This is a review quiz for sharpening your critical thinking skills and preparing you for the NCLEX-PN exam.
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NCLEX-PN Review Quiz 1 (50 Questions)
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NCLEX-PN Review Quiz 1 (50 Questions)
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A. Expressing feelings of low self-worth
B. Discussing remorse and guilt for actions
C. Displaying dependence on others
D. Expressing anger toward others
3. The nurse is caring for a client following removal of the thyroid. Immediately post-op, the nurse should:
A. Maintain the client in a semi-Fowler’s position with the head and neck supported by pillows
B. Encourage the client to turn her head side to side, to promote drainage of oral secretions
C. Maintain the client in a supine position with sandbags placed on either side of the head and neck
D. Encourage the client to cough and breathe deeply every 2 hours, with the neck in a flexed position
A. Dairy products
B. Carbonated beverages
C. Refined sugars
D. Luncheon meats
5. A client is sent to the psychiatric unit for forensic evaluation after he is accused of arson. His tentative diagnosis is antisocial personality disorder. In reviewing the client’s record, the nurse could expect to find:
A. A history of consistent employment
B. A below-average intelligence
C. A history of cruelty to animals
D. An expression of remorse for his actions
6. The licensed vocational nurse may not assume the primary care for a client:
7. The physician has ordered dressings with Sulfamylon cream for a client with full-thickness burns of the hands and arms. Before dressing changes, the nurse should give priority to:
8. The nurse is teaching a group of parents about gross motor development of the toddler. Which behavior is an example of the normal gross motor skill of a toddler?
A. She can pull a toy behind her.
B. She can copy a horizontal line.
C. She can build a tower of eight blocks.
D. She can broad-jump.
9. A client hospitalized with a fractured mandible is to be discharged. Which piece of equipment should be kept on the client with a fractured mandible?
A. Wire cutters
B. Oral airway
D. Tracheostomy set
A. Record the heart rate and call the physician
B. Record the heart rate and administer the medication
C. Administer the medication and recheck the heart rate in 15 minutes
D. Hold the medication and recheck the heart rate in 30 minutes
11. A mother of a 3-year-old hospitalized with lead poisoning asks the nurse to explain the treatment for her daughter. The nurse’s explanation is based on the knowledge that lead poisoning is treated with:
A. Gastric lavage
B. Chelating agents
D. Activated charcoal
A. Elbow restraints
B. Full arm restraints
C. Wrist restraints
D. Mummy restraints
13. A client with glaucoma has been prescribed Timoptic (timolol) eyedrops. Timoptic should be used with caution in the client with a history of:
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
15. Which of the following is a common complaint of the client with end-stage renal failure?
A. Weight loss
C. Ringing in the ears
16. Which of the following medication orders needs further clarification?
A. Darvocet 65 mg PO q 4–6 hrs. PRN
B. Nembutal 100 mg PO at bedtime
C. Coumadin 10mg PO
D. Estrace 2 mg PO q day
17. The best diet for the client with Meniere’s syndrome is one that is:
A. High in fiber
B. Low in sodium
C. High in iodine
D. Low in fiber
18. 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
19. An 8-year-old admitted with an upper-respiratory infection has an order for O2 saturation via pulse oximeter. To ensure an accurate reading, the nurse should:
A. Place the probe on the child’s abdomen
B. Calibrate the oximeter at the beginning of each shift
C. Apply the probe and wait 15 minutes before obtaining a reading
D. Place the probe on the child’s finger
20. An infant with Tetralogy of Fallot is discharged with a prescription for lanoxin elixir. 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
21. The client scheduled for electroconvulsive therapy tells the nurse, “I’m so afraid. What will happen to me during the treatment?” Which of the following statements is most therapeutic for the nurse to make?
A. “You will be given medicine to relax you during the treatment.”
B. “The treatment will produce a controlled grand mal seizure.”
C. “The treatment might produce nausea and headache.”
D. “You can expect to be sleepy and confused for a time after the treatment.”
22. Which of the following skin lesions is associated with Lyme’s disease?
A. Bull’s eye rash
B. Papular crusts
23. Which of the following snacks would be suitable for the child with gluten-induced enteropathy?
A. Soft oatmeal cookie
B. Buttered popcorn
C. Peanut butter and jelly sandwich
D. Cheese pizza
B. Elevated temperature
C. Weight gain
D. Elevated blood pressure
25. Which information should be given to the client taking phenytoin (Dilantin)?
A. Taking the medication with meals will increase its effectiveness.
B. The medication can cause sleep disturbances.
C. More frequent dental appointments will be needed for special gum care.
D. The medication decreases the effects of oral contraceptives.
26. A client with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin?
A. Calcium gluconate
D. Protamine sulfate
27. The nurse is formulating a plan of care for a client with a cognitive disorder. Which activity is most appropriate for the client with confusion and short attention span?
