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Saturday, 11 July 2015

ANSWERS AND RATIONALES PRACTICE QUESTIONS PART =5


NCLEX PRACTICE QUESTIONS PART - 05 ANSWERS AND RATIONALES... 


             





       [Q.NO.151-250 ]



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151.  Answer A  is  correct.  Following  a  total  mastectomy,  the  client’s  right  arm should  be  elevated  on  pillows  to  facilitate  lymph  drainage.  Answers  B,  C, and  D are  incorrect  because  they  would  not  help  facilitate  lymph  drainage and would create increased edema in the affected extremity.  





152.  Answer  B  is  correct.  Nitroglycerin  is  used  to  dilate  coronary  blood  vessels, which  pro-vides  improved  circulation  to  the  myocardium.  Answers  A,  C,  and  D describe the effects of digoxin, not nitroglycerin; therefore, they are incorrect.  






153.  Answer  D  is  correct. 

The  client  with  flail  chest  will  exhibit  paradoxical  respirations. (With  inspiration,  the  affected  side  will  move  inward;  with  expiration,  the  affected  side will  move  outward.  Flail  chest  is  frequently  associated  with  high-speed  motor  vehicle accidents.)  Answer  A  is  incorrect  because  air or  blood  would  be  present  in  the  tho-racic cavity.  Answer  B  is  incorrect  because  the  trachea  would  be  shifted  to  the  affected  side. Answer C is incorrect because interstitial edema would be present.  





154.  Answer  D  is  correct.  Absence  seizures,  formerly  known  as  petit  mal  seizures, are  characterized  by  brief  lapses  in  consciousness  accompanied  by  rapid  eye blinking,  lip  smacking,  and  minor  myoclonus  of  the  upper  extremities.  Answer  A refers  to  myoclonic  seizure;  therefore,  it  is  incorrect.  Answer  B  refers  to  tonic clonic,  formerly  known  as  grand  mal  seizures;  therefore,  it  is  incorrect.  Answer  C refers to atonic seizures; therefore, it is incorrect.  






155.  Answer  C  is  correct.  Keeping  the  room quiet  and  the  lights  dimmed  will decrease  sensory  stimulation  and  help  keep  the  client  oriented  during  withdrawal from alcohol.  Answer  A  is  incorrect  because  darkness  would  increase  confusion and  disoriention  in  the  client  during  withdrawal.  Answers  B  and  D  are  incorrect because they can con-tribute to the development of seizures.  






156.  Answer  A is  correct.  

A  side  effect  of  antipsychotic  medication  is  the  development  of Parkinsonian  symptoms.  Answers  B  and  C  are  incorrect  choices  because  they  are used  to  reverse  Parkinsonian  symptoms  in  the  client  taking  antipsychotic  medication. Answer  D  is  incorrect  because  the  medication  is  an  anticonvulsant  used  to  stabilize mood. Parkinsonian symptoms are not associated with anticonvulsant medication.  





157.  Answer  B  is  correct.  Exercises,  such  as  swimming,  that  provide  light  passive resist-ance  are  best  for  the  child  with  juvenile  rheumatoid  arthritis.  Answers  A  and C require  movement  of  the  hands  and  fingers  that  could  be  too  painful  for  the child  with  juvenile  rheumatoid  arthritis;  therefore,  they  are  incorrect.  Answer  D  is incorrect because it requires the use of larger joints affected by the disease.  






158.  Answer A  is  correct.  Reports  of  cough  and  fever in  the  client  with  AIDS suggest  infection  with  pneumocystis  carinii,  which  requires  immediate intervention.  Answers  B,  C,  and  D have  conditions  with  more  predictable outcomes;  therefore,  they  are  incor-rect. 





159.  Answer  B  is  correct.  

The  client’s  diabetes  is  well  under  control.  Answer  A  is  incorrect because  it  will  lead  to  elevated  glucose  levels.  Answer  C  is  incorrect  because  the  diet and  insulin  dose  are  appropriate  for  the  client.  Answer  D  is  incorrect  because  the desired range for glycosylated hemoglobin in the adult client is 2.5%–5.9%. 




 160.  Answer  C  is  correct.  

The  purpose  of  the  dexamethasone-suppression  test  is  to identi-fy  clients  who  will  benefit  from therapy  with  antidepressants  and electroconvulsive  therapy  rather  than  psychological  or  social  interventions. Answers A, B, and D contain inaccurate statements; therefore, they are incorrect.  




