PRACTICE QUESTIONS PART =4

NCLEX      PRACTICE QUESTIONS. PART =4 

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1. The nurse is caring for a client with systemic lupus erythematosis (SLE). The major complication associated with systemic lupus erythematosis is: 

❍ A. Nephritis 

❍ B. Cardiomegaly 

❍ C. Desquamation 

❍ D. Meningitis 

2. A client with benign prostatic hypertrophy has been started on Proscar (finasteride). The nurse’s discharge teaching should include: 

❍ A. Telling the client’s wife not to touch the tablets 

❍ B. Explaining that the medication should be taken with meals 

❍ C. Telling the client that symptoms will improve in 1–2 weeks 

❍ D. Instructing the client to take the medication at bedtime, to prevent nocturia 

3. A 5-year-old child is hospitalized for correction of congenital hip dysplasia. During the assessment of the child, the nurse can expect to find the presence of: 

❍ A. Scarf sign 

❍ B. Harlequin sign 

❍ C. Cullen’s sign 

❍ D. Trendelenburg sign 

4. Which diet is associated with an increased risk of colorectal cancer? 

❍ A. Low protein, complex carbohydrates 

❍ B. High protein, simple carbohydrates 

❍ C. High fat, refined carbohydrates 

❍ D. Low carbohydrates, complex proteins

5. The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid: 

❍ A. Holding the infant 

❍ B. Offering a pacifier 

❍ C. Providing a mobile 

❍ D. Offering sterile water 

6. The physician has diagnosed a client with cirrhosis characterized by asterixis. If the nurse assesses the client with asterixis, he can expect to find: 

❍ A. Irregular movement of the wrist 

❍ B. Enlargement of the breasts 

❍ C. Dilated veins around the umbilicus 

❍ D. Redness of the palmar surfaces 

7. The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by: 

❍ A. Giving the medication as ordered 

❍ B. Providing extra water with the medication 

❍ C. Giving the medication with an antacid 

❍ D. Requesting an alternate form of the medication 

8. A client with an inguinal hernia asks the nurse why he should have surgery when he has had a hernia for years. The nurse understands that surgery is recommended to: 

❍ A. Prevent strangulation of the bowel 

❍ B. Prevent malabsorptive disorders 

❍ C. Decrease secretion of bile salts 

❍ D. Increase intestinal motility 

9. The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron? 

❍ A. Tomatoes 

❍ B. Legumes 

❍ C. Dried fruits 

❍ D. Nuts

10. A client is admitted with suspected acute pancreatitis. Which lab finding confirms the diagnosis? 

❍ A. Blood glucose of 260mg/dL 

❍ B. White cell count of 21,000cu/mm 

❍ C. Platelet count of 250,000cu/mm 

❍ D. Serum amylase level of 600 units/dL 

11. The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to: ❍ A. Periodically lie prone without a neck pillow ❍ B. Sleep only in dorsal recumbent position ❍ C. Rest in supine position with his head elevated ❍ D. Sleep on either side, but keep his back straight 

12. The physician has ordered Dilantin (phenytoin) 100mg intravenously for a client with generalized tonic clonic seizures. The nurse should administer the medication: ❍ A. Rapidly with an IV push ❍ B. With IV dextrose ❍ C. Slowly over 2–3 minutes ❍ D. Through a small vein 

13. The nurse is planning dietary changes for a client following an episode of acute pancreatitis. Which diet is suitable for the client? ❍ A. Low calorie, low carbohydrate ❍ B. High calorie, low fat 

❍ C. High protein, high fat 

❍ D. Low protein, high carbohydrate 

14. A client is admitted with a diagnosis of polycythemia vera. The nurse should closely monitor the client for: ❍ A. Increased blood pressure ❍ B. Decreased respirations ❍ C. Increased urinary output ❍ D. Decreased oxygen saturation

15. A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she: ❍ A. Uses an electric blanket at night ❍ B. Dresses in extra layers of clothing ❍ C. Applies a heating pad to her feet ❍ D. Takes a hot bath morning and evening 

16. The nurse caring for a client with a closed head injury obtains an intracranial pressure (ICP) reading of 17mmHg. The nurse recognizes that: ❍ A. The ICP is elevated and the doctor should be notified. ❍ B. The ICP is normal; therefore, no further action is needed. ❍ C. The ICP is low and the client needs additional IV fluids. ❍ D. The ICP reading is not as reliable as the Glascow coma scale. 