A. Taking part in a reality-orientation group
B. Participating in unit community goal setting
C. Going on a field trip with a group of clients
D. Meeting with an assertiveness training group
28. The mother of a child with hemophilia asks the nurse which over-the-counter medication is suitable for her child’s joint discomfort. The nurse should tell the mother to purchase:
29. Which home remedy is suitable to relieve the itching associated with varicella?
A. The urinary meatus is on the dorsum of the penis.
B. The ureters will reflux urine into the kidneys.
C. The urinary meatus is on the top of the penis.
D. The bladder lies outside the abdominal cavity.
31. The recommended time for administering Zantac (ranitidine) is:
A. Before breakfast
C. After dinner
D. At bedtime
A. Pain associated with angina is relieved by rest.
B. Pain associated with myocardial infarction is always more severe.
C. Pain associated with angina is confined to the chest area.
D. Pain associated with myocardial infarction is referred to the left arm.
33. The nurse is developing a bowel-retraining plan for a client with multiple sclerosis. Which measure is likely to be least helpful to the client:
A. Limiting fluid intake to 1000 mL per day
B. Providing a high-roughage diet
C. Elevating the toilet seat for easy access
D. Establishing a regular schedule for toileting
34. The nurse is providing dietary teaching for a client with Meniere’s disease. Which statement indicates that the client understands the role of diet in triggering her symptoms?
A. “I can expect to see more problems with tinnitus if I eat a lot of dairy products.”
B. “I need to limit foods that taste salty or that contain a lot of sodium.”
C. “I can help control problems with vertigo if I avoid breads and cereals.”
D. “I need to eat fewer foods that are high in potassium, such as raisins and bananas.”
A. Facial swelling
B. Pulse deficits
C. Ankle edema
D. Diminished reflexes
36. An adolescent with borderline personality is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this client?
A. The client will remain in her room when feeling overwhelmed by sadness.
B. The client will request medication when feeling loss of emotional control.
C. The client will leave group activities to pace when feeling anxious.
D. The client will seek out a staff member to verbalize feelings of anger and sadness.
37. A client with angina has an order for nitroglycerin ointment. Before applying the medication, the nurse should:
A. Apply the ointment to the previous application
B. Obtain both a radial and an apical pulse
C. Remove the previously applied ointment
D. Tell the client he will experience pain relief in 15 minutes
38. The nurse is caring for a client who is unconscious following a fall. Which comment by the nurse will help the client become reoriented when he regains consciousness?
A. “I am your nurse and I will be taking care of you today.”
B. “Can you tell me your name and where you are?”
C. “I know you are confused right now, but everything will be alright.”
D. “You were in an accident that hurt your head. You are in the hospital.”
39. Following a generalized seizure, the nurse can expect the client to:
A. Be unable to move the extremities
B. Be drowsy and prone to sleep
C. Remember events before the seizure
D. Have a drop in blood pressure
40. A client with oxalate renal calculi should be taught to avoid eating:
41. A 6-year-old is diagnosed with Legg-Calve Perthes disease of the right femur. An important part of the child’s care includes instructing the parents:
A. To increase the amount of dietary protein
B. About exercises to strengthen affected muscles
C. About relaxation exercises to minimize pain in the joints
D. To prevent weight bearing on the affected leg
42. The nurse is assessing an infant with Hirschsprung’s disease. The nurse can expect the infant to:
A. Weigh less than expected for height and age
B. Have a scaphoid-shaped abdomen
C. Exhibit clubbing of the fingers and toes
D. Have hyperactive deep tendon reflexes
43. The physician has prescribed supplemental iron for a prenatal client. The nurse should tell the client to take the medication with:
44. The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
A. “I need to reduce my daily intake to 1,200 calories a day.”
B. “I need to drink at least a quart of milk a day.”
C. “I shouldn’t add salt when I am cooking.”
D. “I need to eat more protein and fiber each day.”
45. An elderly client is admitted to the psychiatric unit from the nursing home. Transfer information indicates that the client has become confused and disoriented, with behavioral problems. The client will also likely show a loss of ability in:
46. The physician has ordered an external monitor for a laboring client. If the fetus is in the left occipital posterior (LOP) position, the nurse knows that the ultrasound transducer will be located:
A. Near the symphysis pubis
B. Near the umbilicus
C. Over the fetal back
D. Over the fetal abdomen
47. A client develops tremors while withdrawing from alcohol. Which medication is routinely administered to lessen physiological effects of alcohol withdrawal?
A. Dolophine (methadone)
B. Klonopin (clonazepam)
C. Narcan (Naloxone)
D. Antabuse (disulfiram)
48. A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client’s breakfast should be served within:
A. 15 minutes
B. 20 minutes
C. 30 minutes
D. 45 minutes
49. A 10-year-old has an order for Demerol (meperidine) 35 mg IM for pain. The medication is available as Demerol 50mg per ml. How much should the nurse administer?
