NCLEX-PN Final Exam

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NCLEX-PN FINAL EXAM 2 0 2 1 / 2 0 2 2VERIFIED SOLUTION1.A 24-year-old female client is scheduled for surgery in the morning. Which of thefollowing is the primary responsibility of the nurse?A.Taking the vital signsB.Obtaining the permitC.Explaining the procedureD.Checking the lab work2.The nurse is working in the emergency room when a client arrives with severe bums ofthe left arm, hands, face, and neck. Which action should receive priority?A.Starting an IVB.Applying oxygenC.Obtaining blood gasesD.Medicating the client for pain3.The nurse is visiting a home health client with osteoporosis. The diem has a newprescription for alendronate (Fosamax). Which instruction should be given to the client?A.Rest in bed after taking the medication for at least 30 minutesB.Avoid rapid movements after taking the medicationC.Take the medication with water onlyD.Allow at least 1 hour between taking the medicine and taking other medications

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4.The nurse is making initial rounds on a client with a C5 fracture and cmtchfield tongs.Which equipment should be kept at the bedside?A.A pair of forcepsB.A torque wrenchC.A pair of wire cuttersD.A screwdriver5.An infant weighs 7 pounds at birth. The expected weight by1year should be:A.10poundsB.12poundsC.18 poundsD.21 pounds6.A client is admitted with a Ewing's sarcoma. Which symptoms would be expected due tothis tumor's location'5A.HemiplegiaB.AphasiaC.NauseaD.Bone pain7.The nurse is caring for a client with epilepsy who is being treated with carbamazepine(Tegretol). Which laboratory value might indicate a serious side effect of this drug?A.Uric acid of 5mg/dL

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B.Hematocrit of 33%C.WBC 2,000 per cubic millimeterD.Platelets 150,000 per cubic millimeter8.A 6-month-old client is admitted with possible intussuception. Which question during thenursing history is least helpful in obtaining information regarding this diagnosis?A."Tell me about his pain.1'B."What does his vomit look like?’1C.''Describe his usual diet."D."Have you noticed changes in his abdominal size?"9.The nurse is assisting a client with diverticulosis to select appropriate foods. Which foodshould be avoided?A.BranB.Fresh peachesC.Cucumber saladD.Yeast rolls10.A client has rectal cancer and is scheduled for an abdominal perineal resection. Whatshould be the priority nursing care during the post-op period?A.Teaching howrto irrigate the illeostomyB.Stopping electrolyte loss in the incisional areaC.Encouraging a high-fiber dietD.Facilitating perineal wound drainage

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11.The nurse is performing discharge teaching on a client with diverticulitis who has beenplaced on a low-roughage diet. Which food would have to be eliminated from this client's diet?A.Roasted chickenB.NoodlesC.Cooked broccoliD.Custard12.A client arrives in the emergency room with a possible fractured femur. The nurse shouldanticipate an order for:A.Trendelenburg positionB.Ice to the entire extremityC.Buck's tractionD.An abduction pillow13.A client with cancer is to undergo an intravenous pyelogram. The nurse should:A.Force fluids 24 hours before the procedureB.Ask the client to void immediately before the studyC.Hold medication that affects the central nervous system for 12 hours pre- and post-testD.Cover the client's reproductive organs with an x-ray shield14.The nurse is caring for a client ’with a malignancy. The classification of the primary7tumor is Tis. The nurse should plan care for a tumor:A.That cannot be assessedB.That is in situ

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C.With increasing lymph node involvementD.Withdistantmetastasis15.A chent is 2 days post-operative coion resection. After a coughing episode, the client'swound eviscerates. Which nursing action is most appropriate?A.Reinsert the protruding organ and cover with 4*4sB.Cover the wound with a sterile 4x4 and ABD dressingC.Cover the wound with a sterile saline-soaked dressingD.Applyan abdominal binder and manual pressure to the wound16.The nurse is preparing a client for surgery. Which item is most important to removebefore sending the dient to surgery7?A.Hearing aidB.Contact lensesC.Wedding ringD.Artificial eye17.The nurse on the 3-11 shift is assessing the chart of a client with an abdominal aneurysmscheduled for surgery7in the morning and finds that the consent form has been signed, but theclient is unclear about the surgery7and possible complications. Which is the most appropriateaction?A.Call the surgeon and ask him or her to see the chent to clarify the informationB.Explain the procedure and complications to the clientC.Check in the physician's progress notes to see if understanding has been documentedD.Check with the client's family to see if they understand the procedure fully