17. A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer? ❍ A. A family history of laryngeal cancer ❍ B. Chronic inhalation of noxious fumes ❍ C. Frequent straining of the vocal cords ❍ D. A history of frequent alcohol and tobacco use 

18. The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia? ❍ A. Difficulty in breathing after exertion ❍ B. Numbness and tingling in the extremities ❍ C. A faster than usual heart rate ❍ D. Feelings of lightheadedness 

19. A client with rheumatoid arthritis is beginning to develop flexion contractures of the knees. The nurse should tell the client to: ❍ A. Lie prone and let her feet hang over the mattress edge ❍ B. Lie supine, with her feet rotated inward ❍ C. Lie on her right side and point her toes downward ❍ D. Lie on her left side and allow her feet to remain in a neutral position

20. The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to: ❍ A. Speak using words that rhyme ❍ B. Repeat words or phrases used by others ❍ C. Include irrelevant details in conversation ❍ D. Make up new words with new meanings 

21. The mother of a 1-year-old with sickle cell anemia wants to know why the condition didn’t show up in the nursery. The nurse’s response is based on the knowledge that: ❍ A. There is no test to measure abnormal hemoglobin in newborns. ❍ B. Infants do not have insensible fluid loss before a year of age. ❍ C. Infants rarely have infections that would cause them to have a sickling crises. ❍ D. The presence of fetal hemoglobin protects the infant. 

22. Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis? ❍ A. Brushing the teeth ❍ B. Drinking a glass of juice ❍ C. Holding a cup of coffee ❍ D. Brushing the hair

23. A client with B negative blood requires a blood transfusion during surgery. If no B negative blood is available, the client should be transfused with: ❍ A. A positive blood ❍ B. B positive blood ❍ C. O negative blood ❍ D. AB negative blood 

24. The nurse notes that a post-operative client’s respirations have dropped from 14 to 6 breaths per minute. The nurse administers Narcan (naloxone) per standing order. Following administration of the medication, the nurse should assess the client for: 

❍ A. Pupillary changes 

❍ B. Projectile vomiting ❍ C. Wheezing respirations ❍ D. Sudden, intense pain

25. A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh: ❍ A. 14 pounds ❍ B. 18 pounds ❍ C. 25 pounds ❍ D. 30 pounds 

26. A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms? ❍ A. Tossed salad with oil and vinegar dressing ❍ B. Baked potato with sour cream and chives ❍ C. Cream of tomato soup and crackers ❍ D. Mixed fruit and yogurt 

27. A client with congestive heart failure has been receiving digoxia (Laxoxin). Which finding indicates that the medication is having a desired effect? ❍ A. Increased urinary output ❍ B. Stabilized weight ❍ C. Improved appetite 
❍ D. Increased pedal edema 

28. Which play activity is best suited to the gross motor skills of the toddler? 

❍ A. Coloring book and crayons 

❍ B. Ball 
❍ C. Building cubes 
❍ D. Swing set 

29. A client in labor admits to using alcohol throughout the pregnancy. The most recent use was the day before. Based on the client’s history, the nurse should give priority to assessing the newborn for: 
❍ A. Respiratory depression 
❍ B. Wide-set eyes 
❍ C. Jitteriness 
❍ D. Low-set ears 

30. The physician has ordered Basalgel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include: 

❍ A. Constipation 
❍ B. Urinary retention 
❍ C. Diarrhea 
❍ D. Confusion

31. A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is: 
❍ A. Loss of sensation in the lower extremities 
❍ B. Back pain that lessens when standing 
❍ C. Decreased urinary output 
❍ D. Pulsations in the periumbilical area 

32. The nurse is caring for a client hospitalized with nephotic syndrome. Based on the client’s treatment, the nurse should: 
❍ A. Limit the number of visitors 
❍ B. Provide a low-protein diet 
❍ C. Discuss the possibility of dialysis 
❍ D. Offer the client additional fluids 

33. A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has: 
❍ A. Low blood pressure 
❍ B. A slow, regular pulse

❍ C. Warm, flushed skin 

❍ D. Increased urination 

34. A 5-month-old infant is admitted to the ER with a temperature of 103.6°F and irritability. The mother states that the child has been listless for the past several hours and that he had a seizure on the way to the hospital. A lumbar puncture confirms a diagnosis of bacterial meningitis. The nurse should assess the infant for: ❍ A. Periorbital edema ❍ B. Tenseness of the anterior fontanel ❍ C. Positive Babinski reflex 