161.  Answer  A is  correct.  

Stadol  reduces  the  perception  of  pain,  which  allows  the post-operative  client  to  rest.  Answers  B  and  C  are  not  affected  by  the  medication; therefore,  they  are  incorrect.  Relief  of  pain  generally  results  in  less  nausea,  but  it is not the intended effect of the medication; therefore, answer D is incorrect.  




162.  Answer B  is  correct.  Children  with  cystic  fibrosis  are  susceptible  to  chronic sinusitis  and  nasal  polyps,  which  might  require  surgical  removal.  Answer A  is incorrect  because  it  is  a  congenital  condition  in  which  there  is  a  bony obstruction  between  the  nares  and  the  pharynx.  Answers  C and  D are  not specific to the child with cystic fibro-sis; therefore, they are incorrect.  






163.  Answer C is  correct.  

During  the  emergent  phase,  the  nursing  priority  for a client  with  burns  confined  to  the  lower body  would  focus  on  the  risk  for fluid volume  deficit.  Answers  A  and  B  are  incorrect  because  there  is  no  indication that  the  airway  is  involved.  Answer D is  incorrect  because  pain  does  not  take priority over the manage-ment of hypovolemia.  




164.  Answer  D  is  correct.  

Lipid-lowering  agents  are  contraindicated  in  the  client with  active  liver  disease.  Answers  A,  B,  and  C  are  incorrect  because  they are not con-traindicated in the client with active liver disease.  




165.  Answer D is  correct.  

An  appropriate  activity  for  the  client  who  has  recently had  an  MI  is  sitting  on  the  side  of  the  bed  for  5  minutes  three  times  a  day with  assistance.  Answers  A  and  C are  incorrect  because  they  increase  the workload  on  the  heart  too  soon  after  the  MI.  Answer B  is  incorrect  because  it does not allow the client enough activity.  




166.  Answer  C  is  correct.  

The  client  with  hypertension  should  be  placed  on  a  low  sodium, low  cholesterol,  high  fiber  diet.  Oatmeal  is  low  in  sodium  and  high  in  fiber.  Answer  A  is incorrect  because  cornflakes  and  whole  milk  are  higher  in  sodium  and  are  poor sources  of  fiber.  Answers  B  and  D  are  incorrect  choices  because  they  contain  animal proteins that are high in both cholesterol and sodium.  






167.  Answer  A  is  correct.  Following  hypospadias  repair,  the  child  will  need  to avoid  strad-dle  toys,  such  as  a  rocking  horse,  until  allowed  by  the  surgeon. Answers  B,  C,  and  D  do  not  relate  to  the  post-operative  care  of  the  child with hypospadias; therefore, they are incorrect.  







168.  Answer A  is  correct.  

Eating  carbohydrates  such  as  dry  crackers  or toast before  aris-ing  helps  to  alleviate  morning  sickness.  Answer B  is  incorrect because  the  additional  fat  might  increase  the  client’s  nausea.  Answer C is incorrect  because  the  client  does  not  need  to  skip  meals.  Answer D is  the treatment  of  hypoglycemia,  not  morning  sick-ness;  therefore,  it  is  incorrect.  






169.  Answer D is  correct.  

An  esophageal  tamponade  is  used  to  control  bleeding in  the  client  with  esophageal  varices.  Answers  A,  B,  and  C  are  incorrect because  they  can  be  assigned  to  either the  novice  RN or the  LPN with assisted care by the nursing assis-tant.  






170.  Answer B is  correct.  

The  modified  Blalock  Taussig  procedure  is  a  palliative procedure  in  which  the  subclavian  artery  is  joined  to  the  pulmonary  artery, thus  allowing  more  blood  to  reach  the  lungs.  Answers  A,  C,  and  D  contain inaccurate statements; there-fore, they are incorrect. 





 171.  Answer A  is  correct.  

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;  therefore,  answers  B  and  D are  incorrect.  The  stethoscope should not be used to assess other clients; therefore, answer C is incorrect.  





172.  Answer  B  is  correct.  

The  medication  will  be  needed  throughout  the  child’s  lifetime. Answers A, C, and D contain inaccurate statements; therefore, they are incorrect.  





173.  Answer B is  correct.  Glucotrol  XL  is  given  once  a  day  with  breakfast. Answer A  is  incorrect  because  the  client  would  develop  hypoglycemia while  sleeping.  Answers  C and  D are  incorrect  choices  because  the  client would develop hypoglycemia later in the day or evening.  






