Wednesday, 29 July 2015

PRACTICE QUESTIONS PART =7 ANSWER AND RATIONALES



NCLEX PRACTICE QUESTIONS PART - 07 ANSWERS AND RATIONALES.. 






[Q.NO.101-200 ]



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101.  Answer  B  is  correct. 

 An  amniotomy  is  an  artificial  rupture  of  membranes  and  normal amniotic fluid is straw-colored and odorless. A, C, and D are abnormal findings.  






102.  Answer  D  is  correct.  Diabeta  is  an  antidiabetic  medication  that  can  result  in hypo-glycemia. A, B, and D are incorrect because they are not related to Diabeta.  







103.  Answer B is  correct. 
 The  normal  fetal  heart  rate  is  120–160bpm;  100110bpm  is  bradycardia.  The  first  action  would  be  to  turn  the  client  to  the  left side  and  apply  oxy-gen.  Answer  A is  not  indicated  at  this  time.  Answer C is not  the  best  action  for clients  experiencing  bradycardia.  There  is  no  data  to indicate the need to move the client to the delivery room at this time.  






104.  Answer  D  is  correct.  Arterial  ulcers  are  painful.  A,  B,  and  C  are  incorrect because they do not describe arterial ulcers.  







105.  Answer  B  is  correct.  Applying  a  fetal  heart  monitor  is  the  correct  action  at  this  time. There  is  no  need  to  prepare  for  a  Caesarean  section  or  to  place  the  client  in  Genu Pectoral  position  (knee-chest),  so  answers  A  and  C  are  incorrect.  Answer  D  is incorrect because there is no need for an ultrasound based on the finding.  







106.  Answer B is  correct. 

 The  nurse  decides  to  apply  an  external  monitor because  the  membranes  are  intact.  Answers  A,  C,  and  D are  incorrect.  The cervix  is  dilated  enough  to  use  an  internal  monitor,  if  necessary.  An  internal monitor  can  be  applied  if  the  client  is  at  0-station.  Contraction  intensity  has no bearing on the application of the fetal monitor.  






107.  Answer  D  is  correct.  Clients  admitted  in  labor  are  told  not  to  eat  during  labor,  to avoid  nausea  and  vomiting.  Ice  chips  may  be  allowed,  but  this  amount  of  fluid might  not  be  sufficient  to  prevent  fluid  volume  deficit.  In  answer  A,  impaired  gas exchange  related  to  hyperventilation  would  be  indicated  during  the  transition phase. Answers B and C are not correct in relation to the stem.  







108.  Answer D is  correct.  

This  information  indicates  a  late  deceleration.  This type  of  decel-eration  is  caused  by  uteroplacental  lack  of  oxygen.  Answer A has  no  relation  to  the  readings,  so  it’s  incorrect;  answer B  results  in  a variable deceleration; and answer C is indicative of an early deceleration.  






109.  Answer  C  is  correct.  
The  initial  action  by  the  nurse  observing  a  late  deceleration should  turn  the  client  to  the  side—preferably,  the  left  side.  Administering  oxygen  is also  indicated.  Answer  A  might  be  necessary  but  not  before  turning  the  client  to  her side.  Answer  B  is  not  necessary  at  this  time.  Answer  D  is  incorrect  because  there  is no  data  to  indicate  that  the  monitor  has  been  applied  incorrectly.   







110.  Answer D is  correct.  
A deceleration  to  90–100bpm  at  the  end  of contractions  are  late  decelerations.  This  finding  is  ominous  (bad) and  should be reported. A, B, and D are normal findings and are therefore incorrect.  







111.  Answer  C  is  correct.  Epidural  anesthesia  decreases  the  urge  to  void  and sensation  of  a  full  bladder.  A  full  bladder  will  decrease  the  progression  of labor. Answers A, B, and D are incorrect for the stem.  






112.  Answer  B  is  correct.  Lutenizing  hormone  released  by  the  pituitary  is  responsible  for ovulation.  At  about  day  14,  the  continued  increase  in  estrogen  stimulates  the  release of  lutenizing  hormone  from  the  anterior  pituitary.  The  LH  surge  is  responsible  for  ovulation,  or  the  release  of  the  dominant  follicle  in  preparation  for  conception,  which occurs  within  the  next  10–12  hours  after  the  LH  levels  peak.  Answers  A,  C,  and  D  are incorrect  because  estrogen  levels  are  high  at  the  beginning  of  ovulation,  the  endometrial lining is thick, not thin, and the progesterone levels are high, not low.  







113.  Answer C is  correct.  
The  success  of  the  rhythm  method  of  birth  control  is dependent  on  the  client’s  menses  being  regular.  It  is  not  dependent  on  the age  of  the  client,  fre-quency  of  intercourse,  or range  of  the  client’s temperature; therefore, answers A, B, and D are incorrect.  







114.  Answer  C  is  correct.  
The  best  method  of  birth  control  for  the  client  with  diabetes  is the  diaphragm.  A  permanent  intrauterine  device  can  cause  a  continuing  inflammatory response  in  diabetics  that  should  be  avoided,  oral  contraceptives  tend  to  elevate blood  glucose  levels,  and  contraceptive  sponges  are  not  good  at  preventing pregnancy. Therefore, answers A, B, and D are incorrect.  