❍ D. Negative scarf sign 

35. A client with AIDS is admitted with a diagnosis of pneumocystis carinii pneumonia. Shortly after his admission, he becomes confused and disoriented. He attempts to pull out his IV and refuses to wear an O2 mask. Based upon his mental status, the priority nursing diagnosis is: ❍ A. Social isolation ❍ B. Risk for injury ❍ C. Ineffective coping ❍ D. Anxiety

36. The doctor has ordered Ampicillin 100mg every 6 hours IV push for an infant weighing 7kg. The suggested dose for infants is 25–50mg/kg/day in equally divided doses. The nurse should: ❍ A. Give the medication as ordered ❍ B. Give half the amount ordered ❍ C. Give the ordered amount q 12 hrs. ❍ D. Check the order with the doctor 

37. An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately? 

❍ A. Hourly urinary output of 40–50cc ❍ B. Bright red urine with many clots ❍ C. Dark red urine with few clots ❍ D. Requests for pain med q 4 hrs.

 
38. Which statement by the parent of a child with sickle cell anemia indicates an understanding of the disease? ❍ A. “The pain he has is due to the presence of too many red blood cells.” ❍ B. “He will be able to go snow-skiing with his friends as long as he stays warm.” ❍ C. “He will need extra fluids in summer to prevent dehydration.” ❍ D. “There is very little chance that his brother will have sickle cell.” 

39. A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to: ❍ A. Determine whether the ear infection has affected her hearing ❍ B. Make sure that she has taken all the antibiotic 

❍ C. Document that the infection has completely cleared ❍ D. Obtain a new prescription, in case the infection recurs 

40. A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of Sydenham’s chorea? ❍ A. Irregular movements of the extremities and facial grimacing ❍ B. Painless swellings over the extensor surfaces of the joints ❍ C. Faint areas of red demarcation over the back and abdomen ❍ D. Swelling, inflammation, and effusion of the joints

41. A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to: ❍ A. Prevent insensible water loss ❍ B. Provide a moist environment with oxygen at 30% ❍ C. Prevent dehydration and reduce fever ❍ D. Liquefy secretions and relieve laryngeal spasm 

42. The nurse is suctioning the tracheostomy of an adult client. The recommended pressure setting for performing tracheostomy suctioning on the adult client is: ❍ A. 40–60mmHg ❍ B. 60–80mmHg ❍ C. 80–120mmHg ❍ D. 120–140mmHg 

43. A client is admitted with a diagnosis of myxedema. An initial assessment of the client would reveal the symptoms of: ❍ A. Slow pulse rate, weight loss, diarrhea, and cardiac failure ❍ B. Weight gain, lethargy, slowed speech, and decreased respiratory rate 

❍ C. Rapid pulse, constipation, and bulging eyes ❍ D. Decreased body temperature, weight loss, and increased respirations 

44. Which statement describes the contagious stage of varicella? ❍ A. The contagious stage is 1 day before the onset of the rash until the appearance of vesicles. ❍ B. The contagious stage lasts during the vesicular and crusting stages of the lesions. ❍ C. The contagious stage is from the onset of the rash until the rash disappears. ❍ D. The contagious stage is 1 day before the onset of the rash until all the lesions are crusted. 

45. The nurse is reviewing the results of a sweat test taken from a child with cystic fibrosis. Which finding supports the client’s diagnosis? ❍ A. A sweat potassium concentration less than 40mEq/L ❍ B. A sweat chloride concentration greater than 60mEq/L ❍ C. A sweat potassium concentration greater than 40mEq/L ❍ D. A sweat chloride concentration less than 40mEq/L

46. A client in labor has an order for Demerol (meperidine) 75 mg. IM to be administered 10 minutes before delivery. The nurse should: ❍ A. Wait until the client is placed on the delivery table and administer the medication ❍ B. Question the order ❍ C. Give the medication IM during the delivery to prevent pain from the episiotomy ❍ D. Give the medication as ordered

47. Which of the following statements describes Piaget’s stage of concrete operations? ❍ A. Reflex activity proceeds to imitative behavior. ❍ B. The ability to see another’s point of view increases. ❍ C. Thought processes become more logical and coherent. ❍ D. The ability to think abstractly leads to logical conclusion. 

