NCLEX-PN Practice Exam #06 In Text Mode: All questions and answers are given for reading and answering at your own pace.
Question 1. Physician’s orders for a client with acute pancreatitis include the following: strict NPO, NG tube to low intermittent suction. The nurse recognizes that these interventions will:
A). Decrease the client’s need for insulin.
B). Prevent secretion of gastric acid.
C). Eliminate the need for analgesia.
D). Reduce the secretion of pancreatic enzymes.
Question 1 Answer: D). Reduce the secretion of pancreatic enzymes.
Question 1 Explanation: Placing the client on strict NPO status will stop the inflammatory process by reducing the secretion of pancreatic enzymes. The use of low, intermittent suction prevents release of secretion in the duodenum. Decreasing the client’s need for insulin is incorrect because the client requires exogenous insulin. Preventing secretion of gastric acid is incorrect because it does not prevent the secretion of gastric acid. Eliminating the need for analgesia is incorrect because it does not eliminate the need for analgesia.
Question 2. A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
A). Before lunch.
B). After dinner.
C). With breakfast.
D). At bedtime.
Question 2 Answer: C). With breakfast.
Question 2 Explanation: Glucotrol XL is given once a day with breakfast. At bedtime is incorrect because the client would develop hypoglycemia while sleeping. Before lunch and after dinner are incorrect because the client would develop hypoglycemia later in the day or evening.
Question 3. The nurse is teaching the parents of a newborn with osteogenesis imperfecta. The nurse should tell the parents:
A). That the baby will need daily calcium supplements.
B). That only the bones are affected by the disease.
C). To lift the baby by the buttocks when diapering.
D). That the condition is a temporary one.
Question 3 Answer: C). To lift the baby by the buttocks when diapering.
Question 3 Explanation: To prevent fractures, the parents should lift the baby by the buttocks rather than the ankles when diapering. Children with osteogenesis imperfecta have normal calcium and phosphorus levels. The condition is not temporary. The teeth and the sclera are also affected.
Question 4. The mother of a child with cystic fibrosis tells the nurse that her child makes “snoring” sounds when breathing. The nurse is aware that many children with cystic fibrosis have:
A). Choanal atresia.
B). Nasal polyps.
C). Enlarged adenoids.
D). Septal deviations.
Question 4 Answer: B). Nasal polyps.
Question 4 Explanation: Children with cystic fibrosis are susceptible to chronic sinusitis and nasal polyps, which might require surgical removal. Choanal atresia is incorrect because it is a congenital condition in which there is a bony obstruction between the nares and the pharynx.Septal deviations and enlarged adenoids are not specific to the child with cystic fibrosis; therefore, they are incorrect.
Question 5. The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?
A). Coolness and discoloration of the digits.
B). Complaints of pain.
C). Difficulty moving the digits.
D). Temperature of 100°F.
Question 5 Answer: A). Coolness and discoloration of the digits.
Question 5 Explanation: Coolness and discoloration of the reimplanted digits indicates compromised circulation, which should be reported immediately to the physician. The temperature should be monitored, but the client would receive antibiotics to prevent infection. Complaints of pain and difficulty moving the digits are expected following amputation and reimplantation; therefore, they are incorrect.
Question 6. The physician has prescribed Cognex (tacrine) for a client with dementia. The nurse should monitor the client for adverse reactions, which include:
A). Urinary retention.
Question 6 Answer: B). Jaundice.
Question 6 Explanation: An adverse reaction to Cognex is drug-induced hepatitis. The nurse should monitor the client for signs of jaundice. Other answer choices are incorrect because they are not associated with the use of Cognex.
Question 7. The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:
A). The medication schedule can be arranged to allow for drug holidays..
B). The medication is given one time daily every other day..
C). The medication will be needed only during times of rapid growth..
D). The medication will be needed throughout the child’s lifetime..
Question 7 Answer: D). The medication will be needed throughout the child’s lifetime..
Question 7 Explanation: The medication will be needed throughout the child’s lifetime. Other answer questions contain inaccurate statements; therefore, they are incorrect.
Question 8. The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25mL. The nurse should:
A). Divide the amount into two injections and administer in each vastus lateralis muscle.
B). Divide the amount in two injections and give one in the ventrogluteal muscle and one in the vastus lateralis muscle.
C). Give the medication in one injection in the ventrogluteal muscle.
D). Give the medication in one injection in the dorsogluteal muscle.
Question 8 Answer: A). Divide the amount into two injections and administer in each vastus lateralis muscle.
Question 8 Explanation: No more than 1mL should be given in the vastus lateralis of the infant. Other answer choices are incorrect because the dorsogluteal and ventrogluteal muscles are not used for injections in the infant.
Question 9. A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents?
A). Increase her intake of high-calorie foods for healing.
B). Keep the bed flat, with a small pillow beneath the cast.
C). Provide crayons and a coloring book for play activity.
