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Exam Cram NCLEX-PN Practice Questions Part 2

Nursing50 CardsCreated 4 months ago

This flashcard set reviews NCLEX-PN-style questions focused on post-operative care, lab value analysis, and critical thinking. It helps reinforce key concepts such as airway monitoring after transsphenoidal surgery and identifying electrolyte imbalances like hypokalemia.

The client is receiving total parenteral nutrition (TPN). Which lab should be evaluated while the client is receiving TPN?

A. Hemoglobin
B. Creatinine
C. Blood glucose
D. White blood cell count

C. Blood glucose

why?

When the client is receiving TPN, the blood glucose level should be drawn. TPN is a solution that contains large amounts of glucose.

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Key Terms

Term
Definition

The client is receiving total parenteral nutrition (TPN). Which lab should be evaluated while the client is receiving TPN?

A. Hemoglobin
B. Creatinine
C. Blood glucose
D. White blood cell count

C. Blood glucose

why?

When the client is receiving TPN, the blood glucose level should be drawn. TPN is a solution that contains larg...

The client with a myocardial farction comes to the nurse's station stating that he is ready to go come because there is nothing wrong with him. Which defense mechanism is the client using?

A. Rationalization
B. Denial
C. Projection
D. Conversion reaction

B. Denial

why?

The client who says he has nothing wrong is in denial about his myocardial infarction.

Which lab test would be the least effective in making the diagnosis of myocardial infarction?

A. AST
B. Troponin
C. CK-MB
D. Myoglobin

A. AST

why?

AST is not specific for a myocardial infarction

The licensed practical nurse assigned to the post-partal unit is preparing to administer Rhogam to a post-patrum client. Which of the women is not a candidate for the RhoGam?

A. A gravida IV para 3 that is Rh negative with a Rh postivie baby
B. A gravida I para I that is Rh negative with a Rh positive baby
C. A gravida II para 0 that is Rh negative attempted after a still birth delivery
D. A gravida IV para II that is Rh negative with a Rh negative baby

D. A gravida IV para II that is Rh negative with a Rh negative baby

why?

The mother in answer D is the only one who does not require ...

The first exercise that should be performed by a client with a mastectomy is:

A. Walking the hand up the wall
B. Sweeping the floor
C. Combing her hair
D. Squeezing a ball

D. Squeezing a ball

why?

The first exercise that should be done by the client with a mastectomy is squeezing the ball

This client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept during the test?

A. Atropine sulfate
B. Furosemide
C. Prostigmin
D.Promethazine

A. Atropine sulfate

why?

Atropine sulfate is the antidote for Tensilon and is given to treat cholenergic crises

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TermDefinition

The client is receiving total parenteral nutrition (TPN). Which lab should be evaluated while the client is receiving TPN?

A. Hemoglobin
B. Creatinine
C. Blood glucose
D. White blood cell count

C. Blood glucose

why?

When the client is receiving TPN, the blood glucose level should be drawn. TPN is a solution that contains large amounts of glucose.

The client with a myocardial farction comes to the nurse's station stating that he is ready to go come because there is nothing wrong with him. Which defense mechanism is the client using?

A. Rationalization
B. Denial
C. Projection
D. Conversion reaction

B. Denial

why?

The client who says he has nothing wrong is in denial about his myocardial infarction.

Which lab test would be the least effective in making the diagnosis of myocardial infarction?

A. AST
B. Troponin
C. CK-MB
D. Myoglobin

A. AST

why?

AST is not specific for a myocardial infarction

The licensed practical nurse assigned to the post-partal unit is preparing to administer Rhogam to a post-patrum client. Which of the women is not a candidate for the RhoGam?

A. A gravida IV para 3 that is Rh negative with a Rh postivie baby
B. A gravida I para I that is Rh negative with a Rh positive baby
C. A gravida II para 0 that is Rh negative attempted after a still birth delivery
D. A gravida IV para II that is Rh negative with a Rh negative baby

D. A gravida IV para II that is Rh negative with a Rh negative baby

why?

The mother in answer D is the only one who does not require a RhoGam injection.

The first exercise that should be performed by a client with a mastectomy is:

A. Walking the hand up the wall
B. Sweeping the floor
C. Combing her hair
D. Squeezing a ball

D. Squeezing a ball

why?

The first exercise that should be done by the client with a mastectomy is squeezing the ball

This client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept during the test?

A. Atropine sulfate
B. Furosemide
C. Prostigmin
D.Promethazine

A. Atropine sulfate

why?

