PRACTICE QUESTIONS PART = 5


NCLEX PRACTICE QUESTIONS PART =5 



[Q.NO.151-250]








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 151. A client with breast cancer is returned to the room following a right total mastectomy. The nurse should:   

❍ A.  Elevate the client’s right arm on pillows   
❍ B.  Place the client’s right arm in a dependent sling   
❍ C.  Keep the client’s right arm on the bed beside her   
❍ D.  Place the client’s right arm across her body  



152. The physician has ordered nitroglycerin buccal tablets for a client with stable angina. The nurse knows that nitroglyerin:  
❍ A.  Slows contractions of the heart   
❍ B.  Dilates coronary blood vessels   
❍ C.  Increases the ventricular fill time   
❍ D.  Strengthens contractions of the heart   


153. A trauma client is admitted to the emergency room following a motor vehicle accident. Examination reveals that the left side of the chest moves inward when the client inhales. The finding is suggestive of:  


      ❍ A.  Pneumothorax   
        ❍ B.  Mediastinal shift   
               ❍ C.  Pulmonary contusion
❍ D.  Flail chest   




154. A neurological consult has been ordered for a pediatric client with sus-pected absence seizures. The client with absence seizures can be expect-ed to have:   

❍ A.  Short, abrupt muscle contractions   
❍ B.  Quick, severe bilateral jerking movements   
      ❍ C.  Abrupt loss of muscle tone 
❍ D.  Brief lapse in consciousness  




 155. To decrease the likelihood of seizures and visual hallucinations in a client with alcohol withdrawal, the nurse should:   

❍ A.  Keep the room darkened by pulling the curtains  
 ❍ B.  Keep the light over the bed on at all times   
❍ C.  Keep the room quiet and dim the lights   
❍ D.  Keep the television or radio turned on  




156. A client with schizoaffective disorder is exhibiting Parkinsonian symp-toms. Which medication is responsible for the development of Parkinsonian symptoms?   

❍ A.  Zyprexa (olanzapine)   
❍ B.  Cogentin (benzatropine mesylate)   
❍ C.  Benadryl (diphenhydramine)   
❍ D.  Depakote (divalproex sodium) 





   157. Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?   

❍ A.  Playing video games
❍ B.  Swimming   
  ❍ C.  Working crossword puzzles    ❍ D.  Playing slow-pitch softball  



158. The home health nurse is scheduled to visit four clients. Which client should she visit first?   
❍ A. A client with acquired immunodeficiency syndrome with a cough and reported temperature of 101°F   
❍ B. A client with peripheral vascular disease with an ulcer on the left lower leg   
❍ C. A client with diabetes mellitus who needs a diabetic control index drawn   
❍ D.  A client with an autograft to burns of the chest and trunk  





 159. The glycosylated hemoglobin of a 40-year-old client with diabetes melli-tus is 2.5%. The nurse understands that:   


❍ A.  The client can have a higher-calorie diet.   
❍ B.  The client has good control of her diabetes.   
❍ C.  The client requires adjustment in her insulin dose.   
❍ D.  The client has poor control of her diabetes.   





160. A dexamethasone-suppression test has been ordered for a client with severe depression. The purpose of the dexamethasone suppression test is to:   
❍ A.  Determine which social intervention will be best for the client   
❍ B. Help diagnose the seriousness of the client’s clinical symptoms   
❍ C. Determine whether the client will benefit from electrocon-vulsive therapy
❍ D.  Reverse the depressive symptoms the client is experiencing 




  
161. The physician has ordered Stadol (butorphanol) for a post-operative client. The nurse knows that the medication is having its intended effect if the client:   

❍ A.  Is asleep 30 minutes after the injection   
❍ B.  Asks for extra servings on his meal tray   
❍ C.  Has an increased urinary output   
❍ D.  States that he is feeling less nauseated 





  162. The mother of a child with cystic fibrosis tells the nurse that her child makes ―snoring‖ sounds when breathing. The nurse is aware that many children with cystic fibrosis have:   