174.  Answer  D  is  correct.  

The  client  with  myasthenia  develops  progressive  weakness  that worsens  during  the  day.  Answer  A  is  incorrect  because  it  refers  to  symptoms  of  multiple  sclerosis.  Answer  B  is  incorrect  because  it  refers  to  symptoms  of  Guillain  Barre syndrome. Answer C is incorrect because it refers to Parkinson’s disease.  





175.  Answer D is  correct.  Immaturity  of  the  kidneys  places  the  preterm  infant  at greater  risk  for  toxicity  to  aminoglycosides.  Answers  A,  B,  and  C are  true regarding  the  preterm  infant,  but  they  do  not  increase  the  risk  for toxicity  to the drug; therefore, they are incorrect.  






176.  Answer  B  is  correct.  

To  prevent  fractures,  the  parents  should  lift  the  infant  by the  buttocks  rather  than  the  ankles  when  diapering.  Answer  A  is  incorrect because  infants  with  osteogenesis  imperfecta  have  normal  calcium and phosphorus  levels.  Answer  C  is  incorrect  because  the  condition  is  not  temporary. Answer D is incorrect because the teeth and the sclera are also affected. 






 177.  Answer C is  correct.  Following  a  hip  replacement,  the  client  should  avoid hip  flexion.  Sitting  on  a  soft,  low  sofa  permits  hip  flexion  and  increases  the difficulty  of  standing.  Having  a  pet  is  important  to  the  client’s  emotional  wellbeing;  therefore,  answer A  is  incorrect.  Answers  B  and  D indicate  that  the nurse’s teaching has been effective; there-fore, they are incorrect.  





178.  Answer A  is  correct.  Withholding  oral  intake  will  help  stop  the  inflammatory process  by  reducing  the  secretion  of  pancreatic  enzymes.  Answer B  is incorrect  because  the  client  requires  exogenous  insulin.  Answer C is incorrect  because  it  does  not  prevent  the  secretion  of  gastric  acid.  Answer D is  incorrect  because  it  does  not  eliminate  the  need  for pain  medication.   





179.  Answer  B  is  correct.  

A  rigid  or  boardlike  abdomen  is  suggestive  of peritonitis,  which  is  a  complication  of  diverticulitis.  Answers  A,  C,  and  D  are common findings in diverti-culitis; therefore, they are incorrect.  





180.  Answer D is  correct.  Vancomycin  should  be  administered  slowly  to  prevent ―redman‖  syndrome.  Answer A  is  incorrect  because  the  medication  is  not given  IV push.  Answers  B  and  C are  incorrect  choices  because  they  allow the medication to be given too rapidly.  








181.  Answer  A is  correct.  Protigmine  is  used  to  treat  clients  with  myasthenia  gravis. Answer  B  is  incorrect  because  it  is  used  to  reverse  the  effects  of  neostigmine.  Answer C is  incorrect  because  the  drug  is  unrelated  to  the  treatment  of  myasthenia  gravis. Answer D is incorrect because it is the test for myasthenia gravis.  






182.  Answer D is  correct.  

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;  there-fore,  answers  A  and  C are  incorrect.  Answer B  is incorrect because the client needs a high-protein diet.  





183.  Answer  B  is  correct.  

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;  therefore,  answers A  and  C are  incorrect.  Answer  D  is  incorrect  because  video  games  are  not appropriate to the age or develop-mental level for the child with cerebral palsy.  





184.  Answer  A is  correct.  

The  client  with  duodenal  ulcers  commonly  complains  of  epigastric  pain  that  is  relieved  by  eating  a  meal  or  snack.  Answer  B  is  incorrect  because  the client  with  a  duodenal  ulcer  frequently  reports  weight  gain.  Answers  C  and  D  are incorrect because they describe symptoms associated with gastric ulcers. 





185.  Answer D is  correct.  Complications  following  a  stapedectomy  include damage  to  the  seventh  cranial  nerve  that  results  in  changes  in  taste  or  facial sensation.  Answers  A  and  B  are  incorrect  because  they  are  expected immediately  following  a  stapedectomy.  Answer C is  incorrect  because  it involves the twelfth cranial nerve (hypoglossal nerve).  






