
Cranial nerves 9 and 10 are the glossopharyngeal and vagus nerves. The gag reflex would be evaluated.
Question 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?
A
Palpate the mass
B
Measure the length of the mass
C
Percuss the mass
D
Auscultate the mass
Question 11 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 12
The nurse is assessing a 4 month-old infant. Which motor skill would the nurse anticipate finding?
A
Hold a rattle
B
Bang two blocks
C
Wave “bye-bye”
D
Drink from a cup
Question 12 Explanation:
The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.
Question 13
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. Do you remember where you are?”
D
“Good morning. You’re in the hospital. I am your nurse Elaine Jones.”
Question 13 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 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?
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 14 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 15
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
Notify the anesthesia department and the surgeon of the client’s refusal
C
Ask the client if there are second thoughts about having the procedure
D
Ask the client if the preference would be to remove the dentures in the operating room receiving area
Question 15 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 16
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
Rhinoplasty
B
Dermabrasion
C
Rhytidectomy
D
Blepharoplasty
Question 16 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 17
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
Competitive board games with older children
C
Playing alone with hand held computer games
D
Playing cooperatively with other preschoolers
Question 17 Explanation:
Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.
Question 18
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 18 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 19
While performing a physical examination on a newborn, which assessment should be reported to the physician?
A
Acrocyanosis and edema of the scalp
B
Head circumference of 40 cm
C
Heart rate of 160 and respirations of 40
D
Chest circumference of 32 cm
Question 19 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 20
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 insulin
B
Feed the infant glucose water (10%)
C
Place infant in a warmer
D
Administer oxygen
Question 20 Explanation:
After birth, the infant of a diabetic mother is often hypoglycemic.
Question 21
Which action by the mother of a preschooler would indicate a disturbed family interaction?
A
Explains that the injection will burn like abee sting.
B
Tells her child that if he does not sit down and shut up she will leave him there.
C
Reassures child that it is acceptable to cry.
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 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
Encourage stroking of the infant
C
Restrain all extremities
D
Minimize stimuli for the infant
Question 22 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 23
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
Offering the client pamphlets on support groups for brain cancer
C
Reminding the client that advances in technology are occurring everyday
D
Providing accurate information about the disease and treatment options
Question 23 Explanation:
Providing information for the client is the best technique for a new diagnosis.
Question 24
During the history, which information from a 21 year old client would indicate a risk for development of testicular cancer?
A
Undescended testicle
B
Genital Herpes
C
Hydrocele
D
Measles
Question 24 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.
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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
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 1 Explanation:
The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.
Question 2
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
Offering the client pamphlets on support groups for brain cancer
D
Providing accurate information about the disease and treatment options
Question 2 Explanation:
Providing information for the client is the best technique for a new diagnosis.
Question 3
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
Increase mainline IV rate
B
Change the fluid to Ringer’s Lactate
C
Turn the client to the left
D
Turn off the infusion
Question 3 Explanation:
Stopping the infusion will decrease contractions and possibly remove uterine pressure on the fetus, which is a possible cause of the deceleration.
Question 4
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
Measure the length of the mass
C
Palpate the mass
D
Auscultate the mass
Question 4 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 5
When assessing a newborn whose mother consumed alcohol during the pregnancy, the nurse would assess for which of these clinical manifestations?
A
wide-spaced eyes, smooth filtrum, flattened nose
B
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 6
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
February 21
C
November 8
D
December 24
Question 6 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 7
What equipment would be necessary to complete an evaluation of cranial nerves 9 and 10 during a physical assessment?
A
A pen light
B
An ophthalmoscope
C
A tongue depressor and flashlight
D
A cotton ball
Question 7 Explanation:
Cranial nerves 9 and 10 are the glossopharyngeal and vagus nerves. The gag reflex would be evaluated.
Question 8
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
increased growth of facial hair.
C
neck wrinkles.
D
pronounced wrinkles on the face.
Question 8 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 9
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
Dilute nonfat dry milk
D
Fluoridated tap water
Question 9 Explanation:
Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.
Question 10
During the history, which information from a 21 year old client would indicate a risk for development of testicular cancer?
A
Genital Herpes
B
Measles
C
Hydrocele
D
Undescended testicle
Question 10 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 11
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
“Good morning. You’re in the hospital. I am your nurse Elaine Jones.”
C
“Good morning. Do you remember where you are?”
D
“Hello. My name is Elaine Jones and I am your nurse for today.”
Question 11 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 12
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
“I will have to call your doctor and report this.”
B
“That’s OK, its all right to skip your medication now and then.”
C
“Do you understand the consequences of refusing your prescribed treatment?”
D
“Is there a reason why you don’t want to take your medicine?”
Question 12 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 13
Which action by the mother of a preschooler would indicate a disturbed family interaction?
A
Tells her child that the injection can be given while he’s in her lap
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
Reassures child that it is acceptable to cry.
Question 13 Explanation:
Threatening a child with abandonment will destroy the child’s trust in his family
Question 14
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 14 Explanation:
Epiphyseal fractures often interrupt a child’s normal growth pattern
Question 15
Which nursing intervention would be a priority during the care of a 2 month old after surgery?
A
Restrain all extremities
B
Demonstrate to the mother how she can assist with her infant’s care.
C
Encourage stroking of the infant
D
Minimize stimuli for the infant
Question 15 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 16
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
Ask the client if there are second thoughts about having the procedure
D
Notify the anesthesia department and the surgeon of the client’s refusal
Question 16 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 17
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 an empty nipple
C
Place medication in a full bottle of formula
D
Place in supine position. Administer medication using a plastic syringe
Question 17 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 18
Which of these statements, when made by the nurse, is most effective when communicating with a 4-year-old?
A
“This will be like having a little stick in your arm.”
B
“Tell me where you hurt.”
C
“Anything you tell me is confidential.”
D
“Other children like having their blood pressure taken.”
Question 18 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 19
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 insulin
B
Place infant in a warmer
C
Feed the infant glucose water (10%)
D
Administer oxygen
Question 19 Explanation:
After birth, the infant of a diabetic mother is often hypoglycemic.
Question 20
While performing a physical examination on a newborn, which assessment should be reported to the physician?
A
Chest circumference of 32 cm
B
Head circumference of 40 cm
C
Acrocyanosis and edema of the scalp
D
Heart rate of 160 and respirations of 40
Question 20 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 21
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 alone with hand held computer games
C
Competitive board games with older children
D
Playing cooperatively with other preschoolers
Question 21 Explanation:
Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.
Question 22
What question would be most important to ask a male client who is in for a digital rectal examination?
A
“Have you noticed a change in the force of the urinary system?”
B
“Have you noticed a change in tolerance of certain foods in your diet?”
C
“Do you notice polyuria in the AM?”
D
“Do you notice any burning with urination or any odor to the urine?”
Question 22 Explanation:
This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.
Question 23
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
Rhinoplasty
B
Rhytidectomy
C
Dermabrasion
D
Blepharoplasty
Question 23 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 24
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
alcohol taken with medication.
C
increased oxidative enzyme levels.
D
medications containing magnesium.
Question 24 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.
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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.