NCLEX-PN Practice Exam #07 In Text Mode: All questions and answers are given for reading and answering at your own pace.
Question 1. The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care, the nurse should:
A). Administer the medication 30 minutes before meals.
B). Maintain strict intake and output.
C). Check the pulse before giving the medication.
D). Provide oral hygiene and gum care every shift.
Question 1 Answer: D). Provide oral hygiene and gum care every shift.
Question 1 Explanation: Gingival hyperplasia is a side effect of Dilantin; therefore, the nurse should provide oral hygiene and gum care every shift. Other answer choices do not apply to the medication; therefore, they are incorrect.
Question 2. A pediatric client with burns to the hands and arms has dressing changes with Sulfamylon (mafenide acetate) cream. The nurse is aware that the medication:
A). Will cause dark staining of the surrounding skin.
B). Can alter the function of the thyroid.
C). Produces a cooling sensation when applied.
D). Produces a burning sensation when applied.
Question 2 Answer: D). Produces a burning sensation when applied.
Question 2 Explanation: The client should receive pain medication 30 minutes before the application of Sulfamylon. Staining of the surrounding skin refers to silver nitrate. Produces a cooling sensation when applied refers to Silvadene. Can alter the function of the thyroid it refers to Betadine.
Question 3. The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true regarding collection of cultures for cytomegalovirus?
A). Collection of one specimen is sufficient..
B). Pregnant caregivers may obtain cultures.
C). Accurate diagnosis depends on fresh specimens..
D). Stool cultures are preferred for definitive diagnosis..
Question 3 Answer: C). Accurate diagnosis depends on fresh specimens..
Question 3 Explanation: Fresh specimens are essential for accurate diagnosis of CMV.Urine, sputum, and oral swab are preferred. Pregnant caregivers should not be assigned to care for clients with suspected or known infection with CMV. A convalescent culture is obtained 2–4 weeks after diagnosis.
Question 4. The LPN is reviewing the lab results of an elderly client when she notes a specific gravity of 1.006 . The nurse recognizes that:
A). The client has a normal specific gravity..
B). The client has diluted urine from fluid overload..
C). The client has impaired renal function..
D). The client has mild to moderate dehydration..
Question 4 Answer: A). The client has a normal specific gravity..
Question 4 Explanation: The normal specific gravity is 1.005-1.030.
Question 5. A client with pancreatitis has requested pain medication. Which pain medication is indicated for the client with pancreatitis?
A). Codeine (codeine).
B). Demerol (meperidine).
C). Morphine (morphine sulfate).
D). Toradol (ketorolac).
Question 5 Answer: B). Demerol (meperidine).
Question 5 Explanation: To prevent spasms of the sphincter of Oddi, the client with pancreatitis should receive nonopiate analgesics for pain. The client with pancreatitis might be prone to bleed; therefore, Toradol is not a drug of choice for pain control. Morphine and codeine, opiate analgesics, are contraindicated for the client with pancreatitis.
Question 6. The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
A). Pull the ear straight out.
B). Pull the ear up and back.
C). Leave the ear undisturbed.
D). Pull the ear down and back.
Question 6 Answer: D). Pull the ear down and back.
Question 6 Explanation: When administering ear drops to a child under 3 years of age, the nurse should pull the ear down and back to straighten the ear canal. Pullig the ear straight out and leaving the ear undisturbed are incorrect positions for administering ear drops.Pulling the ear up and back is used for administering ear drops to an adult client.
Question 7. The physician has ordered a blood test for H. pylori . The nurse should prepare the client by:
A). Explaining that a small dose of radioactive isotope will be used.
B). Telling the client that no special preparation is needed.
C). Giving an oral suspension of glucose 1 hour before the test.
D). Withholding intake after midnight.
Question 7 Answer: B). Telling the client that no special preparation is needed.
Question 7 Explanation: No special preparation is needed for the blood test for H. pylori. Withholding intake after midnight is incorrect because the client is not NPO before the test. Explaining that a small dose of radioactive isotope will be used is incorrect because it refers to preparation for the breath test. Giving an oral suspension of glucose 1 hour before the test is incorrect because glucose is not administered before the test.