115.  Answer D is  correct.  

The  signs  of  an  ectopic  pregnancy  are  vague  until  the fallopian  tube  ruptures.  The  client  will  complain  of  sudden,  stabbing  pain  in the  lower quadrant  that  radiates  down  the  leg  or up  into  the  chest.  Painless vaginal  bleeding  is  a  sign  of  placenta  previa,  abdominal  cramping  is  a  sign of  labor,  and  throbbing  pain  in  the  upper  quadrant  is  not  a  sign  of  an  ectopic pregnancy, making answers A, B, and C incorrect.  







116.  Answer C is  correct.  
All  of  the  choices  are  tasty,  but  the  pregnant  client needs  a  diet  that  is  balanced  and  has  increased  amounts  of  calcium. Answer A  is  lacking  in  fruits  and  milk.  Answer B  contains  the  potato  chips, which  contain  a  large  amount  of  sodi-um.  Answer C contains  meat,  fruit, potato  salad,  and  yogurt,  which  has  about  360mg  of  calcium.  Answer D is not the best diet because it lacks vegetables and milk prod-ucts.  





117.  Answer B is  correct.  

The  client  with  hyperemesis  has  persistent  nausea and  vomiting.  With  vomiting  comes  dehydration.  When  the  client  is dehydrated,  she  will  have  meta-bolic  acidosis.  Answers  A  and  C are incorrect  because  they  are  respiratory  dehydra-tion.  Answer D is  incorrect because the client will not be in alkalosis with persistent vomiting.  








118.  Answer  B  is  correct.  
The  most  definitive  diagnosis  of  pregnancy  is  the  presence  of fetal  heart  tones.  The  signs  in  answers  A,  C,  and  D  are  subjective  and  might  be  related to  other  medical  conditions.  Answers  A  and  C  may  be  related  to  a  hydatidiform  mole, and  answer  D  is  often  present  before  menses  or  with  the  use  of  oral  contraceptives.








119.  Answer C is  correct.  

The  infant  of  a  diabetic  mother is  usually  large  for gestational  age.  After  birth,  glucose  levels  fall  rapidly  due  to  the  absence  of glucose  from  the  mother.  Answer A  is  incorrect  because  the  infant  will  not  be small  for gestational  age.  Answer B  is  incorrect  because  the  infant  will  not  be hyperglycemic.  Answer D is  incor-rect  because  the  infant  will  be  large,  not small, and will be hypoglycemic, not hyper-glycemic.  






120.  Answer  B  is  correct.  

When  the  client  is  taking  oral  contraceptives  and  begins  antibiotics,  another  method  of  birth  control  should  be  used.  Antibiotics  decrease  the  effectiveness  of  oral  contraceptives.  Approximately  5–10  pounds  of  weight  gain  is  not unusual,  so  answer  A  is  incorrect.  If  the  client  misses  a  birth  control  pill,  she  should  be instructed  to  take  the  pill  as  soon  as  she  remembers  the  pill.  Answer  C  is  incorrect.  If she  misses  two,  she  should  take  two;  if  she  misses  more  than  two,  she  should  take  the missed  pills  but  use  another  method  of  birth  control  for  the  remainder  of  the  cycle. Answer  D  is  incorrect  because  changes  in  menstrual  flow  are  expected  in  clients  using oral contraceptives. Often these clients have lighter menses.  







121.  Answer  B is  correct.  
Clients  with  HIV  should  not  breastfeed  because  the  infection  can  be transmitted  to  the  baby  through  breast  milk.  The  clients  in  answers  A,  C,  and  D—  those  with diabetes, hypertension, and thyroid disease—can be allowed to breastfeed.  








122.  Answer  A is  correct.  

The  symptoms  of  painless  vaginal  bleeding  are consistent  with  placenta  previa.  Answers  B,  C,  and  D  are  incorrect.  Cervical check  for  dilation  is  con-traindicated  because  this  can  increase  the  bleeding. Checking  for  firmness  of  the  uterus  can  be  done,  but  the  first  action  should  be  to check the fetal heart tones. A detailed history can be done later.  







123.  Answer  D  is  correct.  
The  client  should  be  advised  to  come  to  the  labor  and  delivery unit  when  the  contractions  are  every  5  minutes  and  consistent.  She  should  also  be told  to  report  to  the  hospital  if  she  experiences  rupture  of  membranes  or  extreme bleeding.  She  should  not  wait  until  the  contractions  are  every  2  minutes  or  until  she has  bloody  discharge,  so  answers  A  and  B  are  incorrect.  Answer  C  is  a  vague  answer and can be related to a urinary tract infection.  








124.  Answer A  is  correct.  Infants  of  mothers  who  smoke  are  often  low  in  birth weight.  Infants  who  are  large  for gestational  age  are  associated  with  diabetic mothers,  so  answer B  is  incorrect.  Preterm  births  are  associated  with smoking,  but  not  with  appro-priate  size  for  gestation,  making  answer C incorrect.  Growth  retardation  is  associated  with  smoking,  but  this  does  not affect the infant length; therefore, answer D is incor-rect.  










125.  Answer  A is  correct.  

To provide  protection  against  antibody  production,  RhoGam should  be  given  within  72  hours.  The  answers  in  B,  C,  and  D  are  too  late  to  provide antibody protection. RhoGam can also be given during pregnancy. 