48. A client admitted to the psychiatric unit claims to be the Pope and insists that he will not be kept away from his subjects. The most likely explanation for the client’s delusion is: ❍ A. A reaction formation 

❍ B. A stressful event ❍ C. Low self-esteem ❍ D. Overwhelming anxiety 

49. Which of the following statements reflects Kohlberg’s theory of the moral development of the preschool-age child? ❍ A. Obeying adults is seen as correct behavior. ❍ B. Showing respect for parents is seen as important. ❍ C. Pleasing others is viewed as good behavior. 

❍ D. Behavior is determined by consequences. 

50. The nurse is caring for an 8-year-old following a routine tonsillectomy. Which finding should be reported immediately? ❍ A. Reluctance to swallow 

❍ B. Drooling of blood-tinged saliva ❍ C. An axillary temperature of 99°F ❍ D. Respiratory stridor

51. The nurse is admitting a client with a suspected duodenal ulcer. The client will most likely report that his abdominal discomfort decreases when he: ❍ A. Avoids eating ❍ B. Rests in a recumbent position ❍ C. Eats a meal or snack 

❍ D. Sits upright after eating 

52. The nurse is assessing a newborn in the well-baby nursery. Which finding should alert the nurse to the possibility of a cardiac anomaly? ❍ A. Diminished femoral pulses ❍ B. Harlequin’s sign ❍ C. Circumoral pallor ❍ D. Acrocyanosis 

53. A 2-year-old is hospitalized with a diagnosis of Kawasaki’s disease. A severe complication of Kawasaki’s disease is: ❍ A. The development of Brushfield spots ❍ B. The eruption of Hutchinson’s teeth ❍ C. The development of coxa plana ❍ D. The creation of a giant aneurysm 

54. The charge nurse is formulating a discharge teaching plan for a client with mild preeclampsia. The nurse should give priority to: 
❍ A. Teaching the client to report a nosebleed 
❍ B. Instructing the client to maintain strict bed rest ❍ C. Telling the client to notify the doctor of pedal edema 
❍ D. Advising the client to avoid sodium sources in the diet 

55. The nurse is preparing to discharge a client who is taking an MAOI. The nurse should instruct the client to: 
❍ A. Wear protective clothing and sunglasses when outside 
❍ B. Avoid over-the-counter cold and hayfever preparations 
❍ C. Drink at least eight glasses of water a day 
❍ D. Increase his intake of high-quality protein 

56. Which of the following meal selections is appropriate for the client with celiac disease? ❍ A. Toast, jam, and apple juice ❍ B. Peanut butter cookies and milk ❍ C. Rice Krispies bar and milk ❍ D. Cheese pizza and Kool-Aid

57. A client with hyperthyroidism is taking lithium carbonate to inhibit thyroid hormone release. Which complaint by the client should alert the nurse to a problem with the client’s medication? ❍ A. The client complains of blurred vision. ❍ B. The client complains of increased thirst and increased urination. ❍ C. The client complains of increased weight gain over the past year. ❍ D. The client complains of rhinorrhea. 

58. The physician has ordered intravenous fluid with potassium for a client admitted with gastroenteritis and dehydration. Before adding potassium to the intravenous fluid, the nurse should: ❍ A. Assess the urinary output ❍ B. Obtain arterial blood gases ❍ C. Perform a dextrostick 

❍ D. Obtain a stool culture 

59. A 2-month-old infant has just received her first Tetramune injection. The nurse should tell the mother that the immunization: ❍ A. Will need to be repeated when the child is 4 years of age ❍ B. Is given to determine whether the child is susceptible to pertussis ❍ C. Is one of a series of injections that protects against diphtheria, pertussis, tetanus and H.influenza b ❍ D. Is a one-time injection that protects against measles, mumps, rubella and varicella 

60. A client with Addison’s disease has been receiving glucocorticoid therapy. Which finding indicates a need for dosage adjustment? ❍ A. Dryness of the skin and mucus membranes ❍ B. Dizziness when rising to a standing position ❍ C. A weight gain of 6 pounds in the past week ❍ D. Difficulty in remaining asleep

61. The nurse is caring for an obstetrical client in early labor. After the rupture of membranes, the nurse should give priority to: ❍ A. Applying an internal monitor ❍ B. Assessing fetal heart tones ❍ C. Assisting with epidural anesthesia ❍ D. Inserting a Foley catheter 

62. The physician has prescribed Synthroid (levothyroxine) for a client with myxedema. Which statement indicates that the client understands the nurse’s teaching regarding the medication? 