❍ A.  Choanal atresia
❍ B.  Nasal polyps   

❍ C.  Septal deviations   

❍ D.  Enlarged adenoids  




 
163. The nurse is caring for a client with full thickness burns to the lower half of the torso and lower extremities. During the emergent phase of injury, the primary nursing diagnosis would focus on:   

 ❍ A.  Ineffective airway clearance 

❍ B.  Impaired gas exchange  

❍ C.  Fluid volume deficit   

❍ D.  Pain   





164. A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?   

❍ A.  Prilosec (omeprazole)   

❍ B.  Synthroid (levothyroxine)   

❍ C.  Premarin (conjugated estrogens)   

❍ D.  Lipitor (atorvastatin) 




  
165. Which activity is suitable for a client who suffered an uncomplicated myocardial infarction (MI) 2 days ago?   

❍ A.  Sitting in the bedside chair for 15 minutes three times a day   

❍ B. Remaining on strict bed rest with bedside commode privileges  

❍ C.  Ambulating in the room and hall as tolerated   

❍ D. Sitting on the bedside for 5 minutes three times a day with assistance   





166. The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates the client understands his new diet?   

❍ A.  Cornflakes, whole milk, banana, and coffee   

❍ B.  Scrambled eggs, bacon, toast, and coffee   

❍ C.  Oatmeal, apple juice, dry toast, and coffee   

❍ D.  Pancakes, ham, tomato juice, and coffee  


 167. An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?   

❍ A.  The child should not play on his rocking horse.   

❍ B.  Applying warm compresses will decrease pain.   

❍ C.  Diapering should be avoided for 1–2 weeks.   

❍ D.  The child will need a special diet to promote healing.   





168. An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:   

❍ A.  Keep crackers at the bedside for eating before she arises   

❍ B.  Drink a glass of whole milk before going to sleep at night   

❍ C.  Skip breakfast but eat a larger lunch and dinner   

❍ D. Drink a glass of orange juice after adding a couple of teaspoons of sugar   





169. The nurse is making assignments for the day. The staff consists of an RN, a novice RN, an LPN, and a nursing assistant. Which client should be assigned to the RN?   

❍ A.  A client with peptic ulcer disease   

❍ B.  A client with skeletal traction for a fractured femur   

❍ C.  A client with an abdominal cholecystectomy   

❍ D.  A client with an esophageal tamponade  

 170. A child with Tetralogy of Fallot is scheduled for a modified Blalock Taussig procedure. The nurse understands that the surgery will:   

❍ A.  Reverse the direction of the blood flow   

❍ B.  Allow better blood supply to the lungs   

❍ C.  Relieve pressure on the ventricles   

❍ D.  Prevent the need for further correction 








  171. The nurse has taken the blood pressure of a client hospitalized with methi-cillin-resistant staphylococcus aureus (MRSA). Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
❍ A. The nurse leaves the stethoscope in the client’s room for future use.   


❍ B. The nurse cleans the stethoscope with alcohol and returns it to the exam room.   


❍ C. The nurse uses the stethoscope to assess the blood pressure of other assigned clients.  

❍ D. The nurse cleans the stethoscope with water, dries it, and returns it to the nurse’s station.  

  172. The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:   

❍ A. The medication will be needed only during times of rapid growth.   ❍ B.  The medication will be needed

throughout the child’s lifetime.



❍ C. The medication schedule can be arranged to allow for drug holidays.   ❍ D.  The medication is given one time daily every other day.   






173. A client with diabetes mellitus has a prescription for Glucotrol XL (glip-izide). The client should be instructed to take the medication:  

❍ A.  At bedtime   

❍ B.  With breakfast   

❍ C.  Before lunch   

❍ D.  After dinner  

 174. The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthe-nia gravis?   

❍ A.Visual disturbances, including diplopia   

❍ B. Ascending paralysis and loss of motor function   

❍ C. Cogwheel rigidity and loss of coordination   

❍ D.  Progressive weakness that is worse at the day’s end   







175. A preterm infant with sepsis is receiving Gentamycin (garamycin). Which physiological alteration places the preterm infant at increased risk for toxicity related to aminoglycoside therapy?   