 126.  Answer  B  is  correct.  When  the  membranes  rupture,  there  is  often  a  transient  drop  in the  fetal  heart  tones.  The  heart  tones  should  return  to  baseline  quickly.  Any  alteration in  fetal  heart  tones,  such  as  bradycardia  or  tachycardia,  should  be  reported.  After  the fetal  heart  tones  are  assessed,  the  nurse  should  evaluate  the  cervical  dilation,  vital signs,  and  level  of  discomfort,  making  answers  A,  C,  and  D  incorrect.  







127.  Answer A  is  correct.  
The  active  phase  of  labor occurs  when  the  client  is dilated  4–7cm.  The  latent  or  early  phase  of  labor is  from  1cm  to  3cm  in dilation,  so  answers  B  and  D are  incorrect.  The  transition  phase  of  labor is 8–10cm in dilation, making answer C incorrect.  






128.  Answer  B  is  correct.  

The  infant  of  an  addicted  mother  will  undergo  withdrawal. Snugly  wrapping  the  infant  in  a  blanket  will  help  prevent  the  muscle  irritability  that these  babies  often  experience.  Teaching  the  mother  to  provide  tactile  stimulation or  provide  for  early  infant  stimulation  are  incorrect  because  he  is  irritable  and needs  quiet  and  lit-tle  stimulation  at  this  time,  so  answers  A  and  D  are  incorrect. Placing  the  infant  in  an  infant  seat  in  answer  C  is  incorrect  because  this  will  also cause movement that can increase muscle irritability.  







129.  Answer  C  is  correct.  Following  epidural  anesthesia,  the  client  should  be  checked for  hypotension  and  signs  of  shock  every  5  minutes  for  15  minutes.  The  client  can  be checked  for  cervical  dilation  later  after  she  is  stable.  The  client  should  not  be  positioned  supine  because  the  anesthesia  can  move  above  the  respiratory  center  and the  client  can  stop  breathing.  Fetal  heart  tones  should  be  assessed  after  the  blood pres-sure is checked. Therefore, answers A, B, and D are incorrect.  








130.  Answer B is  correct.  

The  best  way  to  prevent  post-operative  wound infection  is  hand  washing.  Use  of  prescribed  antibiotics  will  treat  infection, not  prevent  infections,  mak-ing  answer A  incorrect.  Wearing  a  mask  and asking  the  client  to  cover her  mouth  are  good  practices  but  will  not  prevent wound infections; therefore, answers C and D are incorrect.  







131.  Answer B is  correct.  

The  client  with  a  hip  fracture  will  most  likely  have disalignment.  Answers  A,  C,  and  D are  incorrect  because  all  fractures cause  pain,  and  coolness  of  the  extremities  and  absence  of  pulses  are indicative of compartment syndrome or peripheral vascular disease.  








132.  Answer  B  is  correct.  

After  menopause,  women  lack  hormones  necessary  to  absorb  and utilize  calcium.  Doing  weight-bearing  exercises  and  taking  calcium  supplements  can  help to  prevent  osteoporosis  but  are  not  causes,  so  answers  A  and  C  are  incor-rect.  Body types  that  frequently  experience  osteoporosis  are  thin  Caucasian  females,  but  they  are not most likely related to osteoporosis, so answer D is incorrect.  






133.  Answer B is  correct.  

The  infant’s  hips  should  be  off  the  bed  approximately 15° in  Bryant’s  traction.  Answer A  is  incorrect  because  this  does  not  indicate that  the  traction  is  working  correctly,  nor does  C.  Answer D is  incorrect because Bryant’s traction is a skin traction, not a skeletal traction.  







134.  Answer  A is  correct.  Balanced  skeletal  traction  uses  pins  and  screws.  A  Steinman pin  goes  through  large  bones  and  is  used  to  stabilize  large  bones  such  as  the  femur. Answer  B  is  incorrect  because  only  the  affected  leg  is  in  traction.  Kirschner  wires  are used  to  stabilize  small  bones  such  as  fingers  and  toes,  as  in  answer  C.  Answer  D  is incorrect because this type of traction is not used for fractured hips. 







135.  Answer  A  is  correct.  Bleeding  is  a  common  complication  of  orthopedic  surgery.  The blood-collection  device  should  be  checked  frequently  to  ensure  that  the  client  is  not hemorrhaging.  The  client’s  pain  should  be  assessed,  but  this  is  not  life-threatening.   When  the  client  is  in  less  danger,  the  nutritional  status  should  be  assessed and  an  immobilizer  is  not  used;  thus,  answers  B,  C,  and  D  are  incorrect. 







136.  Answer  A is  correct.  
The  client’s  family  member  should  be  taught  to  flush  the  tube after  each  feeding  and  clamp  the  tube.  The  placement  should  be  checked  before  feedings,  and  indigestion  can  occur  with  the  PEG  tube,  just  as  it  can  occur  with  any  client, so  answers  B  and  C  are  incorrect.  Medications  can  be  ordered  for  indigestion,  but  it  is not  a  reason  for  alarm.  A  percutaneous  endoscopy  gastrostomy  tube  is  used  for clients  who  have  experienced  difficulty  swallowing.  The  tube  is  inserted  directly  into the stomach and does not require swallowing; therefore, answer D is incorrect.  