❍ A. “I will take the medication each morning after breakfast.” 

❍ B. “I will check my heart rate before taking the medication.” 

❍ C. “I will report visual disturbances to my doctor.” 

❍ D. “I will stop the medication if I develop gastric upset.”

63. The nurse is caring for a client with a radium implant for the treatment of cervical cancer. While caring for the client with a radioactive implant, the nurse should: 

❍ A. Provide emotional support by spending additional time with the client 

❍ B. Stand at the foot of the bed when talking to the client 

❍ C. Avoid handling items used by the client 

❍ D. Wear a badge to monitor the amount of time spent in the client’s room 

64. The nurse is caring for a client hospitalized with bipolar disorder, manic phase who is taking lithium. Which of the following snacks would be best for the client with mania? 

❍ A. Potato chips 

❍ B. Diet cola 

❍ C. Apple 

❍ D. Milkshake 

65. The physician has prescribed imipramine (ToFranil) for a client with depression. The nurse should continue to monitor the client’s affect because the maximal effects of tricyclic antidepressant medication do not occur for: 

❍ A. 48–72 hours 

❍ B. 5–7 days 

❍ C. 2–4 weeks 

❍ D. 3–6 months

66. An elderly client with glaucoma has been prescribed Timoptic eyedrops. Timoptic should be used with caution in clients with a history of: 

❍ A. Diabetes 

❍ B. Gastric ulcers 

❍ C. Emphysema 

❍ D. Pancreatitis 

67. A 2-year-old is hospitalized with suspected intussusception. Which finding is associated with intussusception? 

❍ A. “Currant jelly” stools 

❍ B. Projectile vomiting 

❍ C. “Ribbonlike” stools 

❍ D. Palpable mass over the flank 

68. Which of the following findings would be expected in the infant with biliary atresia? 

❍ A. Rapid weight gain and hepatomegaly 

❍ B. Dark stools and poor weight gain 

❍ C. Abdominal distention and poor weight gain 

❍ D. Abdominal distention and rapid weight gain

69. A client is being treated for cancer with linear acceleration radiation. The physician has marked the radiation site with a blue marking pen. The nurse should: 

❍ A. Remove the unsightly markings with acetone or alcohol 

❍ B. Cover the radiation site with loose gauze dressing 

❍ C. Sprinkle baby powder over the radiated area 

❍ D. Refrain from using soap or lotion on the marked area

70. The blood alcohol concentration of a client admitted following a motor vehicle accident is 460mg/dL. The nurse should give priority to monitoring the client for: 

❍ A. Loss of coordination 

❍ B. Respiratory depression 

❍ C. Visual hallucinations 

❍ D. Tachycardia

71. The nurse is caring for a client with acromegaly. Following a transphenoidal hypophysectomy, the nurse should: 

❍ A. Monitor the client’s blood sugar 

❍ B. Suction the mouth and pharynx every hour 

❍ C. Place the client in low Trendelenburg position 

❍ D. Encourage the client to cough 

72. A client newly diagnosed with diabetes is started on Precose (acarbose). The nurse should tell the client that the medication should be taken: 

❍ A. 1 hour before meals 

❍ B. 30 minutes after meals 

❍ C. With the first bite of a meal 

❍ D. Daily at bedtime 

73. A client with a deep decubitus ulcer is receiving therapy in the hyperbaric oxygen chamber. Before therapy, the nurse should: 

❍ A. Apply a lanolin-based lotion to the skin 

❍ B. Wash the skin with water and pat dry 

❍ C. Cover the area with a petroleum gauze 

❍ D. Apply an occlusive dressing to the site 

74. The physician has ordered DDAVP (desmopressin acetate) for a client with diabetes insipidus. Which finding indicates that the medication is having its intended effect? 

❍ A. The client’s appetite has improved. 

❍ B. The client’s morning blood sugar was 120mg/dL. 

❍ C. The client’s urinary output has decreased. 

❍ D. The client’s activity level has increased. 