186.  Answer  C  is  correct.  

Most  infants  begin  nocturnal  sleep  lasting  9–11  hours  by  3–4 months  of  age.  Answers  A  and  B  are  incorrect  because  the  infant  is  still  waking  for nighttime feedings. Answer D is incorrect because it does not answer the question.  





187.  Answer A  is  correct.  

The  goal  of  oxygen  therapy  for the  client  with emphysema  is  maintaining  a  PaO2  of  50  to  60mmHg.  Answers  B,  C,  and  D are incorrect because the PaO2 levels are too high.  





188.  Answer  B  is  correct.  

The  medication  is  having  its  intended  effect  when  the client’s  urine  specific  gravity  is  within  the  normal  range.  Answers  A  and  D  refer  to the  client  with  dia-betes  mellitus  not  diabetes  insipidus;  therefore,  they  are incorrect.  Answer  C  is  incorrect  because  it  is  not  related  to  diabetes  insipidus.  





189.  Answer  A is  correct.  
The  child  with  myelomeningocele  is  at  greatest  risk  for  the development  of  latex  allergy  because  of  repeated  exposure  to  latex  products  during surgery  and  from  numerous  urinary  catheterizations.  The  clients  in  answers  B,  C,  and D are much less likely to be exposed to latex; therefore, they are incorrect.  




190.  Answer D  is  correct.  

The  therapeutic  range  for  aminophylline  is  10–20 micrograms/mL.  Answers  A,  B,  and  C  are  incorrect  because  they  are  too low to be therapeutic.  







191.  Answer  C  is  correct.  

The  priority  nursing  diagnosis  for  a  client  with  acromegaly focuses  on  the  risk  for  ineffective  airway  clearance.  Answers  A,  B,  and  D  apply  to  the client with acromegaly but do not take priority; therefore, they are incorrect.  




192.  Answer  C  is  correct.  

The  nurse  can  help  increase  ventilation  and  perfusion  to  all areas  of  the  lungs  by  turning  the  client  every  hour.  Rocking  beds  can  also  be used  to  keep  the  client  in  constant  motion.  Answer  A  is  incorrect  because  the client  with  ARDS  will  have  respirations  controlled  by  the  ventilator.  Answer  B  is incorrect  because  the  nurse  must  have  a  physician’s  order  to  increase  the  PEEP. Answer D is incorrect because it will not increase ventilation and perfusion.  




193.  Answer  D  is  correct.  

The  nurse  or  parent  should  use  a  cupped  hand  when performing  chest  percussion.  Answer  A  is  incorrect  because  the  hand  should  be cupped.  Answer  B  is  incorrect  because  the  child’s  position  should  be  changed every  5–10  minutes,  and  the  whole  session  should  be  limited  to  20  minutes. Answer C is incorrect because chest per-cussion should be done before meals.  





194.  Answer  A is  correct.  

The  client  with  Addison’s  disease  requires  lifetime  management with  steroids.  The  nurse  should  stress  the  importance  of  taking  the  medication  exactly as  directed  by  the  physician,  as  well  as  reporting  adverse  reactions  to  the  medication. The  client  should  be  cautioned  not  to  skip  doses  or  to  abruptly  discontinue  the  medication.  Answers  B,  C,  and  D  should  be  included  in  the  client’s  teaching  but  do  not pose life-threatening consequences; therefore, they are incorrect.  





195.  Answer  B  is  correct.  

Air  embolus  can  occur  with  insertion,  maintenance,  and  removal of  central  line  catheters.  The  client’s  history  of  recent  removal  of  a  central  line  and  the development  of  dyspnea,  substernal  chest  pain,  confusion,  and  fear  suggest  an  air embolus.  Answer  A  is  incorrect  because  it  is  not  associated  with  central  line  use. Answer  C  is  incorrect  because  the  symptoms  do  not  suggest  bleeding.  Answer  D  is incorrect because it is not a complication of central line use.  



196.  Answer  A is  correct. 

 No  more  than  1mL  should  be  given  in  the  vastus  lateralis of  the  infant.  Answers  B,  C,  and  D  are  incorrect  because  the  dorsogluteal  and ventrogluteal muscles are not used for injections in the infant. 





 197.  Answer  C  is  correct.  

Depot  injections  of  Haldol  are  administered  every  4  weeks. Answers  A  and  B  are  incorrect  because  the  medication  is  still  in  the  client’s  system. Answer  D  is  incorrect  because  the  medication  has  been  eliminated  from  the  client’s system,  which  allows  the  symptoms  of  schizophrenia  to  return.   