Question 8. A client with a hiatal hernia has been taking magnesium hydroxide for relief of heartburn. Overuse of magnesium-based antacids can cause the client to have:
B). Weight gain.
Question 8 Answer: A). Diarrhea.
Question 8 Explanation: Overuse of magnesium-containing antacids results in diarrhea. Antacids containing calcium and aluminum cause constipation. Weight gain and anorexia are not associated with the use of magnesium antacids; therefore, they are incorrect.
Question 9. A newborn has been diagnosed with exstrophy of the bladder. The nurse should position the newborn:
B). With the head elevated.
D). On either side.
Question 9 Answer: D). On either side.
Question 9 Explanation: Placing the newborn in a side-lying position helps the urine to drain from the exposed bladder. Prone is incorrect because it would position the child on the exposed bladder. Supine and head elevated are incorrect because they would allow the urine to pool.
Question 10. A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:
A). Water only.
B). Orange juice.
C). Apple juice.
Question 10 Answer: B). Orange juice.
Question 10 Explanation: Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent source of ascorbic acid. The medication should be taken with orange juice or tomato juice. Iron should not be taken with milk because it interferes with absorption. Apple juice does not contain high amounts of ascorbic acid.
Question 11. The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:
Question 11 Answer: A). Tinnitus.
Question 11 Explanation: Tinnitus is a sign of aspirin toxicity. Other answer choices are not related to aspirin toxicity; therefore, they are incorrect.
Question 12. A client who was admitted with chest pain and shortness of breath has a standing order for oxygen via mask. Standing orders for oxygen mean that the nurse can apply oxygen at:
A). 10L per minute.
B). 12L per minute.
C). 6L per minute.
D). 2L per minute.
Question 12 Answer: C). 6L per minute.
Question 12 Explanation: With standing orders, the nurse can administer oxygen at 6L per minute via mask. 2L per minute is incorrect because the amount is too low to help the client with chest pain and shortness of breath. 10 L per minute and 12 L per minute have oxygen levels requiring a doctor’s order.
Question 13. The physician has ordered aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is:
Question 13 Answer: D). Tinnitus.
Question 13 Explanation: Tinnitus is a sign of aspirin toxicity. Other answer choices are not related to aspirin toxicity; therefore, they are incorrect.
Question 14. Before administering a nasogastric feeding to a client hospitalized following a CVA, the nurse aspirates 40mL of residual. The nurse should:
A). Replace the aspirate and withhold the feeding.
B). Discard the aspirate and begin the feeding.
C). Replace the aspirate and administer the feeding.
D). Discard the aspirate and withhold the feeding.
Question 14 Answer: C). Replace the aspirate and administer the feeding.
Question 14 Explanation: The nurse should replace the aspirate and administer the feeding because the amount aspirated was less than 50mL. The aspirate should not be discarded. The feeding should not be withheld.
Question 15. A client is admitted with burns of the right arm, chest, and head. According to the Rule of Nines, the percent of burn injury is:
Question 15 Answer: C). 27%.
Question 15 Explanation: Burn injury of the arm (9%), chest (9%), and head (9%) accounts for burns covering 27% of the total body surface area.
Question 16. The nurse is caring for a client with an ileostomy. The nurse should pay careful attention to care around the stoma because:
A). Stools are less watery and contain more solid matter..
B). It is difficult to fit the appliance to the stoma site..
C). Digestive enzymes cause skin breakdown..
D). The stoma will heal more slowly than expected..
Question 16 Answer: C). Digestive enzymes cause skin breakdown..
Question 16 Explanation: Stool from the ileostomy contains digestive enzymes that can cause severe skin breakdown.
Question 17. A child is hospitalized with a fractured femur involving the epiphysis. Epiphyseal fractures are serious because:
A). Callus formation prevents bone healing..
B). Bone marrow is lost through the fracture site..
C). Normal bone growth is affected..
D). Blood supply to the bone is obliterated..
Question 17 Answer: C). Normal bone growth is affected..
Question 17 Explanation: Growth plates located in the epiphysis can be damaged by epiphyseal fractures. Other answer choices are untrue statements; therefore, they are incorrect.
Question 18. The physician has ordered a low-potassium diet for a child with acute glomerulonephritis. Which snack is suitable for the child with potassium restrictions?