Atropine sulfate is the antidote for Tensilon and is given to treat cholenergic crises

The client is scheduled for a pericentesis. Which instruction should be given to the client before the exam?

A. "You will need to lay flat during the exam."
B. "You need to empty your bladder before the procedure."
C. "You will be alseep during the procedure."
D. "The doctor will injuect a medication to treat your illness during the procedure."

B. "You need to empty your bladder before the procedure."

why?

The client scheduled for a pericentesis should be told to empty the bladder, to prevent the risk of puncturing the bladder when the needle is inserted. A pericentesis is done to remove fluid from the peritoneal cavity.

To ensure safety while administering a Nitroglycerin patch, the nurse should:

A. Wear gloves
B. Shave the area where the patch should be applied
C. Wash the area thoroughly with soap and rinse with hot water
D. Apply the patch to the buttocks

A. Wear gloves

why?

To protect herself, the nurse should wear gloves when applying a nitroglycerin patch or cream.

A 25 year old male is brought to the ER with a piece of metal in his eye. Which action by the nurse is correct?

A. Use a magnet to remove the object
B. Rinse the eye thoroughly with saline
C. Cover both eyes with paper cups
D. Patch the affected eye only

C. Cover both eyes with paper cups

why?

Covering both eyes prevents consensual movement of the affected eye.

The physician has order sodium warfrin ( Coumadin) for the client with thrombophlebitis. The order should be entered to administer the medication at:

A. 0900
B. 1200
C. 1700
D. 2100

C. 1700

why?

Sodium warfarin is administered in the late afternoon, at approximately 1700 hours. this allows for accurate bleeding times to be drawn in the morning.

The schizophrenic client has become disruptive and requires seclusion. Which staff member can institute seclusion?

A. Secrurity guard
B. RN
C. LPN
D. The nursing assistant

B. RN

why?

The RN is the only one of these who can legally put the client in seclusion. The only other healthcare worker who is allowed to initiate seclusion is the doctor.

The client is admitted with chronic obstructive pulmonary disease. Blood gases reveal a pH of 7.36, CO2 at 45, O2 at 84, HCO3 at 28. The nurse would assess the client to be in:

A. Uncompensated acidosis
B. Compensated alkalosis
C. Compensated respiratory acidosis
D. Uncompensated metabolic acidosis

C. Compensated respiratory acidosis

why?

The client is experiencing compensated respiratory acidosis. The pH is within the normal range but is lower than 7.40, so it is on the acidic side. The CO2 level is elevated, the oxygen level is below normal, and the bicarb level is slightly elevated. In respiratory disorders, the pH will be in inverse of the CO2 and bicarb level. This means that if the pH is low, the CO2 and bicarb levels will be elevated.

The nurse is assessing the client recently returned from surgery. The nurse is aware that the best way to assess pain is to:

A. Take blood pressure, pulse, and temp
B. Ask the client to rate his pain from 1-5
C. Watch the client's facial expression
D. Ask the client if he is in pain

B. Ask the client to rate his pain from 1-5

why?

The best way to evaluate pain levels is to ask the client to rate his pain on a scale.

The nursing is participating in a discharge teaching for the post-partal client. The nurse is aware that an effective means of managing discomfort associated with a episiotomy after discharge is:

A. Promethazine
B. Aspirin
C. Sitz bath
D. Ice bath

C. Sitz bath

why?

A sitz bath will help with swelling and improve healing

Which of the following post-op diets are most appropriate for a client who has had a hemorroidectomy?

A. High fiber
B. Low-residue
C. Bland
D. Clear liquids

D. Clear liquids

why?

After surgery, the client will be placed o n a clear-liquid diet and progressed to a regular diet. stool softeners will be included in the plan of care, to avoid constipation.

The physician has ordered a culture for the client with suspected Gonorrhea. The nurse should obtain what type of culture?

A. Blood
B. Nasopharyngeal secretions
C. Stool
D. Genital secretions

D. Genital secretions

why?

A culture for gonorrhea is taken from the genital secretions. The culture is placed in a warm environment, where it can grow nisseria gonorrhea

The nurse is caring for a client with cerebral plasy. The nurse should provide frequent rest periods because:

A: Grimacing and withering movements decrease with relaxation and rest.
B. Hypoactive deep tendon reflexes become more active with rest
C. Stretch reflexes become more increases with rest
D. Fine motor movements are improved

A. Grimacing and withering movements decrease with relaxation and rest.

why?

Frequent rest periods help to relx tense muscles and preserve energy

The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?

A. A client with Alzheimer's
B. A client with pnuemonia
C. A client with appendicitis
D. A client with thrombophebitis

A. A client with Alzheimer's

why?