198.  Answer  C  is  correct.  

The  client  should  take  a  deep  breath  and  hold  it  (Valsalva maneuver)  when  the  central  line  is  being  removed.  This  increases  the  intrathoracic pressure  and  decreases  the  likelihood  of  having  an  air embolus.  Answers  A  and  B  do not  increase  intrathoracic  pressure;  therefore,  they  are  incorrect  for  the  situation. Answer D increases the likelihood of air embolus; therefore, it is incorrect.  




199.  Answer D is  correct.  

The  earliest  sign  of  cystic  fibrosis  is  meconium  ileus, which  may  be  present  in  the  newborn  with  the  disease.  Answers  A,  B,  and C are later mani-festations; therefore, they are incorrect.  




200.  Answer  D  is  correct.  Tucking  a  disposable  diaper  at  the  perineal  opening  will help  prevent  soiling  of  the  cast  by  urine  and  stool.  Answer  A  is  incorrect  because the  head  of  the  bed  should  be  elevated.  Answer  B  is  incorrect  because  the  child can  place  the  crayons  beneath  the  cast,  causing  pressure  areas  to  develop. Answer  C  is  incorrect  because  the  child  does  not  need  high-calorie  foods  that would cause weight gain while she is immobilized by the cast.  





201.  Answer  B  is  correct.  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;  therefore,  answer  A  is  incorrect.  Answers  C  and  D  are  expected  following amputation and reimplantation; therefore, they are incorrect.  






202.  Answer C is  correct.  

The  obstetrical  client  under  age  18  is  at  greatest risk  for CPD  because  pelvic  growth  is  not  fully  completed.  Answers  A,  B, and D are incorrect because these clients are not as likely to have CPD. 




 203.  Answer  A is  correct.  Priority  of  care  should  focus  on  maintaining  the  client’s airway.  Answers  B  and  C  are  important  to  the  client’s  care,  but  they  do  not  take priority  over  maintaining  the  client’s  airway;  therefore,  they  are  incorrect.  Answer D is incorrect because the client will require a passive range of motion exercise. 





 204.  Answer  B  is  correct.  Answers  A,  C,  and  D  are  incorrect  because  they  are inaccurate amounts.  






205.  Answer  A is  correct.  Following  extracorporeal  lithotripsy,  the  urine  will  appear  cherry red  in  color  but  will  gradually  change  to  clear  urine.  Answer  B  is  incorrect  because  the urine  will  be  red,  not  orange.  Answer  C  is  incorrect  because  the  urine  will  be  not  be dark  red  or  cloudy  in  appearance.  Answer  D  is  incorrect  because  it  describes  the  urinary output of the client with acute glomerulonephritis. 







 206.  Answer  A is  correct.  Special  rotational  or  directional  catheters  will  be  used  to remove  the  plaque.  Answer  B  is  incorrect  because  it  describes  ablation.  Answer C is  incorrect  because  it  describes  percutaneous  transluminal  coronary angioplasty. Answer D is incorrect because it refers to lipid-lowering agents.  






207.  Answer C is  correct.  

A stage  II  pressure  ulcer  has  cracks  and  blisters  with areas  of  redness  and  induration.  Answer A  is  incorrect  because  it  describes the  appearance  of  a  stage  IV  pressure  ulcer.  Answer B  is  incorrect  because it  describes  the  appearance  of  a  stage  III  pressure  ulcer.  Answer D is incorrect  because  it  describes  the  appear-ance  of  a  stage  I  pressure  ulcer.   





209.  Answer  B  is  correct. 

 An  adverse  reaction  to  Cognex  is  drug-induced  hepatitis. The  nurse  should  monitor  the  client  for  signs  of  jaundice.  Answers  A,  C,  and  D are incor-rect because they are not associated with the use of Cognex.  





210.  Answer  A is  correct.  

The  child  with  cystic  fibrosis  needs  a  diet  that  is  high  in  calo-ries, with  high  protein  and  moderate  amounts  of  fat.  Answers  B,  C,  and  D  are  incorrect because they do not meet the nutritional requirements imposed by the disease. 






 211.  Answer  C  is  correct.  Apricots  are  low  in  potassium;  therefore,  this  is  a  suitable snack  for  the  client  on  a  potassium-restricted  diet.  Raisins,  oranges,  and bananas are all high in potassium; therefore, answers A, B, and D are incorrect.  