Question 18 Answer: A). Apricots.
Question 18 Explanation: Apricots are low in potassium; therefore, it is a suitable snack of the client on a potassium-restricted diet. Raisins, oranges, and bananas are all good sources of potassium; therefore, are incorrect.
Question 19. The mother of a 3-month-old with esophageal reflux asks the nurse what she can do to lessen the baby’s reflux. The nurse should tell the mother to:
A). Burp the baby after the feeding is completed.
B). Place the baby supine with head elevated.
C). Burp the baby frequently throughout the feeding.
D). Feed the baby only when he is hungry.
Question 19 Answer: C). Burp the baby frequently throughout the feeding.
Question 19 Explanation: Burping the baby frequently throughout the feeding will help prevent gastric distention that contributes to esophageal reflux. Feeding the baby only when he is hungry and burping the baby after the feeding is completed are incorrect because they allow air to collect in the baby’s stomach, which contributes to reflux. Placing the baby supine with head elevated is incorrect because the baby should be placed side-lying with the head elevated, to prevent aspiration.
Question 20. The nurse is providing dietary teaching for a client with gout. Which dietary selection is suitable for the client with gout?
A). Steak, baked potato, tossed salad.
B). Stuffed crab, steamed rice, peas.
C). Broiled liver, macaroni and cheese, spinach.
D). Baked chicken, pasta salad, asparagus casserole.
Question 20 Answer: A). Steak, baked potato, tossed salad.
Question 20 Explanation: Steak, baked potato, and tossed salad are lower in purine than the other choices. Liver, crab, and chicken are high in purine.
Question 21. The nurse is preparing to give an oral potassium supplement. The nurse should:
A). Give the medication without diluting it.
B). Give the medication on an empty stomach.
C). Give the medication with 4oz. of juice.
D). Give the medication with water only.
Question 21 Answer: C). Give the medication with 4oz. of juice.
Question 21 Explanation: Oral potassium supplements should be given in at least 4oz. of juice or other liquid, to prevent gastric upset and to disguise the unpleasant taste. Other answer choices are incorrect because they cause gastric upset.
Question 22. A client with schizophrenia has been taking Thorazine (chlorpromazine) 200mg four times a day. Which finding should be reported to the doctor immediately?
A). The client naps throughout the day.
B). The client complains of a sore throat.
C). The client complains of thirst.
D). The client has gained 4 pounds in the past 2 months.
Question 22 Answer: B). The client complains of a sore throat.
Question 22 Explanation: The nurse should carefully monitor the client taking Thorazine for signs of infection that can quickly become overwhelming. Other answer choices are incorrect because they are expected side effects of the medication.
Question 23. A client receiving chemotherapy for breast cancer has an order for Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of the chemotherapy. The purpose of the medication is to:
A). Prevent anemia.
B). Increase neutrophil counts.
C). Promote relaxation.
D). Prevent nausea.
Question 23 Answer: D). Prevent nausea.
Question 23 Explanation: Zofran is given before chemotherapy to prevent nausea. Other answer choices are not associated with the medication; therefore, they are incorrect.
Question 24. When performing a newborn assessment, the nurse measures the circumference of the neonate’s head and chest. Which assessment finding is expected in the normal newborn?
A). The head and chest circumference are the same..
B). The head is 3cm smaller than the chest..
C). The head is 4cm larger than the chest..
D). The head is 2cm larger than the chest..
Question 24 Answer: D). The head is 2cm larger than the chest..
Question 24 Explanation: The head circumference of the normal newborn is approximately 33cm, while the chest circumference is 31cm. The head and chest are not the same circumference. The head is larger in circumference than the chest. The difference in head circumference and chest circumference is too great.
Question 25. A client has an order for Dilantin (phenytoin) .2g orally twice a day. The medication is available in 100mg capsules. For the morning medication, the nurse should administer:
A). 2 capsules.
B). 4 capsules.
C). 1 capsule.
D). 3 capsules.
Question 25 Answer: A). 2 capsules.
Question 25 Explanation: The nurse should administer two capsules. Other answer choices contain inaccurate amounts; therefore, they are incorrect.