❍ A.  Lack of subcutaneous fat deposits  

❍ B.  Immature central nervous system   

❍ C.  Presence of fetal hemoglobin   

❍ D.  Immaturity of the renal system  






 176. The nurse is teaching the parents of an infant with osteogenesis imper-fecta. The nurse should tell the parents:   

❍ A.  That the infant will need daily calcium supplements   
❍ B.  That it is best to lift the infant by the buttocks when diapering   
❍ C.  That the condition is a temporary one  
 ❍ D.  That only the bones of the infant are affected by the disease  





 177. The home health nurse is visiting an elderly client following a hip replacement. Which finding requires further teaching? 
  
❍ A.  The client shares her apartment with a cat.   
❍ B.  The client has a grab bar near the commode.   
❍ C.  The client usually sits on a soft, low sofa.   
❍ D.  The client wears supportive shoes with nonskid soles.   






178. Physician’s orders for a client with acute pancreatitis include the follow-ing: strict NPO and nasogastric tube to low intermittent suction. The nurse recognizes that witholding oral intake will:   
❍ A.  Reduce the secretion of pancreatic enzymes   
❍ B.  Decrease the client’s need for insulin   
❍ C.  Prevent the secretion of gastric acid   
❍ D.  Eliminate the need for pain medication  






 179. A client with diverticulitis is admitted with nausea, vomiting, and dehy-dration. Which finding suggests a complication of diverticulitis?   
❍ A.  Pain in the left lower quadrant   
❍ B.  Boardlike abdomen   
❍ C.  Low-grade fever   
❍ D.  Abdominal distention   





180. The physician has ordered Vancocin (vancomycin) 500mg IV every 6 hours for a client with MRSA. The medication should be administered:   

❍ A.  IV push   
❍ B.  Over 15 minutes   
❍ C.  Over 30 minutes   
❍ D.  Over 60 minutes   




181. The diagnostic work-up of a client hospitalized with complaints of pro-gressive weakness and fatigue confirm a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:   

❍ A.  Prostigmine (neostigmine)   
❍ B.  Atropine (atropine sulfate)   
❍ C.  Didronel (etidronate)   
❍ D.  Tensilon (edrophonium)  





 182. A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?   
❍ A.  High calorie, high protein, high fat   
❍ B.  High calorie, high carbohydrate, low protein   
❍ C.  High calorie, low carbohydrate, high fat   
❍ D.  High calorie, high protein, low fat   






183. The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?  

 ❍ A. Patching one of the eyes to help strengthen the ocular muscles   
❍ B. Providing suckers and pinwheels to help strengthen tongue movement   
❍ C.  Providing musical tapes to provide auditory training   
❍ D. Encouraging play with a video game to improve muscle coordination   








184. A client is admitted with a diagnosis of duodenal ulcer. A common com-plaint of the client with a duodenal ulcer is:   




❍ A.  Epigastric pain that is relieved by eating   

❍ B.  Weight loss   

❍ C.  Epigastric pain that is worse after eating   
❍ D.  Vomiting after eating   

185. A client with otosderosis is scheduled for a stapedectomy. Which finding suggests a complication involving the seventh cranial nerve?   


 ❍ A.  Diminished hearing   
     ❍ B.  Sensation of fullness in the ear  
 ❍ C.  Inability to move the tongue side to side   
❍ D.  Changes in facial sensation  




186. At the 6-week check-up, the mother asks when she can expect the baby to sleep all night. The nurse should tell the mother that most infants begin to sleep all night by age:  

 ❍ A.  1 month   
❍ B.  2 months   
❍ C.  3–4 months  
 ❍ D.  5–6 months 


187.  A client with emphysema has been receiving oxygen at 3L per minute by  nasal cannula. The nurse knows that the goal of the client’s oxygen therapy is achieved when the client’s PaO2 reading is:    
❍ A.  50–60mm Hg   
❍ B.  70–80mm Hg   
❍ C.  80–90mm Hg   
❍ D.  90–98mm Hg   