75. A client with pregnancy-induced hypertension is scheduled for a C-section. Before surgery, the nurse should keep the client: 

❍ A. On her right side 

❍ B. Supine with a small pillow 

❍ C. On her left side 

❍ D. In knee chest position

76. The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin? 

❍ A. Prothrombin time 

❍ B. Clot retraction time 

❍ C. Partial thromboplastin time 

❍ D. Bleeding time 

77. An adolescent client with cystic acne has a prescription for Accutane (isotretinoin). Which lab work is needed before beginning the medication? 

❍ A. Complete blood count 

❍ B. Clean-catch urinalysis 

❍ C. Liver profile 

❍ D. Thyroid function test 

78. Twenty-four hours after an uncomplicated labor and delivery, a client’s WBC is 12,000cu/mm. The elevation in the client’s WBC is most likely an indication of: 

❍ A. A normal response to the birth process 

❍ B. An acute bacterial infection 

❍ C. A sexually transmitted virus 

❍ D. Dehydration from being NPO during labor 

79. The home health nurse is visiting a client who plans to deliver her baby at home. Which statement by the client indicates an understanding regarding screening for phenylketonuria (PKU)? 

❍ A. “I will need to take the baby to the clinic within 24 hours of delivery to have blood drawn.” 

❍ B. “I will need to schedule a home visit for PKU screening when the baby is 3 days old.” 

❍ C. “I will remind the midwife to save a specimen of cord blood for the PKU test.” 

❍ D. “I will have the PKU test done when I take her for her first immunizations.”

80. The physician has ordered intubation and mechanical ventilation for a client with periods of apnea following a closed head injury. Arterial blood gases reveal a pH of 7.47, PCO2 of 28, and HCO3 of 23. These findings indicate that the client has: 

❍ A. Respiratory acidosis

❍ B. Respiratory alkalosis 

❍ C. Metabolic acidosis 

❍ D. Metabolic alkalosis 

81. A client is diagnosed with emphysema and cor pulmonale. Which findings are characteristic of cor pulmonale? 

❍ A. Hypoxia, shortness of breath, and exertional fatigue 

❍ B. Weight loss, increased RBC, and fever 

❍ C. Rales, edema, and enlarged spleen 

❍ D. Edema of the lower extremities and distended neck veins 

82. A client with a laryngectomy returns from surgery with a nasogastric tube in place. The primary reason for placement of the nasogastric tube is to: 

❍ A. Prevent swelling and dysphagia 

❍ B. Decompress the stomach 

❍ C. Prevent contamination of the suture line 

❍ D. Promote healing of the oral mucosa 

83. The physician orders the removal of an in-dwelling catheter the second postoperative day for a client with a prostatectomy. The client complains of pain and dribbling of urine the first time he voids. The nurse should tell the client that: 

❍ A. Using warm compresses over the bladder will lessen the discomfort. 

❍ B. Perineal exercises will be started in a few days to help relieve his symptoms. 

❍ C. If the symptoms don’t improve, the catheter will have to be reinserted. 

❍ D. His complaints are common and will improve over the next few days. 

84. A client with a right lobectomy is being transported from the intensive care unit to a medical unit. The nurse understands that the client’s chest drainage system: 

❍ A. Can be disconnected from suction if the chest tube is clamped
❍ B. Can be disconnected from suction, but the chest tube should remain unclamped
❍ C. Must remain connected by means of a portable suction
❍ D. Must be kept even with the client’s shoulders during the transport

85. A nurse is caring for a client with a myocardial infarction. The nurse recognizes that the most common complication in the client following a myocardial infarction is: 

❍ A. Right ventricular hypertrophy 

❍ B. Cardiac dysrhythmia 

❍ C. Left ventricular hypertrophy 

❍ D. Hyperkalemia 

86. A client develops a temperature of 102°F following coronary artery bypass surgery. The nurse should notify the physician immediately because elevations in temperature: 

❍ A. Increase cardiac output 

❍ B. Indicate cardiac tamponade 

❍ C. Decrease cardiac output 

❍ D. Indicate graft rejection 

87. The chart indicates that a client has expressive aphasia following a stroke. The nurse understands that the client will have difficulty with: 

❍ A. Speaking and writing 

❍ B. Comprehending spoken words 

❍ C. Carrying out purposeful motor activity 

❍ D. Recognizing and using an object correctly 

88. A client receiving Parnate (tranylcypromine) is admitted in a hypertensive crisis. Which food is most likely to produce a hypertensive crisis when taken with the medication? 