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18.The client with diabetes is preparing for discharge. During discharge teaching, the nurseassesses the clients ability to care for himself Which statement made by the client wouldindicate a need for follow-up after discharge?A."I live bymyself."B.”1 have trouble seeing.,rC."I have a cat in the house with me.D."I usually drive myself to the doctor.1119.The client is receiving total parenteral nutrition (TPN). Which lab test should beevaluated while the client is receiving TPN?A.HemoglobinB.CreatinineC.Blood glucoseD.White blood cell count20.The client with a myocardial infarction comes to the nurse's station stating that he isready to go home because there is nothing wrong with him. Which defense mechanism is theclient using?A.RationalizationB.DenialC.ProjectionD.Conversion reaction

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21.Which laboratory test would be the least effective in making the diagnosis of amyocar dial infarction?A.ASTB.TroponinC.CK-MBD.Myoglobin22.The licensed practical nurse assigned to the post-partal unit is preparing to administerRhogam to a postpartum client. Which woman is not a candidate for RhoGam?A.A gravida IV para 3 that is Rh negative with an Rh-positive babyB.A gravida I para 1 that is Rh negative with an Rh-positive babyC.A gravida II para 0 that is Rh negative admitted after a stillbirth deliveryD.A gravida IV para 2 that is Rh negative with an Rh-negative baby23.The first exercise that should be performed by the client who had a mastectomy is:A.Walking the hand up the wallB.Sweeping the floorC.Combing her hairD.Squeezing a ball24.The client is scheduled for a Tensilon test to check for Myasthenia Gravis. Whichmedication should be kept available during the test?

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A.Atropine sulfateB.FurosemideC.ProstigminD.Promethazine25.The client is scheduled for a pericentesis. Which instruction should be given to the clientbefore the exam?A."You will need to lay flat during the exam.1'B."You need to empty your bladder before the procedure."C."You will be asleep during the procedure."D."The doctor will inject a medication to treat your illness during the procedure."26.To ensure safety while administering a nitroglycerine patch, the nurse should:A.Wear glovesB.Shave the area where the patch will be appliedC.Wash the area thoroughly with soap and rinse with hot waterD.Apply the patch to the buttocks27.The physician has prescribed ttanylcypromine sulfate (Parnate) lOmg bid. The nurseshould teach the client to refrain from eating foods containing tyramine because it may cause:A.HypertensionB.HyperthermiaC.MelanomaD.Urinary retention

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28.The child with seizure disorder is being treated with Dilantin (phenytoin). Which of thefollowing statements by the patient's mother indicates to the nurse that the patient isexperiencing 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.'129.A 3-year-old is admitted to the unit following a tonsillectomy. Which of the followingwould indicate a complication of the surgery?A.Decreased appetiteB.A low-grade feverC.Chest congestionD.Constant swallowing30.A 6-year-old with cerebral palsy functions at the level of an 18-month- old. Whichfinding 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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31.WTiich information obtained from the mother of a child with cerebral palsy most Likelycorrelates to the diagnosis?A.She was bom at 42 weeks gestation.B.She had meningitis when she was 6 months old.C.She had physiologic jaundice after delivery7.D.She has frequent sore throats.32.A 10-year-old is being treated for asthma. Before administering Theodur, the nurseshould check the:A.Urman7outputB.Blood pressureC.PulseD.Temperature33.An elderly client is diagnosed with ovarian cancer. She has surgery followed bychemotherapy7with a fluorouracil (Adrucil) IV. What should the nurse do if she notices crystalsand cloudiness in the IV medication?A.Discard the solution and order a new bagB.Warm the solutionC.Continue the infusion and document the findingD.Discontinue the medication34.The client is diagnosed with multiple myoloma. The doctor has orderedcyclophosphamide (Cytoxan). Which instruction should be given to the client?