188.  A client with diabetes insipidus is receiving DDAVP (desmopressin acetate). Which lab finding indicates that the medication is having its  intended effect?   
❍ A.  Blood glucose 92mg/dL  
❍ B.  Urine specific gravity 1.020   ❍ C.  White blood count of 7,500   ❍ D.  Glycosylated hemoglobin 3.5mg/dL   





189. Which of the following pediatric clients is at greatest risk for latex allergy?      

❍ A. The child with a myelomeningocele   
❍ B. The child with epispadias   
❍ C. The child with coxa plana   
❍    D.  The child with rheumatic fever   





190.  The physician has ordered a serum aminophylline level for a client with   chronic obstructive lung disease. The nurse knows that the therapeutic  range for aminophylline is:    


❍ A.  1–3 micrograms/mL   
❍ B.  4–6 micrograms/mL   
❍ C.  7–9 micrograms/mL   
❍ D.  10–20 micrograms/mL   





191.  The nurse is developing a plan of care for a client with acromegaly. Which nursing diagnosis should receive priority?  

❍ A.  Alteration in body image related to change in facial features   
❍ B.  Risk for immobility related to joint pain   
❍ C. Risk for ineffective airway clearance related to obstruction of airway by tongue   
❍ D.  Sexual dysfunction related to altered hormone secretion





192.A client  with  acute  respiratory  distress  syndrome  (ARDS) is placed  on  mechanical  ventilation.  To  increase  ventilation  and perfusion to all areas of the lungs, the nurse should:  


❍ A.  Tell the client to inhale deeply during the inspiratory cycle  

❍ B.  Increase the positive end expiratory pressure (PEEP)  ❍ C.  Turn the client every hour 

❍  D.  Administer  medication  to  prevent  the  client  from fighting the ventilator  






193.  The  nurse  is  teaching  the  mother  of  a  child  with  cystic  fibrosis how to do chest percussion. The nurse should tell the mother to:  


❍ A.  Use the heel of her hand during percussion  
❍  B.  Change  the  child’s  position  every  20  minutes during percussion sessions  
❍ C.  Do percussion after the child eats and at bedtime  
❍ D.  Use cupped hands during percussion  










194.  A  client  with  Addison’s  disease  asks  the  nurse  what  he  needs  to know to manage his condition. The nurse should give priority to:  

❍  A.  Emphasizing  the  need  for  strict  adherence  to  his medication regimen  

❍  B.  Teaching  the  client  to  avoid  lotions  and  skin preparations containing alcohol  

❍ C.  Explaining the need to avoid extremes of temperature  

❍  D.  Assisting  the  client  to  choose  a  diet  that  contains adequate protein, fat, and carbohydrates  

195.  The  nurse  is  caring  for  a  client  following  the  removal  of  a  central  line catheter  when  the  client  suddenly  develops  dyspnea  and  complains  of substernal  chest  pain.  The  client  is  noticeably  confused  and  fearful.   Based  on  the  client’s  symptoms,  the  nurse  should  suspect  which compli-cation of central line use?  

❍ A.  Myocardial infarction  

❍ B.  Air embolus  

❍ C.  Intrathoracic bleeding  

❍  D.   Vagal  response   




  196. The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25mL. The nurse should:   

❍ A. Divide the amount into two injections and administer in each vastus lateralis muscle   

❍ B. Give the medication in one injection in the dorsogluteal muscle   ❍ C. Divide the amount in two injections and give one in the ven-trogluteal muscle and one in the vastus lateralis muscle   

❍ D. Give the medication in one injection in the ventrogluteal muscle   

197. A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:   

❍ A.  1 week   

❍ B.  2 weeks   

❍ C.  4 weeks   

❍ D.  6 weeks   





198. The physician is preparing to remove a central line. The nurse should tell the client to:   

❍ A.  Breathe normally   

❍ B.  Take slow, deep breaths   

❍ C.  Take a deep breath and hold it   

❍ D.  Breathe as quickly as possible   

199. Cystic fibrosis is an exocrine disorder that affects several systems of the body. The earliest sign associated with a diagnosis of cystic fibrosis is:   

❍ A.  Steatorrhea   

❍ B.  Frequent respiratory infections   

❍ C.  Increased sweating   

❍ D.  Meconium ileus   

200. A 3-year-old is immobilized in a hip spica cast. Which discharge instruc-tion should be given to the parents?   

❍ A.  Keep the bed flat, with a small pillow beneath the cast.   