137.  Answer  C  is  correct. 
 The  client  with  a  total  knee  replacement  should  be  assessed  for anemia.  An  hgb  of  7  is  extremely  low  and  might  require  a  blood  transfusion.  Scant bleeding  on  the  dressing  is  not  extreme.  Circle  and  date  and  time  the  bleeding  and monitor  for  changes  in  the  client’s  status.  A  low-grade  temperature  is  not  unusual  after surgery.  Ensure  that  the  client  is  well  hydrated,  and  recheck  the  temperature  in  one hour.  Voiding  after  surgery  is  also  not  uncommon  and  no  need  for  concern;  there-fore, answers A, B, and D are incorrect.  







138.  Answer  B  is  correct.  
The  parents  make  stained  glass  as  a  hobby.  Stained  glass is  put  together  with  lead,  which  can  drop  on  the  work  area,  where  the  child  can consume the lead beads. Answers A, C, and D do not pose a threat to the child.  







139.  Answer  A is  correct.  
The  equipment  that  can  help  with  activities  of  daily  living  is the  high-seat  commode.  The  hip  should  be  kept  higher  than  the  knee.  The recliner  is  good  because  it  prevents  90°  flexion  but  not  daily  activities.  A  TENS (Transcutaneous  Electrical  Nerve  Stimulation)  unit  helps  with  pain  management and  an  abduction  pil-low  is  used  to  prevent  adduction  of  the  hip  and  possibly dislocation of the prosthesis; therefore, answers B, C, and D are incorrect.  







140.  Answer  B  is  correct.  Narcan  is  the  antidote  for  narcotic  overdose.  If hypoxia  occurs,  the  client  should  have  oxygen  administered  by  mask,  not cannula.  There  is  no  data  to  support  the  administration  of  blood  products  or cardioresuscitation, so answers A, C, and D are incorrect.  











141.  Answer  B  is  correct. 
 The  6-year-old  should  have  a  roommate  as  close  to  the  same age  as  possible,  so  the  12-year-old  is  the  best  match.  The  10-year-old  with  sarcoma has  cancer  and  will  be  treated  with  chemotherapy  that  makes  him  immune  suppressed,  the  6-year-old  with  osteomylitis  is  infected,  and  the  client  in  answer  A  is  too old and is female; therefore, answers A, C, and D are incorrect.  








142.  Answer B is  correct.  

Cox  II  inhibitors  have  been  associated  with  heart attacks  and  strokes.  Any  changes  in  cardiac  status  or signs  of  a  stroke should  be  reported  imme-diately,  along  with  any  changes  in  bowel  or bladder habits  because  bleeding  has  been  linked  to  use  of  Cox  II  inhibitors. The  client  does  not  have  to  take  the  medication  with  milk,  remain  upright,  or allow 6 weeks for optimal effect, so answers A, C, and D are incorrect.  








143.  Answer  D  is  correct. 




 A  plaster-of-Paris  cast  takes  24  hours  to  dry,  and  the  client should  not  bear  weight  for  24  hours.  The  cast  should  be  handled  with  the  palms, not  the  fingertips,  so  answer  A  is  incorrect.  Petaling  a  cast  is  covering  the  end  of the  cast  with  cast  batting  or  a  sock,  to  prevent  skin  irritation  and  flaking  of  the  skin under  the  cast.  B  is  incorrect  because  petaling  the  cast  is  done  by  the  health  care provider  who  applied  the  cast.  The  client  should  be  told  not  to  dry  the  cast  with  a hair  dryer  because  this  causes  hot  spots  and  could  burn  the  client.  This  also causes  unequal  drying;  thus,  answer  C  is  incorrect.   







144.  Answer  A  is  correct.  

There  is  no  reason  that  the  client’s  friends  should  not be  allowed  to  autograph  the  cast;  it  will  not  harm  the  cast  in  any  way,  so answers B, C, and D are incorrect. 







 145.  Answer A  is  correct. 
 The  nurse  is  performing  the  pin  care  correctly  when she  uses  ster-ile  gloves  and  Q-tips.  Clean  gloves  are  not  acceptable.  A licensed  practical  nurse  can  perform  pin  care,  there  is  no  need  to  clean  the weights; therefore, answers B, C, and D are incorrect. 







 146.  Answer  A  is  correct.  
A  body  cast  or  spica  cast  extends  from  the  upper abdomen  to  the  knees  or  below.  Bowel  sounds  should  be  checked  to  ensure that the client is not experiencing a paralytic illeus. Checking the blood  pressure  is  a  treatment  for  any  client,  offering  pain  medication  is  not  called  for,  and checking for swelling isn’t specific to the stem, so answers B, C, and D are incorrect.  







147.  Answer C is  correct.  
Halo  traction  will  be  ordered  for the  client  with  a cervical  frac-ture.  Russell’s  traction  is  used  for bones  of  the  lower extremities, as  is  Buck’s  traction.  Cruchfield  tongs  are  used  while  in  the  hospital  and  the client is immobile; therefore, answers A, B, and D are incorrect.  







148.  Answer  B  is  correct.  
The  controller  for  the  continuous  passive-motion  device  should be  placed  away  from  the  client.  Many  clients  complain  of  pain  while  having  treatments with  the  CPM,  so  they  might  turn  off  the  machine.  The  CPM  flexes  and  extends  the leg.  The  client  is  in  the  bed  during  CPM  therapy,  so  answer  A  is  incorrect.  Answer  C  is incorrect  because  clients  will  experience  pain  with  the  treatment.  Use  of  the  CPM  does not alleviate the need for physical therapy, as suggested in answer D.  