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A."Walk about a mile a day to prevent calcium loss."B."Increase the fiber in your diet."C."Report nausea to the doctor immediately."D.“'Drink at least eight large glasses of water a day."35.The client is taking rifampin 600mg po daily to treat his tuberculosis. Which action bythe nurse indicates understanding of the medication?A.Telling the client that the medication will need to be taken with juiceB.Telling the client that the medication will change the color of the urineC.Telling the client to take the medication before going to bed at nightD.Telling the dient to take the medication if night sweats occur36.The client is taking prednisone 7.5mg po each morning to treat his systemic lupuserrythymatosis. Which statement best explains die reason for taking die prednisone in themorning?A.There is less chance of forgetting the medication if taken in the morning.B.There will be less fluid retention if taken in the morning.C.Prednisone is absorbed best with the breakfast meal.D.Morning administration mimics the body's natural secretion of coiticosteroid.37.A 20-year-old female has a prescription for tetracycline. While teaching, the client how totake her medicine, the nurse learns that the client is also taking Ortho-Novum oral contraceptivepills. Which instructions should be included in the teaching plan?A.The oral contraceptives will decrease the effectiveness of the tetracycline.

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B.Nausea often results from taking oral contraceptives and antibiotics.C.Toxicity can result when taking these two medications together.D.Antibiotics can decrease the effectiveness of oral conuaceptives, so the client should usean alternate method of birth control.38.A 60-year-old diabetic is taking glyburide (Diabeta) 1.25mg daily to treat Type IIdiabetes mellitus. Which statement indicates the need for further teaching?A."I will keep candy with me just in case my blood sugar drops."B."I need to stay out of the sun as much as possible."C."I often skip dinner because I don't feel hungry.1’D."I always wear my medical identification.1,39.The physician prescribes regular insulin, 5 units subcutaneous. Regular insulin begins toexert an effect:A.In 5-10 minutesB.In 10- 20 minutesC.In 30- 60 minutesD.In 60- 120 minutes40.Vitamin K (aquamephyton) is administered to a newborn shortly after birth for which ofthe following reasons?A.To prevent dehydrationB.To treat infectionC.To replace electrolytesD.To facilitate clotting

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41.The client with an ileostomy is being discharged. Which teaching, should be included inthe plan of care?A.Use Karaya powder to seal the bag.B.Irrigate the ileostomy daily.C.Stomahesive is the best skin protector.D.Neosporin ointment can be used to protect the skin.42.The client has an order for FeSo4 liquid. Which method of administration would be best?A.Administer the medication with milkB.Administer the medication with a mealC.Administer the medication with orange juiceD.Administer the medication undiluted43.The client anives in the emergency room with a hyphema. Which action by the nursewould be bestDA.Elevate the head of the bed and apply ice to the eyeB.Place the diem in a supine position and apply heat to the kneeC.Insert a Foley catheter and measure the intake and outputD.Perform a vaginal exam and check for a discharge44.The nurse is making assignments for the day. Which client should be assigned to thenursing assistant?

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A.The 1Eryear-old with a fracture to two cervical vertebraeB.The infant with meningitisC.The elderly client with a thyroidectomy 4 days agoD.The client with a thoracotomy 2 days ago45.The client arrives in the emergency room with a ’’bull's eye" rash. Which question wouldbe most appropriate for the nurse to ask the client?A"Have you found any ticks on your body?"B."Have you had any nausea in the last 24 hours?"C."Have you been outside the country in the last 6 months?"D."Have you had any fever for the past few days?"46.Which of the following is the best indicator of the diagnosis of HIV?A.White blood cell countB.ELISAC.Western BlotD.Complete blood count47.The nurse is evaluating nutritional outcomes for an elderly client with anorexia. Whichdata best indicates that the plan of care is effective?A.The client selects a balanced diet from the menu.B.The client's hematocrit improves.C.The client's tissue turgor improves.D.The client gains weight.