D). Tuck a disposable diaper beneath the cast at the perineal opening.
Question 9 Answer: D). Tuck a disposable diaper beneath the cast at the perineal opening.
Question 9 Explanation: Tucking a disposable diaper at the perineal opening will help prevent soiling of the cast by urine and stool. Keeping the bed flat, with a small pillow beneath the cast is incorrect because the head of the bed should be elevated. Providing crayons and a coloring book for play activity is incorrect because the child can place the crayons beneath the cast, causing pressure areas to develop. Increasing her intake of high-calorie foods for healing is incorrect because the child does not need high-calorie foods that would cause weight gain while she is immobilized by the cast.
Question 10. The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:
A). Didronel (etidronate).
B). Tensilon (edrophonium).
C). Prostigmine (neostigmine).
D). Atropine (atropine sulfate).
Question 10 Answer: C). Prostigmine (neostigmine).
Question 10 Explanation: Protigmine is used to treat clients with myasthenia gravis. Atropine (atropine sulfate) is incorrect because it is used to reverse the effects of neostigmine. Didronel (etidronate) is incorrect because the drug is unrelated to the treatment of myasthenia gravis. Tensilon (edrophonium) is incorrect because it is the test for myasthenia gravis.
Question 11. An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:
A). Skip breakfast but eat a larger lunch and dinner.
B). Drink a glass of orange juice after adding a couple of teaspoons of sugar.
C). Keep crackers at the bedside for eating before she arises.
D). Drink a glass of whole milk before going to sleep at night.
Question 11 Answer: C). Keep crackers at the bedside for eating before she arises.
Question 11 Explanation: Eating a carbohydrate source such as dry crackers or toast before arising helps alleviate symptoms of morning sickness. Drinking a glass of whole milk is incorrect because the additional fat might increase the client’s nausea. The client does not need to skip meals. Drinking a glass of orange juice after adding a couple of teaspoons of sugar is the treatment of hypoglycemia, not morning sickness; therefore, it is incorrect.
Question 12. When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
A). Dark, smoky-colored urine with high specific gravity.
B). Cherry-red urine that gradually becomes clearer.
C). Orange-tinged urine containing particles of calculi.
D). Dark red urine that becomes cloudy in appearance.
Question 12 Answer: B). Cherry-red urine that gradually becomes clearer.
Question 12 Explanation: Following extracorporeal lithotripsy, the urine will appear cherry red in color but will gradually change to clear urine. The urine will be red, not orange. The urine will be not be dark red or cloudy in appearance.Dark, smoky-colored urine with high specific gravity is incorrect because it describes the urinary output of the client with acute glomerulonephritis.
Question 13. The nurse is teaching the mother of a child with cystic fibrosis how to do postural drainage. The nurse should tell the mother to:
A). Use cupped hands during percussion.
B). Change the child’s position every 20 minutes.
C). Use the heel of her hand during percussion.
D). Do percussion after the child eats and at bedtime.
Question 13 Answer: A). Use cupped hands during percussion.
Question 13 Explanation: The nurse or parent should use a cupped hand when performing chest percussion. Using the heel of her hand during percussion is incorrect because the hand should be cupped. The child’s position should be changed every 5–10 minutes and the whole session should be limited to 20 minutes. Percussion should be done before meals.
Question 14. An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?
A). The child should not play on his rocking horse..
B). Applying warm compresses to decrease pain..
C). Diapering should be avoided for 1–2 weeks..
D). The child will need a special diet to promote healing..
Question 14 Answer: A). The child should not play on his rocking horse..
Question 14 Explanation: The child will need to avoid straddle toys, swimming, and rough play until allowed by the surgeon. Other answer choices do not relate to the post-operative care of the child with hypospadias; therefore, they are incorrect.
Question 15. A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
A). Lipitor (atorvastatin).
B). Synthroid (levothyroxine).
C). Premarin (conjugated estrogens).
D). Prilosec (omeprazole).
Question 15 Answer: A). Lipitor (atorvastatin).
Question 15 Explanation: Lipid-lowering agents are contraindicated in the client with active liver disease. Other answer choices are incorrect because they are not contraindicated in the client with active liver disease.
Question 16. The physician has ordered Stadol (butorphanol) for a post-operative client. The nurse knows that the medication is having its intended effect if the client:
A). Is asleep 30 minutes after the injection.
B). Asks for extra servings on his meal tray.
C). States that he is feeling less nauseated.
D). Has an increased urinary output.
Question 16 Answer: A). Is asleep 30 minutes after the injection.
Question 16 Explanation: Stadol reduces the perception of pain, which allows the post-operative client to rest. Relief of pain generally results in less nausea, but it is not the intended effect of the medication.
Question 17. A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
A). 6 weeks.
B). 2 weeks.
C). 4 weeks.
D). 1 week.
Question 17 Answer: C). 4 weeks.