149.  Answer  A is  correct.  
The  client’s  palms  should  rest  lightly  on  the  handles.  The elbows  should  be  flexed  no  more  than  30°  but  should  not  be  extended.  Answer  B  is incorrect  because  0°  is  not  a  relaxed  angle  for  the  elbows  and  will  not  facilitate  correct walker  use.  The  client  should  walk  to  the  middle  of  the  walker,  not  to  the  front  of  the walker,  making  answer  C  incorrect.  The  client  should  be  taught  not  to  carry  the  walker because this would not provide stability; thus, answer D is incorrect.  







150.  Answer  C  is  correct.  
The  client  with  a  prolapsed  cord  should  be  treated  by  elevating the  hips  and  covering  the  cord  with  a  moist,  sterile  saline  gauze.  The  nurse  should  use her  fingers  to  push  up  on  the  presenting  part  until  a  cesarean  section  can  be  performed.  Answers  A,  B,  and  D  are  incorrect.  The  nurse  should  not  attempt  to  replace the cord, turn the client on the side, or cover with a dry gauze. 








 151.  Answer  B  is  correct.  

Chest  tubes  work  to  reinflate  the  lung  and  drain  serous  fluid.  The tube  does  not  equalize  expansion  of  the  lungs.  Pain  is  associated  with  collapse  of  the lung,  and  insertion  of  chest  tubes  is  painful,  so  answers  A  and  C  are  incorrect.  Answer D is true, but this is not the primary rationale for performing chest tube insertion.  








152.  Answer  D  is  correct.  Success  with  breastfeeding  depends  on  many  factors,  but the  most  dependable  reason  for  success  is  desire  and  willingness  to  continue the  breast-feeding  until  the  infant  and  mother  have  time  to  adapt.  The educational  level,  the  infant’s  birth  weight,  and  the  size  of  the  mother’s  breast have  nothing  to  do  with  suc-cess,  so  answers  A,  B,  and  C  are  incorrect. 





153.  Answer C is  correct. 

 Green-tinged  amniotic  fluid  is  indicative  of  meconium staining.  This  finding  indicates  fetal  distress.  The  presence  of  scant  bloody discharge  is  normal,  as  are  frequent  urination  and  moderate  uterine contractions, making answers A, B, and D incorrect.  








154.  Answer C is  correct.  Duration  is  measured  from  the  beginning  of  one contraction  to  the  end  of  the  same  contraction.  Answer A  refers  to frequency.  Answer B  is  incorrect  because  we  do  not  measure  from  the  end of  one  contraction  to  the  beginning  of  the  next  contraction.  Duration  is  not measured from the peak of the contraction to the end, as stated in D. 







 155.  Answer  B is  correct.  
The  client  receiving  Pitocin  should  be  monitored  for  decelera-tions. There  is  no  association  with  Pitocin  use  and  hypoglycemia,  maternal  hyper-reflexia,  or fetal movement; therefore, answers A, C, and D are incorrect.  







156.  Answer D is  correct.  
Fetal  development  depends  on  adequate  nutrition and  insulin  regulation.  Insulin  needs  increase  during  the  second  and  third trimesters,  insulin  requirements  do  not  moderate  as  the  pregnancy progresses,  and  elevated  human  choronic  gonadotrophin  elevates  insulin needs, not decreases them; therefore, answers A, B, and C are incorrect.  







157.  Answer A  is  correct.  
A calm  environment  is  needed  to  prevent  seizure activity.  Any  stimulation  can  precipitate  seizures.  Obtaining  a  diet  history should  be  done  later,  and  administering  an  analgesic  is  not  indicated because  there  is  no  data  in  the  stem  to  indicate  pain.  Therefore,  answers  B and  C are  incorrect.  Assessing  the  fetal  heart  tones  is  important,  but  this  is not the highest priority in this situation as stated in answer D.  







158.  Answer  A is  correct. 
 The  client  who  is  age  42  is  at  risk  for  fetal  anomalies  such as  Down  syndrome  and  other  chromosomal  aberrations.  Answers  B,  C,  and  D are  incorrect NURSING PAPERS  because  the  client  is  not  at  higher  risk  for  respiratory  distress syndrome or pathological jaundice, and Turner’s syndrome is a genetic disorder.  







159.  Answer  C  is  correct.  

The  client  with  a  missed  abortion  will  have  induction  of labor.  Prostin  E.  is  a  form of  prostaglandin  used  to  soften  the  cervix. Magnesium sulfate  is  used  for  preterm labor  and  preeclampsia,  calcium gluconate  is  the  antidote  for  mag-nesium sulfate,  and  Parlodel  is  a  dopamine receptor  stimulant  used  to  treat  Parkinson’s  disease;  therefore,  answers  A,  B, and D are incorrect. Parlodel was used at one time to dry breast milk.  









160.  Answer  A is  correct. 

 The  client’s  blood  pressure  and  urinary  output  are  within  normal limits.  The  only  alteration  from  normal  is  the  decreased  deep  tendon  reflexes.  The nurse  should  continue  to  monitor  the  blood  pressure  and  check  the  magnesium  level. The  therapeutic  level  is  4.8–9.6mg/dL.  Answers  B,  C,  and  D  are  incorrect  because there  is  no  need  to  stop  the  infusion  at  this  time  or  slow  the  rate.  Calcium  gluconate  is the antidote for magnesium sulfate, but there is no data to indicate toxicity.  