50. Which antibiotic is contraindicated for the treatment of infections in infants and young children?
A. Tetracyn (tetracycline)
B. Amoxil (amoxicillin)
C. Cefotan (cefotetan)
D. E-Mycin (erythromycin)
Answers and Rationale
1. Answer D is correct. The suicidal client has difficulty expressing anger toward others. The depressed suicidal client frequently expresses feelings of low self-worth, feelings of remorse and guilt, and a dependence on others; therefore, answers A, B, and C are incorrect.
2. Answer D is correct. Answers A, B, and C are incorrect because they contain lower amounts of potassium. (Note that the banana contains 450mg K+, the orange contains 235mg K+, the pear contains 208mg K+, and the apple contains 165mg K+.)
3. Answer A is correct. Following a thyroidectomy, the client should be placed in semi-Fowler’s position to decrease swelling that would place pressure on the airway. Answers B, C, and D are incorrect because they would increase the chances of post-operative complications that include bleeding, swelling, and airway obstruction.
4. Answer D is correct. Luncheon meats contain preservatives such as nitrites that have been linked to gastric cancer. Answers A, B, and C have not been found to increase the risk of gastric cancer; therefore, they are incorrect.
5. Answer C is correct. A history of cruelty to people and animals, truancy, setting fires, and lack of guilt or remorse are associated with a diagnosis of conduct disorder in children, which becomes a diagnosis of antisocial personality disorder in adults. Answer A is incorrect because the client with antisocial personality disorder does not hold consistent employment. Answer B is incorrect because the IQ is usually higher than average. Answer D is incorrect because of a lack of guilt or remorse for wrong-doing.
6. Answer C is correct. The licensed vocational nurse may not assume primary care of the client with a central venous access device. The licensed vocational nurse may care for the client in labor, the client post-operative client, and the client with bipolar disorder; therefore, answers A, B, and D are incorrect.
7. Answer A is correct. Sulfamylon produces a painful sensation when applied to the burn wound; therefore, the client should receive pain medication before dressing changes. Answers B, C, and D do not pertain to dressing changes for the client with burns, so they are incorrect.
8. Answer A is correct. According to the Denver Developmental Screening Test, the child can pull a toy behind her by age 2 years. Answers B, C, and D are not accomplished until ages 4–5 years; therefore, they are incorrect.
9. Answer A is correct. The client with a fractured mandible should keep a pair of wire cutters with him at all times to release the device in case of choking or aspiration. Answer B is incorrect because the wires would prevent insertion of an oral airway. Answer C is incorrect because it would be of no use in releasing the wires. Answer D is incorrect because it would be used only as a last resort in case of airway obstruction.
10. Answer B is correct. The infant’s apical heart rate is within the accepted range for administering the medication. Answers A, C, and D are incorrect because the apical heart rate is suitable for giving the medication.
11. Answer B is correct. Chelating agents are used to treat the client with poisonings from heavy metals such as lead and iron. Answers A and D are used to remove noncorrosive poisons; therefore, they are incorrect. Answer C prevents vomiting; therefore, it is an incorrect response.
12. Answer A is correct. The least restrictive restraint for the infant with cleft lip and cleft palate repair is elbow restraints. Answers B, C, and D are more restrictive and unnecessary; therefore, they are incorrect.
13. Answer C is correct. Beta blockers such as timolol (Timoptic) can cause bronchospasms in the client with chronic obstructive lung disease. Timoptic is not contraindicated for use in clients with diabetes, gastric ulcers, or pancreatitis; therefore, answers A, B, and C are incorrect.
14. Answer D is correct. Leaving a nightlight on during the evening and night shifts helps the client remain oriented to the environment and fosters independence. Answers A and B will not decrease the client’s confusion. Answer C will increase the likelihood of confusion in an elderly client.
15. Answer B is correct. Pruritis or itching is caused by the presence of uric acid crystals on the skin, which is common in the client with end-stage renal failure. Answers A, C, and D are not associated with end-stage renal failure.
16. Answer C is correct. There is no specified time or frequency for the ordered medication. Answers A, B, and C contain specified time and frequency.
17. Answer B is correct. A low-sodium diet is best for the client with Meniere’s syndrome. Answers A, C, and D do not relate to the care of the client with Meniere’s syndrome; therefore, they are incorrect.
18. Answer B is correct. Increased voiding at night is a symptom of right-sided heart failure. Answers A and D are incorrect because they are symptoms of left-sided heart failure. Answer C does not relate to the client’s diagnosis; therefore, it is incorrect.