❍ B.  Provide crayons and a coloring book for play activity.   

❍ C.  Increase her intake of high-calorie foods for healing.   

❍ D. Tuck a disposable diaper beneath the cast at the perineal opening







 201. The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?  



❍ A.  Temperature of 100°F   


❍ B.  Coolness and discoloration of the digits   

❍ C.  Complaints of pain   

❍ D.  Difficulty moving the digits   





202. Which client is at greatest risk for a caesarean section due to cephalopelvic disproportion (CPD)?   


❍ A.  A 25-year-old gravida 2, para 1   

❍ B.  A 30-year-old gravida 3, para 2   

❍ C.  A 17-year-old gravida 1, para 0   

❍ D.  A 32-year-old gravida 1, para 0   





203. The nurse is caring for a client with amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease). The nurse should give priority to:   

❍ A.  Assessing the client’s respiratory status   

❍ B.  Providing an alternate means of communication   

❍ C.  Referring the client and family to community support groups   

❍ D.  Instituting a routine of active range-of-motion exercises   

204. The physician has ordered Claforan (cefotaxime) 1g every 6 hours. The pharmacy sends the medication premixed in 100mL of D5W with instructions to infuse the medication over 1 hour. The IV set delivers 20 drops per milliliter. The nurse should set the IV rate at:  

 ❍ A.  50 drops per minute   

❍ B.  33 drops per minute   

❍ C.  25 drops per minute   

❍ D.  12 drops per minute  




 205. When assessing the urinary output of a client who has had extracorpore-al lithotripsy, the nurse can expect to find:   

❍ A.  Cherry-red urine that gradually becomes clearer   

❍ B.  Orange-tinged urine containing particles of calculi   

❍ C.  Dark red urine that becomes cloudy in appearance   

❍ D.  Dark, smoky-colored urine with high specific gravity  







206. A client scheduled for an atherectomy asks the nurse about the procedure. The nurse understands that :

❍ A.  Plaque will be removed by rotational or directional catheters.   

❍ B.  Plaque will be destroyed by a laser.  

❍ C. A balloon-tipped catheter will compress fatty lesions against the vessel wall.   

❍ D.  Medication will be used to dissolve the build-up of plaque.   





207.  An elderly client has a stage II pressure ulcer on her sacrum. During  assessment of the client’s skin, the nurse would expect to find:  


❍ A.  A deep crater with a nonpainful wound base   

❍ B.  A craterous area with a nonpainful wound base   

❍ C.  Cracks and blisters with redness and induration   

❍ D.  Nonblanchable redness with tenderness and pain  


 208. The physician has prescribed Cognex (tacrine) for a client with dementia. The nurse should monitor the client for adverse reactions, which include:  

❍ A.  Hypoglycemia   

❍ B.  Jaundice   

❍ C.  Urinary retention   

❍ D.  Tinnitus   





209. The suggested diet for a child with cystic fibrosis is one that contains:    
❍  A.  High calories, high protein, moderate fat   
❍  B.  High calories, moderate protein, low fat    
❍  C.  Moderate calories, moderate protein, moderate fat   

❍  D.  Low calories, high protein, low fat   


210. The physician has ordered a low-potassium diet for a client with acute  glomerulonephritis. Which snack is suitable for the client with potassium restrictions?    