The client with Alzheimer's disease is the most stable of these clients and can be assigned to the nursing assistant, who can perform duties such as feeding and assisting the client with activities of daily living.

A client with cancer develops xerostomia. The nurse can help alleviate the discomfort associated with xerostomia by:

A. Offering a hard candy
B. Administering an analgesic medication
C. Splinting swollen joints
D. Providing saliva substitue

D. Providing saliva substitute

why?

Xerostomia is dry mouth, and offering the client a saliva substitute will help the most.

A home health nurse is making preparations for morning visits. Which of the following clients should the nurse visit first?

A. A client with brain- attack (stroke) with tube feeding
B. A client with congestive heart failure complaining of nighttime dyspnea
C. A client with a thoracotomy 6 months ago
D. A client with Parkinson disease

B. The client with congestive heart failure complaining of nighttime dyspnea

why?

The client with congestive heart failure who is complaining of nighttime dyspnea should be seen first because airway si number one in nursing care

A client with glomerulonephritis is placed on a low sodium diet. Which of the following snacks is suitable for the client with low sodium restritctions?

A. Peanut butter cookies
B. Grilled cheese sandwich
C. Cottage cheese and fruit
D. Fresh peach

D. Fresh peach

why?

The fresh peach is the lowest in sodium of these choices

Due to a high census, it had been necessary for a number of clients to be transferred to another unit within the hospital. Which client should be transferred to the post-partum unit?

A. A 66 year old female with gastroenteritis
B. A 40 year old female with a hysterectomy
C. A 27 year old male with sever depression
D. A 28 year old male with ulcerative colitis

B. A 40 year old female with a hysterectomy

why?

The best client to transport to the postpartum units it the 40 year old female with a hysterectomy. The nurses on the postpartum unit will be aware of moral amounts of bleeding and will be equipped to care for this client.

During the change of the shift, the ongoing nurse notes a discrepancy in the number of Perocept (oxycodone) listed in the number present in the narcotics drawer. The nurse's first action should be to:

A. Notify the hospital pharmacist
B. Notify the nursing supervisor
C. Notify the board of nursing
D. Notify the director of nursing

B. Notify the nursing supervisor

why?

The first action the nurse should take is to report the finding to the nurse supervisor and follow the chain of command.

The nurse is assigning staff for the day. Which assignment should be given to the nursing assistant?

A. Taking the vital signs of the 5 month old with brochiolitis
B. Taking the vital signs of a 10 year old with a 2 day post- appendectomy
C. Administering medication to the 2 year old with periorbital cellulitis
D. Adjusting the traction of a 1 year with a fractured tibia

B. Taking the vital signs of a 10 year old with a 2 day post-appendectomy

why?

The client with the appendectomy is the most stable of these clients and can be assigned to a nursing assistant. The client with bronchiolitis has an alteration in the airway, the client with periorbital cellulitis has an infection, and the client with a fracture might be an abused child.

A new nursing graduate indicates in charting enteries that he is a licensed practical nurse, although he has not received the results of the licensing exam. The graduate's actions can result in what type of charge?

A. Fraud
B. Tort
C. Malpractice
D. Negligence

A. Fraud

why?

Identifying oneself as a nurse without a license defrauds the public and can be prosecuted. A tort is a wrongful; malpractice is failing to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to perform care.

A client with acute leukemia develops a low white blood cell count. In addition to the institute of isolation the nurse should:

A. Request that food be served with disposable utensils
B. Ask the client to wear a mask when visitors are present
C. Prep IV with mild soap, water, and alcohol
D. Provide foods in seal single serving packages

D. Provide foods in seal single serving packages

why?

Because the client is immune-suppressed, foods should be served in sealed containers, to avoid food contaminants.

A 70 year old man who is recovering from a stroke exhibits signs of unilateral neglect. Which behavior is suggested of unilateral neglect?

A. The client is observed by shaving only one side of his face
B. The client is unable to distinguish between two tactile stimuli presented simultaneously
C. The client is unable to complete a range a vision without turning his head side to side
D. The client is unable to carry out cognitive and motor activity at the same time

A. The client is observed by shaving only one side of his face

why?

The client with unilateral neglect will neglect one side of the body

The nurse is providing discharge teaching for a client who is taking dissulfiram (Antabuse). The nurse should instruct the client to avoid eating:

A. Peanuts, dates, raisins
B. Figs, chocolate, eggplant
C. Pickles, salad with vinaigrette dressing, and beef
D. Milk, cottage cheese, ice cream

C. Pickles, salad with vinaigrette dressing, beef

why?