161.  Answer  C  is  correct.  Autosomal  recessive  disorders  can  be  passed  from  the parents  to  the  infant.  If  both  parents  pass  the  trait,  the  child  will  get  two  abnormal genes  and  the  disease  results.  Parents  can  also  pass  the  trait  to  the  infant. Answer  A  is  incorrect  because,  to  have  an  affected  newborn,  the  parents  must be  carriers.  Answer  B  is  incorrect  because  both  parents  must  be  carriers. Answer  D  is  incorrect  because  the  parents  might  have  affected  children  









162.  Answer  D  is  correct.  

Alpha  fetoprotein  is  a  screening  test  done  to  detect  neural tube  defects  such  as  spina  bifida.  The  test  is  not  mandatory,  as  stated  in  answer A.  It  does  not  indicate  cardiovascular  defects,  and  the  mother’s  age  has  no bearing on the need for the test, so answers B and C are incorrect.  







163.  Answer  B  is  correct.  During  pregnancy,  the  thyroid  gland  triples  in  size.  This makes  it  more  difficult  to  regulate  thyroid  medication.  Answer  A  is  incorrect because  there  could  be  a  need  for  thyroid  medication  during  pregnancy.  Answer C is  incorrect  because  the  thyroid  function  does  not  slow.  Fetal  growth  is  not arrested if thyroid medication is con-tinued, so answer D is incorrect.  









164.  Answer  C  is  correct.  Cyanosis  of  the  feet  and  hands  is  acrocyanosis.  This  is  a  normal finding  1  minute  after  birth.  An  apical  pulse  should  be  120–160,  and  the  baby  should have  muscle  tone,  making  answers  A  and  B  incorrect.  Jaundice  immediately  after  birth is pathological jaundice and is abnormal, so answer D is incorrect.  








165.  Answer A  is  correct. 

 Clients  with  sickle  cell  crises  are  treated  with  heat, hydration,  oxygen,  and  pain  relief.  Fluids  are  increased,  not  decreased. Blood  transfusions  are  usually  not  required,  and  the  client  can  be  delivered vaginally; thus, answers B, C, and D are incorrect.  







166.  Answer A  is  correct.  

Before  ultrasonography,  the  client  should  be  taught to  drink  plenty  of  fluids  and  not  void.  The  client  may  ambulate,  an  enema  is not  needed,  and  there  is  no  need  to  withhold  food  for 8  hours.  Therefore, answers B, C, and D are incorrect.  







167.  Answer  D  is  correct.DOWNLOAD NURSING PAPERS APPS   

By  1  year  of  age,  the  infant  is  expected  to  triple  his birth weight. Answers A, B, and C are incorrect because they are too low.  









168.  Answer  B  is  correct. 
 A  nonstress  test  is  done  to  evaluate  periodic  movement  of  the fetus.  It  is  not  done  to  evaluate  lung  maturity  as  in  answer  A.  An  oxytocin  challenge test  shows  the  effect  of  contractions  on  fetal  heart  rate  and  a  nonstress  test  does  not measure neurological well-being of the fetus, so answers C and D are incorrect.  








169.  Answer  D  is  correct.  Hypospadias  is  a  condition  in  which  there  is  an opening  on  the  under  side  of  the  penis.  Answers  A,  B,  and  C  do  not describe hypospadias therefore they are incorrect.  









170.  Answer A  is  correct.  Transition  is  the  time  during  labor when  the  client loses  concen-tration  due  to  intense  contractions.  Potential  for injury  related to  precipitate  delivery  has  nothing  to  do  with  the  dilation  of  the  cervix,  so answer B  is  incorrect.  There  is  no  data  to  indicate  that  the  client  has  had anesthesia or fluid volume deficit, making answers C and D incorrect. 










 171.  Answer  C  is  correct.  Varicella  is  chicken  pox.  This  herpes  virus  is  treated  with  antiviral  medications.  The  client  is  not  treated  with  antibiotics  or  anticoagulants  as  stated  in answers  A  and  D.  The  client  might  have  a  fever  before  the  rash  appears,  but  when  the rash appears, the temperature is usually gone, so answer B is incorrect.  










172.  Answer  B  is  correct.  Clients  with  chest  pain  can  be  treated  with  nitroglycerin,  a beta  blocker  such  as  propanolol,  or  Varapamil.  There  is  no  indication  for  an antibiotic  such  as  Ampicillin,  so  answers  A,  C,  and  D  are  incorrect.   







173.  Answer  B  is  correct.  
Anti-inflammatory  drugs  should  be  taken  with  meals  to  avoid stomach  upset.  Answers  A,  C,  and  D  are  incorrect.  Clients  with  rheumatoid  arthritis should  exercise,  but  not  to  the  point  of  pain.  Alternating  hot  and  cold  is  not  necessary, especially  because  warm,  moist  soaks  are  more  useful  in  decreasing  pain.  Weightbearing activities such as walking are useful but is not the best answer for the stem.  








174.  Answer D is  correct.  Morphine  is  contraindicated  in  clients  with  gallbladder disease  and  pancreatitis  because  morphine  causes  spasms  of  the  Sphenter of  Oddi.  Meperidine,  Mylanta,  and  Cimetadine  are  ordered  for pancreatitis, making answers A, B, and C incorrect.  