❍ A. Processed cheese 

❍ B. Cottage cheese 

❍ C. Cream cheese 

❍ D. Cheddar cheese 

89. To prevent deformities of the knee joints in a client with an exacerbation of rheumatoid arthritis, the nurse should: 

❍ A. Tell the client to remain on bed rest until swelling subsides 

❍ B. Discourage passive range of motion because it will cause further swelling

 ❍ C. Encourage motion of the joint within the limits of pain 

❍ D. Tell the client she will need joint immobilization for 2–3 weeks

90. The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should: 

❍ A. Apply a clean dressing to protect the wound 

❍ B. Cover the exposed visera with a sterile saline gauze 

❍ C. Gently replace the abdominal contents 

❍ D. Cover the area with a petroleum gauze 

91. A client is admitted to the emergency room with multiple injuries. What is the proper sequence for managing the client? 

❍ A. Assess for head injuries, control hemorrhage, establish an airway, prevent hypovolemic shock 

❍ B. Control hemorrhage, prevent hypovolemic shock, establish an airway, assess for head injuries 

❍ C. Establish an airway, control hemorrhage, prevent hypovolemic shock, assess for head injuries 

❍ D. Prevent hypovolemic shock, assess for head injuries, establish an airway, control hemorrhage 

92. The nurse is teaching the mother of a child with attention deficit disorder regarding the use of Ritalin (methylphenidate). The nurse recognizes that the mother understands her teaching when she states the importance of: 

❍ A. Offering high-calorie snacks 

❍ B. Watching for signs of infection 

❍ C. Observing for signs of oversedation 

❍ D. Using a sunscreen with an SPF of 30 

93. A home health nurse has several elderly clients in her case load. Which of the following clients is most likely to be a victim of elder abuse? 

❍ A. A 76-year-old female with Alzheimer’s disease 

❍ B. A 70-year-old male with diabetes mellitus 

❍ C. A 64-year-old female with a hip replacement 

❍ D. A 72-year-old male with Parkinson’s disease 

94. A camp nurse is applying sunscreen to a group of children enrolled in swim classes. Chemical sunscreens are most effective when applied: 

❍ A. Just before sun exposure 

❍ B. 5 minutes before sun exposure 

❍ C. 15 minutes before sun exposure 

❍ D. 30 minutes before sun exposure 

95. The physician has made a diagnosis of “shaken child” syndrome for a 13-month-old who was brought to the emergency room after a reported fall from his highchair. Which finding supports the diagnosis of “shaken child” syndrome? 

❍ A. Fracture of the clavicle 

❍ B. Periorbital bruising 

❍ C. Retinal hemorrhages 

❍ D. Fracture of the humerus 

96. A post-operative client has an order for Demerol (meperidine) 75mg and Phenergan (promethazine) 25mg IM every 3–4 hours as needed for pain. The combination of the two medications produces a/an: 

❍ A. Agonist effect 

❍ B. Synergistic effect 

❍ C. Antagonist effect 

❍ D. Excitatory effect 

97. Which obstetrical client is most likely to have an infant with respiratory distress syndrome? 

❍ A. A 28-year-old with a history of alcohol use during the pregnancy 

❍ B. A 24-year-old with a history of diabetes mellitus 

❍ C. A 30-year-old with a history of smoking during the pregnancy 

❍ D. A 32-year-old with a history of pregnancy-induced hypertension 

98. A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Nursing care should include: 

❍ A. Releasing the traction for 5 minutes each shift 

❍ B. Loosening the pins if the client complains of headache 

❍ C. Elevating the head of the bed 90° 

❍ D. Performing sterile pin care as ordered 

99. The nurse is assessing a client following a coronary artery bypass graft (CABG). The nurse should give priority to reporting: 

❍ A. Chest drainage of 150mL in the past hour 

❍ B. Confusion and restlessness 

❍ C. Pallor and coolness of skin

❍ D. Urinary output of 40mL per hour

100. Before administering a client’s morning dose of Lanoxin (digoxin), the nurse checks the apical pulse rate and finds a rate of 54. The appropriate nursing intervention is to: 

❍ A. Record the pulse rate and administer the medication 

❍ B. Administer the medication and monitor the heart rate 

❍ C. Withhold the medication and notify the doctor 

❍ D. Withhold the medication until the heart rate increases 

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