212.  Answer B is  correct.  Hyperventilation  reduces  swelling  and  increased intracranial  pressure  by  decreasing  cerebral  blood  flow.  Answers  A,  C,  and  D do not pertain to the situation; therefore, they are incorrect.  







213.  Answer  B  is  correct.  

No  special  preparation  is  needed  for  the  blood  test  for H.  pylori.  Answer  A  is  incorrect  because  the  client  is  not  NPO  before  the  test. Answer  C  is  incor-rect  because  it  refers  to  preparation  for  the  breath  test. Answer D is incorrect because glucose is not administered before the test.  





214.  Answer  B  is  correct.  

Oral  potassium  supplements  should  be  given  in  at  least 4oz  of  juice  or  other  liquid  such  as  fruit  punch  to  disguise  the  unpleasant  taste. Answers A, C, and D are incorrect because they cause gastric upset.  





215.  Answer  D  is  correct.  

The  client  with  hypomagnesemia  will  have  a  positive Trousseau’s  sign.  Answer  A  is  incorrect  because  the  client  would  have  tachycardia. Answer  B  is  incorrect  because  the  client  would  have  a  positive  Chvostek’s  sign. Answer C is incorrect because the client would have hypotension. 




 216.  Answer  D  is  correct.  

Fresh  specimens  are  essential  for  an  accurate  diagnosis  of CMV.  Answer  A  is  incorrect  because  cultures  of  urine,  sputum,  and  oral  swab  are preferred.  Answer  B  is  incorrect  because  pregnant  caregivers  should  not  be  assigned to  care  for  clients  with  suspected  or  known  infection  with  CMV.  Answer  C  is  incorrect because a convalescent culture is obtained 2–4 weeks after diagnosis.  





217.  Answer  B  is  correct.  

The  client  with  congestive  heart  failure  who  reports  coughing  up frothy  sputum  should  be  carefully  evaluated  for  increasing  pulmonary  edema,  which requires  immediate  treatment.  Answers  A,  C,  and  D  involve  chronic  conditions  with complications  that  require  skilled  nursing  care  and  assessment,  but  they  do  not  present immediate life-threatening situations; therefore, they are incorrect.  





218.  Answer B is  correct.  

The  client  with  neutropenia  needs  to  be  placed  in  a private  room  in  protective  isolation.  The  other  clients  can  be  placed  in  the room with other clients; therefore, answers A, C, and D are incorrect.  





219.  Answer B is  correct.  Asterixis  is  a  symptom  of  impending  liver failure,  so the  client  should  be  cared  for  by  the  RN. The  remaining  clients  can  be cared  for by  the  LPN;  therefore,  answers  A,  C,  and  D are  incorrect.  






219.  Answer  D  is  correct.  Adverse  reactions  to  phenytoin  include  agranulocytosis.  The client’s  WBC  is  abnormally  low  and  should  be  reported  to  the  physician  immediately. Answer  A  is  incorrect  because  elevations  in  serum  creatinine  are  expected  in  the  client with  chronic  renal  failure.  Answer  B  is  wrong  because  a  positive  C  reactive  protein  is usually  present  in  those  with  rheumatic  fever.  Answer  C  is  wrong  because  a  hematocrit of 52% in a client with gastroenteritis can be expected due to dehydration.  






220.  Answer D is  correct.  

The  newly  licensed  nurse  should  not  be  assigned  to provide  pri-mary  care  for the  client  with  noncardiogenic  pulmonary  edema (ARDS) because  the  client’s  condition  warrants  care  by  an  experienced  RN. Answers  A,  B,  and  C are  incor-rect  because  the  newly  licensed  nurse  could assume primary care for clients with those conditions. 




 221.  Answer  C  is  correct. 

 The  client  with  a  lumbar  laminectomy  can  be  safely  cared for  by  the  LPN.  Answer  A  is  incorrect  because  the  client  with  a  high  cervical  injury immobi-lized  by  skeletal  traction  is  best  cared  for  by  the  RN.  Answers  B  and  D are  incorrect  choices  because  these  clients  have  conditions  that  require intravenous medication, which requires the skill of the RN.  