The client taking antabuse should not eat or drink anything containing alcohol or vinegar

A client has been receiving cyanocobalamine (B12) injections for the past 6 weeks. Which lab finding indicates that the medication is having the desired effect?

A. Neutrophil count of 60%
B. Basophil count of 0.5%
C. Monocyte count of 2%
D. Reticlocyte count of 1%

D. Reticlocyte count of 1 %

why?

Cyanocolamine is a B12 medication that is used for pernicious anemia, and a reticulocyte count of 1% indicates that it is having the desired effect.

The nurse has just received a change of shift report. Which client should the nurse assess first?

A. A client 2 hours post-lobectomy with 150 cc drainage
B. A client 2 days post-gastrectomy with scant drainage
C. A client with pnuemonia with a oral temp of 102 F
D. A client with a fractured hip in Bucks traction

A. A client 2 hours post-lobectomy with 150 cc drainage

why?

The first client to be seen is the one who recently returned from surgery.

Several clients are admitted to the ER following a three- car vehicle accident. Which clients can be assigned to share a room in the emergency department during the disaster?

A. The schizophrenic client having visual and auditory hallucinations and the client with ulcerative collitis
B. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm
C. A child whose pupils are fixed and dilated and his parents, and the client with a frontal head injury
D. The client who arrives with a large puncture wound to the abdomen and the client with chest pain

B. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm

why?

Out of all these clients, it is best to hold the pregnant client and the client with a broken arm and facial lacerations in the same room.

The home health nurse is planning for the day's visits. Which client should be seen first?

A. The 78 year old who had a gastrectomy 3 weeks ago with a PEG tube
B. The 5 month old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension
C. The 50 year old with MRSA being treated with Vancomycin via a PICC line
D. The 30 year old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

D. The 30 year old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

why?

The priority client is the one with multiple sclerosis who is being treated with cortisone via the central line. This client is at highest risk for complications.

The nurse is found to be guilty of charting blood glucose results without actually performing the procedure. After talking to the nurse, the charge nurse should:

A. Call the Board of Nursing
B. File a formal reprimand
C. Terminate the nurse
D. Charge the nurse with a tort

B. File a formal reprimand

why?

The action after discussing the problem with the nurse is to document the incident and file a formal reprimand. If the behavior continues or if harm has resulted to the client, the nurse may be terminated and reported to the Board of Nursing, but this is not the first step.

Which information should be reported to the state Board of Nursing?

A. The facility fails to provide literature in both Spanish and English
B. The narcotic count has been incorrect on the unit for the past 3 days.
C. The client fails to receive an itemized account of his bills and services received during his hospital stay
D. The nursing assistant assigned to the client with hepatitis fails to feed the client and give the bath

B. The narcotic count has been incorrect on the unit for the past 3 days.

why?

The Joint Commission on Accreditation of Hospitals will probably be interested in the problems in answers A and C. The failure of the nursing assistant to assist the client with hepatitis should be reported to the charge nurse. If the behavior continues, termination may result.

Which nurse should be assigned to care for the postpartal client with preeclampsia?

A. The nurse with 2 weeks of experience on postpartum
B. The nurse with 3 years of experience in labor and delivery
C. The nurse with 10 years of experience in surgery
D. The nurse with 1 year of experience in the neonatal intensive care unit

B. Th nurse with 3 years of experience in labor and delivery

why?

The nurse in answer B has the most experience with possible complications involved with preeclampsia.

The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, respirations 30. Which action by the nurse should receive priority?

A. Continue to monitor the vital signs
B. Contact the physician
C. Ask the client how he feels
D. Ask the LPN to continue the post-op care

B. Contact the physician

why?

The vital signs are abnormal and should be reported to the doctor immediately.

Which assignment should not be performed by the licensed practical nurse?

A. Inserting a Foley catheter
B. Discounting a nasogastric tube
C. Obtaining a sputum specimen
D. Initiating a blood transfusion

D. Initiating a blood transfusion

why?

A LPN should not assigned to initiate a blood transfusion. The LPN can assist with the transfusion and check ID numbers for the RN. The LPN can be assigned to insert Foley and French urinary catheters, discontinue Levine and Gavage gastric tubes, and obtain all types of specimens.

The nurse witnesses the nursing assistant hitting the client in the long-term care facility. The nursing assistant can be changed with:

A. Negligence
B. Tort
C. Assault
D. Malpractice

C. Assault

why?

Assault is defined as striking or touching the client inappropriately, so a nurse assistant striking a client could be charged with assault.

The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?