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48.The client is admitted following repair of a fractured femur with cast application. Whichnursing assessment should be reported to the doctor?A.PainB.Warm toesC.Pedal pulses rapidD.Paresthesia of the toes49.Which would be an expected finding during injection of dye with a cardiaccatheterization?A.Cold extremity distant to the injection siteB.Warmth in the extremityC.Extreme chest painD.Itching in the extremities50.Which action by the healthcare worker indicates a need for further teaching?A.The nursing assistant wears gloves while giving the client a bath.B.The nurse wears goggles while drawing blood from the client.C.The doctor wrashes his hands before examining the client.D.The nurse wears gloves to take the client's vital signs.51.The client is having electroconvulsive therapy for treatment of severe depression. Whichof the following,indicates that the client's ECT has been effective?

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A.The diem Loses consdousness.B.The client vomits.C.The client's ECG indicates tachycardia.D.The client has a grand mal seizure.52.A 5-year-old is being tested for pinworms. To collect a specimen for assessment ofpinworms, the nurse should teach the mother to:A.Examine the perianal area with a flashlight 2-3 hours after the child is asleep and tocollect any eggs on a clear tapeB.Scrape the skin with a piece of cardboard and bring it to the clinicC.Obtain a stool specimen in the afternoonD.Bring a hair sample to the dime for evaluation53.Which instruction should be given regarding, the medication used to treat enterobiasis(pinworms)?A.Treatment is not recommended for children less chan 10 years of age.B.The entire family should be treated.C.Medication therapy will continue for 1 year.D.Intravenous antibiotic therapy will be ordered.54.Which client should be assigned to the pregnant licensed practical nurseA.The client who just returned after receiving linear accelerator radiation therapy for lungcancerB.The client with a radium implant for cervical cancer

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C.The client who has just been administered soluble brachytherapy for thyroid cancerD.The client who has returned from placement of iridium seeds for prostate cancer55.Which client should be assigned to a private room if only one is available?A.The client with Cushing's syndromeB.The client with diabetesC.The client with acromegalyD.The client with myxedema56.The nurse caring for a client on the pediatric unit administers adult- strength Digitalis tothe 3-pound infant. As a result of her actions, the baby suffers permanent heart and braindamage. The nurse can be charged with:A.NegligenceB.TortC.AssaultD.Malpractice57.Which assignment should not be performed by the licensed practical nurse?A.Inserting a Foley catheterB.Discontinuing a nasogastric tubeC.Obtaining a sputum specimenD.Initiating a blood transfusion

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58.A client in the family planning clinic asks the muse about the most likely time for her toconceive. The nurse explains that conception is most likely to occur when:A.Estrogen levels are low.B.Lutenizing hormone is high.C.The endometrial lining is thin.D.The progesterone level is low.59.A client tells the nurse chat she plans to use the rhythm method of birth control. The nurseis aware that the success of the rhythm method depends on the:A.Age of the clientB.Frequency of intercourseC.Regularity of the mensesD.Range of the client's temperature50.A client with diabetes asks the nurse for advice regarding methods of birth control.Which method of birth control is most suitable for the client with diabetes?A.Intrauterine deviceB.Oral contraceptivesC.DiaphragmD.Contraceptive sponge61.The doctor suspects that the client has an ectopic pregnancy. Which symptom isconsistent with a ±agnosis of ectopic pregnancy?A.Painless vaginal bleeding

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B.Abdominal crampingC.Throbbing pain in the upper quadrantD.Sudden, stabbing pain in the lower quadrant62.The nurse is teaching a pregnant client about nutritional needs during pregnancy. Whichmenu selection will best meet the nutritional needs of the pregnant client?A.Hamburger pattie, green beans, French fries, and iced teaB.Roast beef sandwich, potato chips, baked beans, and colaC.Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced teaD.Fish sandwich, gelatin with fruit, and coffee63.The client with hyperemesis gravidarum is at risk for developing:A.Respiratory alkalosis without dehydrationB.Metabolic acidosis with dehydrationC.Respiratory acidosis without dehydrationD.Metabolic alkalosis with dehydration64.A client with a fractured hip has been placed in traction. WTiicti statement is trueregarding balanced skeletal traction? Balanced skeletal traction:A.Utilizes a pin through bonesB.Requires that both legs be securedC.Utilizes Kirschner wiresD.Is used primarily to heal the fractured hips

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