222.  Answer  A is  correct.  

The  client  with  a  thoracotomy  who  has  110mL  of  drainage  in  the past  hour  has  excessive  bleeding  that  should  be  evaluated  and  reported  to  the physician  immediately.  A  temperature  of  100°F  following  a  surgery  is  not  unusual; therefore,  answer  B  is  incorrect.  Feelings  of  urinary  urgency  are  normal  after  a transurethral  prostatectomy;  therefore,  answer  C  is  incorrect.  Diminished  loss  of  hearing  in  the  hours  following  a  stapedectomy  is  expected  due  to  the  swelling  and  accumulation of blood in the inner ear; therefore, answer D is incorrect.  







223.  Answer  A  is  correct.  Increased  jaundice  and  prolonged  prothrombin  time  are  indications  that  the  liver  is  not  working.  Answer  B  is  incorrect  because  the  symptoms  suggest  infection.  Answer  C  is  incorrect  because  the  symptoms  suggest  obstruction.   Answer D is incorrect because the symptoms are associated with renal failure.  




224.  Answer A  is  correct.  

The  client  with  adrenal  insufficiency  suffers  from fluid  volume  deficit  and  acidosis.  Answers  B,  C,  and  D are  incorrect because they do not pose a life-threatening acid-based imbalance.  





225.  Answer D is  correct.  Sulfamylon  produces  a  burning  sensation  when applied;  there-fore,  the  client  should  receive  pain  medication  30  minutes before  application.  Answer A  is  incorrect  because  it  refers  to  therapy  with silver nitrate.  Answer B  is  incorrect  because  it  refers  therapy  with  Silvadene. Answer C is incorrect because it refers thera-py with to Betadine.  






226.  Answer  D  is  correct.  Gingival  hyperplasia  is  a  side  effect  of  Dilantin,  so the  nurse  should  provide  oral  hygiene  and  gum  care  every  shift.  Answers A, B, and C do not apply to the medication; therefore, they are incorrect.  






227.  Answer C is  correct.  Adverse  reactions  to  Captoten  include  a  decreased white  cell  count.  Answers  A,  B,  and  D  are  incorrect  because  they  are associated with the med-ication.  







228.  Answer C is  correct. 

 Zofran  is  given  before  chemotherapy  to  prevent nausea.  Answers  A,  B,  and  D  are  not  associated  with  the  medication; therefore,  they  are  incor-rect.    





229.  Answer A  is  correct.  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.  Answers  B  and  D  are  incorrect  positions  for administering  ear drops. Answer C is used for administering ear drops to the adult client.  






230.  Answer A  is  correct.  Antibiotics  such  as  Achromycin  should  not  be  taken with  antacids.  Answers  B,  C,  and  D may  be  taken  with  antibiotics;  therefore, they are incor-rect.  






231.  Answer  C  is  correct.  

The  nurse  should  carefully  monitor  the  client  taking  Thorazine for  signs  of  infection  that  can  quickly  become  overwhelming.  Answers  A,  B,  and  D  are incorrect because they are expected side effects of the medication. 





 232.  Answer  A  is  correct.  Claratin  does  not  produce  sedation  like  other  antihistamines. Answers B, C, and D are inaccurate statements; therefore, they are incorrect.  






233.  Answer B is  correct. 

 A cotton-tipped  swab  is  used  to  apply  the  suspension to  the  affected  areas.  Answers  A,  C,  and  D are  incorrect  because  they  do not ensure that the medication reaches the affected areas.  





234.  Answer A  is  correct.  

Iron  is  better absorbed  when  taken  with  ascorbic acid.  Orange  juice  is  an  excellent  source  of  ascorbic  acid.  Answer B  is incorrect  because  the  med-ication  should  be  taken  with  orange  juice  or tomato  juice.  Answer C is  incorrect  because  iron  should  not  be  taken  with milk  because  it  interferes  with  absorption.  Answer D is  incorrect  because apple juice does not contain high amounts of ascorbic acid.  





235.  Answer A  is  correct.  Acetylcysteine  is  the  antidote  for  acetaminophen poisoning.  Answer B  is  incorrect  because  it  is  the  antidote  for  iron  poisoning. Answer C is  incor-rect  because  it  is  the  treatment  for lead  poisoning.  Answer D is incorrect because it is used for noncorrosive poisonings.  





236.  Answer  D  is  correct.  

The  client  should  hold  the  cane  in  the  unaffected  side.  Answer  A is  incorrect  because  this  answer  instructs  the  client  to  hold  the  cane  in  the  affected side.  It  will  not  be  necessary  for  the  client  to  use  a  walker,  and  advancing  the  cane  with the affected leg is not correct; thus, answers B and C are incorrect.  