A. The client with Cushing's disease
B. The client with diabetes
C. The client with acromegaly
D. The client with myxedema

A. The client with Cushing's disease

why?

The client with Cushing's disease has adrenocortical hypersecretion. This increase in the level of cortisone causes the client to be immune suppressed

The nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?

A. The client receiving linear accelerator radiation therapy for lung cancer.
B. The client with a radium implant for cervical cancer
C. The client who has just been administered soluble brachytherapy for thyroid cancer
D. The client who returned from placement of iridium seeds for prostate cancer

A. The client receiving linear accelerator radiation therapy for lung cancer

why?

The pregnant nurse should not be assigned to any client with radioactivity present. Therefore, the client receiving linear accelerator therapy is correct because this client travels to the radium department for therapy, and the radiation stays in the department; the client is not radioactive

The client is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin?

A. Cyanocoblalmine
B. Protamine sulfate
C. Streptokinase
D. Sodium warfarin

B. Protamine sulfate

why?

The antidote for heparin is protamine sulfate. Cyanocolbalamine is B12, Strptokinase is a thrombolytic, and sodium warfarin is an anticoagulant.

The client is admitted with a BP of 210/120. Her doctor orders furosemide (Lasix) 40 mg IV stat. How should the nurse administer the prescribed furosemide to this client?

A. By giving it over 1-2 minutes
B. By hanging it IV piggyback
C. With normal saline only
D. By administering it through a venous access device

A. By giving it over 1-2 minutes

why?

Lasix should be given approximately 1mL per minute to prevent hypotesion

The physician prescribes capropril (Capoten) 25 mg po tid for the client with hypertension. Which of the following adverse reactions can occur with administration of Capoten?

A. Tinnitus
B. Persistent coughing
C. Muscle weakness
D. Diarrhea

B. Persistent coughing

why?

A persistent cough might be related to an adverse reaction to Captoten.

The doctor orders 2% nitroglycerin ointment on a 1-inch dose over 12 hours. Proper application of nitroglycerin ointment includes:

A. Rotating application sites
B. Limiting applications to the chest
C. Rubbing it into the skin
D. Covering it with a gauze dressing

A. Rotating application sites

why?

Sites for the application of nitroglycerin should be rotated, to prevent skin irritation. It can be applied to the back and upper arms, not to the lower extremities.

Lidocaine is a medication frequently ordered for the client experiencing:

A. Atrial tachycardia
B. Ventricular tachycardia
C. Heart block
D. Ventricular brachycardia

B. Ventricular tachycardia
why?

Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electric stimulation threshold of the ventricle without depressing the force of ventricular contractions.

The client is admitted to the ER with shortness of breath, anxiety, and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. Te doctor orders quinidne sulfate. While he is receiving quinidine, the nurse should monitor his ECG for:

A. Peaked P waves
B. Elevated ST segment
C. Inverted T wave
D. Prolonged QT interval

D. Prolonged QT interval

why?

Quinidine can cause widened Q-T intervals and heart block. Other signs of myocardial toxicity are notched P waves and widened QRS complexes. The most common side effects are diarrhea, nausea, and vomiting. The client might experience tinnitus, veritgo, headache, visual disturbances, and confusion.

The physician has prescibed tranylcypromine sulfate (Parnate) 10 mg bid. The nurse should teach the client to refrain from eating foods containing tyramine because it may cause:

A. Hypertension
B. Hyperthermia
C. Melanoma
D. Urinary retention

A. Hypertension

why?

If the client eats foods high in tyramine, he might experience malignant hypertension. Tyramine is found in cheese, sour cream, Chianti wine, sherry, beer, pickled herring, liver, canned figs, raisins, bananas, avocados, chocolate, soy sauce, fava beans, and yeast. These episodes are treated with Regitine, and alpha-adrenergic blocking agent.

The child with seizure disorder is being treated with Dilantin (phenytoin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?

A. "She is very irritable lately."
B. "She sleeps quite a bit of the time."
C. "Her gums look too big for her teeth."
D. "She has gained about 10 pounds in the last 6 months."

C. "Her gums look too big for her teeth.

A 5 year old is admitted to the unit following a tonsillectomy. Which of the following would indicate a complication of the surgery?

A. Decreased appetite
B. A low-grade fever
C. Chest congestion
D. Constant swallowing

D. Constant swallowing

A 6 year old with cerebral palsy functions at the level of an 18 month old. Which finding would support that assessment?

A. She dresses herself
B. She pulls a toy behind her
C. She can build a tower of eight blocks
D. She can copy a horizontal or vertical line.

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B. She pulls a toy behind her