175.  Answer  B  is  correct.  Hallucinogenic  drugs  can  cause  hallucinations.  Continuous observation  is  ordered  to  prevent  the  client  from  harming  himself  during  withdrawal. Answers  A,  C,  and  D  are  incorrect  because  hallucinogenic  drugs  don’t  create  both stimulant  and  depressant  effects  or  produce  severe  respiratory  depression.  However, they do produce psychological dependence rather than physical dependence.  









176.  Answer  B  is  correct.  Barbiturates  create  a  sedative  effect.  When  the  client  stops tak-ing  barbiturates,  he  will  experience  tachycardia,  diarrhea,  and  tachpnea. Answer  A  is  incorrect  even  though  depression  and  suicidal  ideation  go  along  with barbiturate  use;  it  is  not  the  priority.  Muscle  cramps  and  abdominal  pain  are vague  symptoms  that  could  be  associated  with  other  problems.  Tachycardia  is associated with stopping bar-biturates, but euphoria is not.  










177.  Answer A  is  correct.  

If  the  fetal  heart  tones  are  heard  in  the  right  upper abdomen,  the  infant  is  in  a  breech  presentation.  If  the  infant  is  positioned  in the  right  occipital  ante-rior presentation,  the  FHTs  will  be  located  in  the  right lower quadrant,  so  answer B  is  incorrect.  If  the  fetus  is  in  the  sacral  position, the  FHTs  will  be  located  in  the  center of  the  abdomen,  so  answer C is incorrect.  If  the  FHTs  are  heard  in  the  left  lower abdomen,  the  infant  is  most likely in the left occipital transverse position, making answer D incorrect.  








178.  Answer  D  is  correct.  Asthma  is  the  presence  of  bronchiolar  spasms.  This  spasm can  be  brought  on  by  allergies  or  anxiety.  Answer  A  is  incorrect  because  the primary  phys-iological  alteration  is  not  inflammation.  Answer  B  is  incorrect because  there  is  the  pro-duction  of  abnormally  viscous  mucus,  not  a  primary alteration. Answer C is incorrect because infection is not primary to asthma.  









179.  Answer  A is  correct.  

The  client  with  mania  is  seldom sitting  long  enough  to  eat and  burns  many  calories  for  energy.  Answer  B  is  incorrect  because  the  client should  be  treated  the  same  as  other  clients.  Small  meals  are  not  a  correct option  for  this  client.  Allowing  her  into  the  kitchen  gives  her  privileges  that  other clients do not have and should not be allowed, so answer D is incorrect.  







180.  Answer  B  is  correct.  Bryant’s  traction  is  used  for  fractured  femurs  and dislocated  hips.  The  hips  should  be  elevated  15°  off  the  bed.  Answer  A  is incorrect  because  the  hips  should  not  be  resting  on  the  bed.  Answer  C  is incorrect  because  the  hips  should  not  be  above  the  level  of  the  body.  Answer  D is  incorrect  because  the  hips  and  legs  should  not  be  flat  on  the  bed.   






181.  Answer B is  correct.  

Herpes  zoster is  shingles.  Clients  with  shingles  should be  placed  in  contact  precautions.  Wearing  gloves  during  care  will  prevent transmission  of  the  virus.  Covering  the  lesions  with  a  sterile  gauze  is  not necessary,  antibiotics  are  not  prescribed  for  herpes  zoster,  and  oxygen  is  not necessary for shingles; therefore, answers A, C, and D are incorrect.  








182.  Answer  B is  correct.  
A  trough  level  should  be  drawn  30  minutes  before  the  third  or  fourth dose. The times in answers A, C, and D are incorrect times to draw blood levels.  









183.  Answer  B  is  correct.  
The  client  using  a  diaphragm  should  keep  the  diaphragm  in  a cool  location.  Answers  A,  C,  and  D  are  incorrect.  She  should  refrain  from  leaving  the diaphragm  in  longer  than  8  hours,  not  4  hours.  She  should  have  the  diaphragm resized when she gains or loses 10 pounds or has abdominal surgery.  








184.  Answer  C  is  correct.  Mothers  who  plan  to  breastfeed  should  drink  plenty  of liquids,  and  four  glasses  is  not  enough  in  a  24-hour  period.  Wearing  a  support bra  is  a  good  practice  for  the  mother  who  is  breastfeeding  as  well  as  the  mother who  plans  to  bot-tle-feed,  so  answer  A  is  incorrect.  Expressing  milk  from the breast  will  stimulate  milk  production,  making  answer  B  incorrect.  Allowing  the water  to  run  over  the  breast  will  also  facilitate  ―letdown,‖  when  the  milk  begins  to be produced; thus, answer D is incorrect.  









185.  Answer  A is  correct.  

The  facial  nerve  is  cranial  nerve  VII.  If  damage  occurs,  the client  will  experience  facial  pain.  The  auditory  nerve  is  responsible  for  hearing  loss and  tinni-tus,  eye  movement  is  controlled  by  the  Trochear  or  C  IV,  and  the olfactory nerve con-trols smell; therefore, answers B, C, and D are incorrect.  







186.  Answer  B  is  correct.  Clients  taking  Pyridium  should  be  taught  that  the  medication  will turn  the  urine  orange  or  red.  It  is  not  associated  with  diarrhea,  mental  confusion,  or changes  in  taste;  therefore,  answers  A,  C,  and  D  are  incorrect.  Pyridium  can  also cause a yellowish color to skin and sclera if taken in large doses.  