❍ A.  Raisins  
 ❍ B.  Oranges   
❍ C.  Apricots   
❍ D.  Bananas  




 211. A client with increased intracranial pressure is placed on mechanical ven-tilation with hyperventilation. The nurse knows that the purpose of the hyperventilation is to:   
❍ A.  Prevent the development of acute respiratory failure   
❍ B.  Decrease cerebral blood flow   
❍ C.  Increase systemic tissue perfusion   
❍ D.  Prevent cerebral anoxia   



212. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:   


❍ A.  Withholding oral intake after midnight  
 ❍ B.  Telling the client that no special preparation is needed   
❍ C.  Explaining that a small dose of radioactive isotope will   be used  
❍ D.  Giving an oral suspension of glucose 1 hour before the test   


213. The nurse is preparing to give an oral potassium supplement. The nurse should give the medication: 

  
❍ A.  Without diluting it   
❍ B.  With 4oz. of juice   
❍ C.  With water only   
❍ D.  On an empty stomach   

214. A client with acute alcohol intoxication is being treated for hypomagne-semia. During assessment of the client, the nurse would expect to find:   
❍ A.  Bradycardia   
❍ B.  Negative Chvostek’s sign   
❍ C.  Hypertension   
❍ D.  Positive Trousseau’s sign   




215. The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true of the collection of cultures for cytomegalovirus?   
❍ A.  Stool cultures are preferred for definitive diagnosis.   
❍ B.  Pregnant caregivers may obtain cultures.   
❍ C.  Collection of one specimen is sufficient.   
❍ D.  Accurate diagnosis depends on fresh specimens.  







  216. A home health nurse has four clients assigned for morning visits. The nurse should give priority to visiting the client with: 

❍ A.  Diabetes mellitus with a nongranulated ulcer of the right foot   
❍ B. Congestive heart failure who reports coughing up frothy sputum   
❍ C. Hemiplegia with tenderness in the right flank and cloudy urine   
❍ D. Rheumatoid arthritis with soft tissue swelling behind the right knee   









217. Four clients are admitted to a medical unit. If only one private room is available, it should be assigned to:  



❍ A.  The client with ulcerative colitis


❍ B.  The client with neutropenia 

❍ C.  The client with cholecystitis 

❍ D.  The client with polycythemia vera  

 218. The RN is making assignments for the morning staff. Which client should be cared for by the RN?   

❍ A.  A client with hemianopsia   

❍ B.  A client with asterixis   

❍ C.  A client with akathesia   

❍ D.  A client with hemoptysis   





219. The nurse is reviewing the lab reports on several clients. Which one should be reported to the physician immediately?   

❍ A. A serum creatinine of 5.2mg/dL in a client with chronic renal failure   

❍ B.  A positive C reactive protein in a client with rheumatic fever   

❍ C.  A hematocrit of 52% in a client with gastroenteritis   

❍ D. A white cell count of 2,200cu/mm in a client taking Dilantin phenytoin  

 220. The following clients are to be assigned for daily care. The newly licensed nurse should not be assigned to provide primary care for the client with:   

❍ A.  Full-thickness burns of the abdomen and upper thighs   

❍ B.  A fractured hip scheduled for hip replacement   

❍ C.  Ileal reservoir following a cystectomy   

❍ D.  Noncardiogenic pulmonary edema (ARDS)  

 221. The RN is making assignments for clients hospitalized on a neurological unit. Which client should be assigned to the LPN?   

❍ A.  A client with a C3 injury immobilized by Crutchfield tongs 

❍ B.  A client with exacerbation of multiple sclerosis   

❍ C.  A client with a lumbar laminectomy   

❍ D.  A client with hemiplegia and a urinary tract infection   

222. The nurse has just received the change of shift report. The nurse should give priority to assessing the client with:   

❍ A.  A thoracotomy with 110mL of drainage in the past hour   

❍ B.  A cholecystectomy with an oral temperature of 100°F   

❍ C.  A transurethral prostatectomy who complains of urgency   to void  

❍ D. A stapedectomy who reports diminished hearing in the past hour   

223. A client with primary sclerosing cholangitis has received a liver trans-plant. The nurse should give priority to assessing the client for complica-tions. Which findings are associated with an acute rejection of the new liver?   

❍ A.  Increased jaundice and prolonged prothrombin time   

❍ B.  Fever and foul-smelling bile drainage   

❍ C.  Abdominal distention and clay-colored stools   

❍ D.  Increased uric acid and increased creatinine  









 224. The nurse is planning care for a client with adrenal insufficiency. Which nursing diagnosis should receive priority?