237.  Answer  A is  correct. 

 Linear  accelerator  therapy  is  done  in  the  radium  department  and does  not  make  the  client  radioactive.  Answer  B  is  incorrect  because  there  is  no  radiation  emitted  from  the  client.  Answer  C  is  incorrect  because  it  is  not  necessary  for  the nursing  assistant  to  wear  an  apron  when  caring  for  this  client.  Answer  D  is  incorrect because there is no need to reassign the nursing assistant. 




 238.  Answer D is  correct.  

The  client  undergoing  an  angiogram  will experience  a  warm  sensation  as  the  dye  is  injected.  Answers  A,  B,  and  C are not associated with an angiogram.  





239.  Answer  B  is  correct.  

Semi-liquids  are  more  easily  swallowed  by  the  client with  dys-phagia  than  either  liquids  or  solids.  Answers  A,  C,  and  D  do  not improve  the  client’s  ability  to  swallow,  so  they  are  incorrect  choices.   





240.  Answer  A  is  correct.  Placing  the  client  in  the  Trendelenburg  position  will  engorge  the vessels,  make  insertion  of  the  catheter  easier,  and  lessen  the  likelihood  of  air  entering the  central  line.  Answer  B  is  incorrect  because  the  client  will  not  be  more  comfortable in the Trendelenburg position. Answers C and D are not correct statements.  






241.  Answer  B  is  correct.  Taking  deep  breaths  will  decrease  the  discomfort  experienced during  removal  of  the  drain.  Answers  A,  C,  and  D  are  incorrect  statements  because  they do not decrease the discomfort during removal of the drain.  





242.  Answer B is  correct.  Increased  voiding  at  night  is  a  symptom  of  right-sided heart  fail-ure.  Answers  A,  C,  and  D are  incorrect  because  they  are  symptoms of left-sided heart failure.  





243.  Answer  B  is  correct.  

The  CPM  machine  should  not  be  set  at  90°  flexion  until  the fifth  post-operative  day.  Answers  A,  C,  and  D  are  expected  findings  and  do  not require immediate nursing intervention; therefore, they are incorrect.  





244.  Answer  D  is  correct.  
The  multiparous  client  with  a  large  newborn  has  the greatest  risk  for  postpartal  hemorrhage.  Answers  A,  B,  and  C  are  incorrect choices because they do not have a greater risk for postpartal hemorrhage.  




245.  Answer  B  is  correct.  

The  medication  should  be  administered  using  the  calibrated dropper  that  comes  with  the  medication.  Answers  A  and  C  are  incorrect  because  part or  all  of  the  medication  could  be  lost  during  administration.  Answer  D  is  incorrect because part or all of the medication will be lost if the child does not finish the bottle.  




246.  Answer  C  is  correct.  Atropine  is  contraindicated  in  the  client  with  glaucoma  because the  medication  increases  intraocular  pressure.  Answers  A,  B,  and  D  are  not  contraindicated in the client with glaucoma; therefore, they are incorrect answers. 





 247.  Answer  B is  correct. 

 Aged  cheese,  wine,  and  smoked  or  pickled  meats  should  be avoided  by  the  client  taking  an  MAOI,  not  a  phenothiazine.  Answers  A,  C,  and  D  are included in the discharge teaching of a client receiving chlorpromazine (Thorazine). 




 248.  Answer D is  correct.  Leaving  a  nightlight  on  during  the  evening  and  night shifts  helps  the  client  remain  oriented  to  the  environment  and  fosters independence.  Answers  A  and  B  will  not  decrease  the  client’s  confusion. Answer C will increase the likelihood of confusion in an elderly client.  





249.  Answer  C  is  correct.  Elevations  in  white  cell  count  indicate  the  presence  of infection,  which  requires  treatment  before  surgery.  Answers  A,  B,  and  D  are within normal limits and require no intervention.  





250.  Answer  A  is  correct.  Akathisia  is  an  adverse  extrapyramidal  side  effect  of  many older  antipsychotic  medications  such  as  haloperidol  and  chlorpromazine. Answers  B,  C,  and  D  are  not  associated  with  the  use  of  haloperidol.      


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1 comment:

  1. The technological element of the work additionally calls for the pharmacy tech practice test to have excellent business abilities and also they might be likewise be called for to identify medication containers and also classify them under the appropriate name or team - the 100 mg tag should take place the 100 mg container. Simply one mistake, one little oversight might lead to really unfavorable repercussions for a client.

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