Question 17 Explanation: Depot injections of Haldol are administered every 4 weeks. 1 week and 2 weeks are incorrect because the medication is still in the client’s system. 6 weeks is incorrect because the medication has been eliminated from the client’s system, which allows the symptoms of schizophrenia to return.
Question 18. The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
A). The nurse uses the stethoscope to assess the blood pressure of other assigned clients..
B). The nurse cleans the stethoscope with alcohol and returns it to the exam room..
C). The nurse cleans the stethoscope with water, dries it, and returns it to the nurse’s station..
D). The nurse leaves the stethoscope in the client’s room for future use..
Question 18 Answer: D). The nurse leaves the stethoscope in the client’s room for future use..
Question 18 Explanation: The stethoscope should be left in the client’s room for future use. The stethoscope should not be returned to the exam room or the nurse’s station. The stethoscope should not be used to assess other clients.
Question 19. The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
A). Cogwheel rigidity and loss of coordination.
B). Progressive weakness that is worse at the day’s end.
C). Visual disturbances, including diplopia.
D). Ascending paralysis and loss of motor function.
Question 19 Answer: B). Progressive weakness that is worse at the day’s end.
Question 19 Explanation: The client with myasthenia develops progressive weakness that worsens during the day. Visual disturbances, including diplopia is incorrect because it refers to symptoms of multiple sclerosis. Ascending paralysis and loss of motor function is incorrect because it refers to symptoms of Guillain Barre syndrome. Cogwheel rigidity and loss of coordination is incorrect because it refers to Parkinson’s disease.
Question 20. Which of the following pediatric clients is at greatest risk for latex allergy?
A). The child with a myelomeningocele.
B). The child with epispadias.
C). The child with coxa plana.
D). The child with rheumatic fever.
Question 20 Answer: A). The child with a myelomeningocele.
Question 20 Explanation: The child with myelomenigocele is at greatest risk for the development of latex allergy because of repeated exposure to latex products during surgery and from numerous urinary catheterizations. Other answer choices are much less likely to be exposed to latex; therefore, they are incorrect.
Question 21. A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?
A). High calorie, low carbohydrate, high fat.
B). High calorie, high carbohydrate, low protein.
C). High calorie, high protein, low fat.
D). High calorie, high protein, high fat.
Question 21 Answer: C). High calorie, high protein, low fat.
Question 21 Explanation: The suggested diet for the client with AIDS is one that is high calorie, high protein, and low fat. Clients with AIDS have a reduced tolerance to fat because of the disease as well as side effects from some antiviral medications; therefore, high fat diet are incorrect. The client needs a high-protein diet.
Question 22. The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?
A). Encouraging play with a video game to improve muscle coordination.
B). Patching one of the eyes to strengthen the muscles.
C). Providing musical tapes to provide auditory training.
D). Providing suckers and pinwheels to help strengthen tongue movement.
Question 22 Answer: D). Providing suckers and pinwheels to help strengthen tongue movement.
Question 22 Explanation: The nurse can help ready the child with cerebral palsy for speech therapy by providing activities that help the child develop tongue control. Most children with cerebral palsy have visual and auditory difficulties that require glasses or hearing devices rather than rehabilitative training. Video games are not appropriate for the age or developmental level of the child with cerebral palsy.
Question 23. At the 6-week check-up, the mother asks when she can expect the baby to sleep all night. The nurse should tell the mother that most infants begin to sleep all night by age:
A). 2 months.
B). 1 month.
C). 3–4 months.
D). 5–6 months.
Question 23 Answer: C). 3–4 months.
Question 23 Explanation: Most infants begin nocturnal sleep lasting 9–11 hours by 3–4 months of age. 1 and 2 months are incorrect because the infant is still waking for nighttime feedings. 5–6 months is incorrect because it does not answer the question.
Question 24. A client with diverticulitis is admitted with nausea, vomiting, and dehydration. Which finding suggests a complication of diverticulitis?
A). Low-grade fever.
B). Boardlike abdomen.
C). Abdominal distention.
D). Pain in the left lower quadrant.
Question 24 Answer: B). Boardlike abdomen.
Question 24 Explanation: A rigid or boardlike abdomen is suggestive of peritonitis, which is a complication of diverticulitis. Other answer choices are common findings in diverticulitis; therefore, they are incorrect.
Question 25. The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
A). Pancakes, ham, tomato juice, and coffee.
B). Scrambled eggs, bacon, toast, and coffee.
C). Oatmeal, apple juice, dry toast, and coffee.
D). Cornflakes, whole milk, banana, and coffee.
Question 25 Answer: C). Oatmeal, apple juice, dry toast, and coffee.
Question 25 Explanation: Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure.Cornflakes and whole milk are higher in sodium and are poor sources of fiber. Scrambled eggs, bacon,and ham are incorrect because they contain animal proteins that are high in both cholesterol and sodium.