❍ A.  Fluid volume deficit

❍ B.  Sleep pattern disturbance

❍ C.  Altered nutrition

❍ D.  Alterations in body image   






225. 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.  Produces a cooling sensation when applied   
❍ C.  Can alter the function of the thyroid   
❍ D.  Produces a burning sensation when applied  


 










226. The physician has ordered Dilantin (phenytoin) for a client with general-ized seizures. When planning the client’s care the nurse should:   



❍ A.  Maintain strict intake and output  
 ❍ B.  Check the pulse before giving the medication   
❍ C.  Administer the medication 30 minutes before meals   
❍ D.  Provide oral hygiene and gum care every shift  









 



227. The nurse is caring for a client receiving Capoten (captopril). The nurse should be alert for adverse reactions to the drug, which include:   



❍ A.  Increased red cell count   
❍ B.  Decreased sodium level   
❍ C.  Decreased white cell count   
❍ D.  Increased calcium level 











  



228. 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.  Promote relaxation   
❍ C.  Prevent nausea   
❍ D.  Increase neutrophil counts   








229. The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:  



❍ A.  Pull the ear down and back   
❍ B.  Pull the ear straight out   ❍ C.  Pull the ear up and back   ❍ D.  Leave the ear undisturbed   

















230. A client with Lyme’s disease is being treated with Achromycin (tetracy-cline HCl). The nurse should tell the client that the medication will be rendered ineffective if taken with:


❍ A.  Antacids❍ B.  Salicylates❍ C.  Antihistamines❍ D.  Sedative-hypnotics  







 231. 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 complains of thirst.
❍ B.  The client has gained 4 pounds in the past 2 months.
❍ C.  The client complains of a sore throat.
❍ D.  The client naps throughout the day.   


232. The doctor has prescribed Claratin (loratidine) for a client with seasonal allergies. The feature that separates Claratin from other antihistamines such as diphenhydramine is that the medication:
❍ A.  Is nonsedating
❍ B.  Stimulates appetite
❍ C.  Is used for motion sickness   ❍ D.  Is less expensive
233. A 6-month-old is being treated for thrush with Nystatin (mycostatin) oral suspension. The nurse should administer the medication by:
❍ A.  Placing it in a small amount of applesauce
❍ B.  Using a cotton-tipped swab   ❍ C.  Adding it to the infant’s formula
❍ D.  Placing it in 2–3oz. of water
234. A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:
❍ A.  Orange juice
❍ B.  Water only
❍ C.  Milk
❍ D.  Apple juice
235. A child is admitted to the emergency room following ingestion of a bottle of Children’s Tylenol. The nurse is aware that Tylenol poisoning is treated with: ❍ A.  Acetylcysteine
❍ B.  Deferoximine
❍ C.  Edetate calcium disodium   ❍ D.  Activated charcoal  
 






236. The nurse knows that a client with right-sided hemiplegia understands teaching regarding ambulation with a cane if she states:   

❍ A.  ―I will hold the cane in my right hand.‖   

❍ B.  ―I will advance my cane and my right leg at the same time.‖   

❍ C.  ―I will be able to walk only by using a walker.‖   

❍ D.  ―I will hold the cane in my left hand.‖   

237. A nursing assistant assigned to care for a client receiving linear accelera-tor radium therapy for laryngeal cancer states, ―I don’t want to be assigned to that radioactive patient.‖ The best response by the nurse is to:   


❍ A.  Tell the nursing assistant that the client is not radioactive   

❍ B. Tell the nursing assistant to wear a radiation badge to detect the amount of radiation that she is receiving   

❍ C.  Instruct her regarding the use of a lead-lined apron   

❍ D.  Ask a co-worker to care for the client   

238. The nurse caring for a client scheduled for an angiogram should prepare the client for the procedure by telling him to expect:   

❍ A.  Dizziness as the dye is injected   

❍ B.  Nausea and vomiting after the procedure is completed   

❍ C. A decreased heart rate for several hours after the procedure is completed   

❍ D.  A warm sensation as the dye is injected   






239. A client with Parkinson’s disease complains of ―choking‖ when he swal-lows. Which intervention will improve the client’s ability to swallow?   