187.  Answer  B  is  correct.  Accutane  is  contraindicated  for  use  by  pregnant  clients because  it  causes  teratogenic  effects.  Calcium  levels,  apical  pulse,  and creatinine levels are not necessary; therefore, answers A, C, and D are incorrect.  






188.  Answer  D  is  correct.  Clients  taking  Acyclovir  should  be  encouraged  to  drink  plenty  of fluids  because  renal  impairment  can  occur.  Limiting  activity  is  not  necessary,  nor  is eating  a  high-carbohydrate  diet.  Use  of  an  incentive  spirometer  is  not  specific  to clients taking Acyclovir; therefore, answers A, B, and C are incorrect.  








189.  Answer A  is  correct.  

Clients  who  are  pregnant  should  not  have  a  CAT because  radioactive  isotopes  are  used.  However,  clients  with  a  titanium  hip replacement  can  have  an  MRI,  or CAT  scan  so  answer B  is  incorrect.  No antibiotics  are  used  with  this  test  and  the  client  should  remain  still  only when instructed, so answers C and D are not specific to this test. 








 190.  Answer D is  correct.  

Clients  taking  Amphotericin  B  should  be  monitored  for liver,  renal,  and  bone  marrow  function  because  this  drug  is  toxic  to  the kidneys  and  liver,  and  causes  bone  marrow  suppression.  Jaundice  is  a  sign of  liver toxicity  and  is  not  specific  to  the  use  of  Amphotericin  B.  Changes  in vision  are  not  related,  and  nausea  is  a  side  effect,  not  a  sign  of  toxicity;  nor  is urinary  frequency.  Thus,  answers  A,  B,  and  C are  incorrect.   




AIIMS PATNA 2015 STAFF NURSE QUESTION PAPERS





191.  Answer  C  is  correct.  

The  client  with  chest  pain  should  be  seen  first  because this  could  indicate  a  myocardial  infarction.  The  client  in  answer  A  has  a  blood glucose  within  normal  limits.  The  client  in  answer  B  is  maintained  on  blood pressure medica-tion. The client in answer D is in no distress.  235 








192.  Answer  B  is  correct.  Pancreatic  enzymes  should  be  given  with  meals  for  optimal effects.  These  enzymes  assist  the  body  in  digesting  needed  nutrients.  Answers  A,  C, and D are incorrect methods of administering pancreatic enzymes.  








193.  Answer  C  is  correct. 
 The  lens  allows  light  to  pass  through  the  pupil  and  focus light  on  the  retina.  The  lens  does  not  stimulate  the  retina,  assist  with  eye movement, or magnify small objects, so answers A, B, and D are incorrect.  







194.  Answer  C  is  correct. 
 Miotic  eyedrops  constrict  the  pupil  and  allow  aqueous  humor  to drain  out  of  the  Canal  of  Schlemm.  They  do  not  anesthetize  the  cornea,  dilate  the pupil, or paralyze the muscles of the eye, making answers A, B, and D incorrect.  







195.  Answer A  is  correct.  
When  using  eyedrops,  allow  5  minutes  between  the two  medica-tions;  therefore,  answer B  is  incorrect.  These  medications  can be  used  by  the  same  client  but  it  is  not  necessary  to  use  a  cyclopegic  with these medications, making answers C and D incorrect.  








196.  Answer B is  correct.  

Clients  with  color  blindness  will  most  likely  have problems  dis-tinguishing  violets,  blues,  and  green.  The  colors  in  answers  A, C, and D are less com-monly affected.  







197.  Answer  D  is  correct.  
The  client  with  a  pacemaker  should  be  taught  to  count and  record  his  pulse  rate.  Answers  A,  B,  and  C  are  incorrect.  Ankle  edema  is  a sign  of  right-sided  congestive  heart  failure.  Although  this  is  not  normal,  it  is  often present  in  clients  with  heart  disease.  If  the  edema  is  present  in  the  hands  and face,  it  should  be  reported.  Checking  the  blood  pressure  daily  is  not  necessary for  these  clients.  The  client  with  a  pacemaker  can  use  a  microwave  oven,  but  he should stand about 5 feet from the oven while it is operating.  







198.  Answer A  is  correct. 
 Clients  who  are  being  retrained  for bladder  control should  be  taught  to  withhold  fluids  after  about  7  p.m.,  or  1900.  The  times  in answers B, C, and D are too early in the day.  







199.  Answer  D  is  correct.  Cranberry  juice  is  more  alkaline  and,  when  metabolized  by  the body,  is  excreted  with  acidic  urine.  Bacteria  does  not  grow  freely  in  acidic  urine. Increasing  intake  of  meats  is  not  associated  with  urinary  tract  infections,  so  answer  A is  incorrect.  The  client  does  not  have  to  avoid  citrus  fruits  and  pericare  should  be done, but hydrogen peroxide is drying, so answers B and C are incorrect.  








200.  Answer  C  is  correct. 

 NPH  insulin  peaks  in  8–12  hours,  so  a  snack  should  be  offered at  that  time.  NPH  insulin  onsets  in  90–120  minutes,  so  answer  A  is  incorrect.  Answer B  is  untrue  because  NPH  insulin  is  time  released  and  does  not  usually  cause  sudden hypoglycemia. Answer D is incorrect, but the client should eat a bedtime snack.




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