❍ A.  Withholding liquids until after meals   

❍ B.  Providing semiliquid foods when possible   

❍ C.  Providing a fully liquid diet   

❍ D.  Offering small, more frequent meals   

240. Which of the following statements best explains the rationale for placing the client in Trendelenburg position during the insertion of a central line catheter?   

❍ A.  It will facilitate catheter insertion.   

❍ B.  It will make the client more comfortable during the insertion.

❍ C.  It will prevent the occurrence of ventricular tachycardia.   

❍ D.  It will prevent the development of pulmonary emboli. 

241.The doctor has ordered the removal of a Davol drain. Which of the following instructions should the nurse give to the client before removing   the drain?       

❍ A.  The client should be told to breathe normally.   

❍ B. The client should be told to take two or three deep breaths as the drain is being removed.   

❍ C. The client should be told to hold his breath as the drain is being removed.   

❍ D. The client should breathe slowly as the drain is being removed.   




242. Which of the following findings is associated with right-sided heart failure?      

❍ A. Shortness of breath  

❍ B. Nocturnal polyuria   

❍ C. Daytime oliguria   

❍  D.  Crackles in the lungs   






243.  A client returns from surgery with a total knee replacement. Which of the  following findings requires immediate nursing intervention? 

❍ A.  Bloody drainage of 30mL from the Davol drain is present.   

❍ B.  The CPM is set on 90° flexion.  ❍ C.  The client is unable to ambulate to the bathroom.   

❍ D.  The client is complaining of muscle spasms.   


244.  Which of the following postpartal clients is at greatest risk for hemorrhage?   

❍ A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant   

❍ B. A gravida 1 para 0 with a history of polycystic ovarian disease   

❍ C.  A gravida 3 para 3 with a history of low–birth weight infants   

❍ D.  A gravida 4 para 3 with a Caesarean section   

245.  An infant with a ventricular septal defect is discharged with a prescription for lanoxin elixir 0.01mg PO q 12hrs. The bottle is labeled 0.10mg  per 1/2 tsp. The nurse should instruct the mother to:   

❍ A.  Administer the medication using a nipple   

❍ B. Administer the medication using the calibrated dropper in the bottle   

❍ C.  Administer the medication using a plastic baby spoon   

❍ D.  Administer the medication in a baby bottle with 1oz. of water

246. An elderly client with glaucoma is scheduled for a cholecystectomy. Which medication order should the nurse question?   

❍ A.  Meperidine   

❍ B.  Cimetadine   

❍ C.  Atropine   

❍ D.  Promethazine  


 247. Which instruction would not be included in the discharge teaching of the client receiving chlorpromazine (Thorazine)?   

❍ A. ―You will need to wear protective clothing or a sunscreen when you are outside.‖   

❍ B.  ―You will need to avoid eating aged cheese.‖   

❍ C. ―You should carry hard candy with you to decrease dryness of the mouth.‖   

❍ D.  ―You should report a sore throat immediately.‖   

248. An elderly client who experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help with decreasing the client’s confusion by:   

❍ A.  Assigning a nursing assistant to sit with him until he   falls asleep  

❍ B.  Allowing the client to room with another elderly client   

❍ C.  Administering a bedtime sedative   

❍ D.  Leaving a nightlight on during the evening and night shifts   

249. A 4-year-old is scheduled for a routine tonsillectomy. Which of the fol-lowing lab findings should be reported to the doctor?   

❍ A.  A hemoglobin of 12Gm   

❍ B.  A platelet count of 200,000   

❍ C.  A white blood cell count of 16,000   

❍ D.  A urine specific gravity of 1.010   

250. A client with psychotic depression is receiving haloperidol (Haldol). Which of the following adverse effects is associated with haloperidol?   


❍ A.  Akathisia   

❍ B.  Cataracts  

 ❍ C.  Diaphoresis   

❍ D.  Polyuria    







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