19. Answer D is correct. The pulse oximeter should be placed on the child’s finger or earlobe because blood flow to these areas is most accessible for measuring oxygen concentration. Answer A is incorrect because the probe cannot be secured to the abdomen. Answer B is incorrect because it should be recalibrated before application. Answer C is incorrect because a reading is obtained within seconds, not minutes.
20. Answer B is correct. The medication should be administered using the calibrated dropper that comes with the medication. Answers A and C are incorrect because part or all of the medication could be lost during administration. Answer D is incorrect because part or all of the medication will be lost if the child does not finish the bottle.
21. Answer A is correct. The client will receive medication that relaxes skeletal muscles and produces mild sedation. Answers B and D are incorrect because such statements increase the client’s anxiety level. Nausea and headache are not associated with ECT; therefore, answer C is incorrect.
22. Answer A is correct. Lyme’s disease produces a characteristic annular or circular rash sometimes described as a “bull’s eye” rash. Answers B, C, and D are incorrect because they are not symptoms associated with Lyme’s disease.
23. Answer B is correct. The client with gluten-induced enteropathy experiences symptoms after ingesting foods containing wheat, oats, barley, or rye. Corn or millet are substituted in the diet. Answers A, C, and D are incorrect because they contain foods that worsen the client’s condition.
24. Answer B is correct. Neuroleptic malignant syndrome is an adverse reaction that is characterized by extreme elevations in temperature. Answers A and C are incorrect because they are expected side effects. Elevations in blood pressure are associated with reactions between foods containing tyramine and MAOI; therefore, answer D is incorrect.
25. Answer C is correct. Gingival hyperplasia is a side effect of phenytoin. The client will need more frequent dental visits. Answers A, B, and D do not apply to the medication; therefore, they are incorrect.
26. Answer D is correct. Protamine sulfate is given to counteract the effects of enoxaprin as well as heparin. Calcium gluconate is given to counteract the effects of magnesium sulfate; therefore, answer A is incorrect. Answer B is incorrect because aquamephyton is given to counteract the effects of sodium warfarin. Answer C is incorrect because methargine is given to increase uterine contractions following delivery.
27. Answer A is correct. Participating in reality orientation is the most appropriate activity for the client who is confused. Answers B, C, and D are incorrect because they are not suitable activities for a client who is confused.
28. Answer B is correct. The nurse should recommend acetaminophen for the child’s joint discomfort because it will have no effect on the bleeding time. Answers A, C, and D are all nonsteroidal anti-inflammatory medications that can prolong bleeding time; therefore, they are not suitable for the child with hemophilia.
29. Answer D is correct. Applying a paste of baking soda and water soothes the itching and helps to dry the vesicles. The use of baby powder is not recommended for either children; therefore, answer A is incorrect. Answers B and C are incorrect because hydrogen peroxide and saline will not relieve the itching and will prevent the vesicles from crusting.
30. Answer A is correct. The infant with hypospadias has altered patterns of urinary elimination caused by the location of the urinary meatus on the dorsum, or underside, of the penis. Answer B is incorrect because it refers to ureteral reflux. Answer C is incorrect because it refers to epispadias. Answer D is incorrect because it refers to exstrophy of the bladder.
31. Answer D is correct. Zantac (ranitidine) should be administered in one dose at bedtime or with meals. Answers A, B, and C have incorrect times for dosing.
32. Answer A is correct. Pain associated with angina is relieved by rest. Answer B is incorrect because it is not a true statement. Answer C is incorrect because pain associated with angina can be referred to the jaw, the left arm, and the back. Answer D is incorrect because pain from a myocardial infarction can be referred to areas other than the left arm.
33. Answer A is correct. It would not be helpful to limit the fluid intake of a client during bowel retraining. Answers B, C, and D would help the client; therefore, they are incorrect answers.
34. Answer B is correct. The client with Meniere’s disease should limit the intake of foods that contain sodium. Answers A, C, and D have no relationship to the symptoms of Meniere’s disease; therefore, they are incorrect.
35. Answer A is correct. The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Answer B is not related to the question; therefore, it is incorrect. Answer C is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, answer D is incorrect.
36. Answer D is correct. Verbalizing feelings of anger and sadness to a staff member is an appropriate therapeutic goal for the client with a risk of self-directed violence. Answers A and C place the client in an isolated situation to deal with her feelings alone; therefore, they are incorrect. Answer B is incorrect because it does not allow the client to ventilate her feelings.
37. Answer C is correct. The nurse should remove any remaining ointment before applying the medication again. Answer A is incorrect because it interferes with absorption. Answer B does not apply to the question of how to administer the medication; therefore, it is incorrect. Answer D is incorrect because the medication’s action is more immediate.
38. Answer D is correct. Telling the client what happened and where he is helps with reorientation. Answer A does not explain what happened to the client; therefore, it is incorrect. Answer B is not helpful because the client regaining consciousness will not know where he is; therefore, the answer is incorrect. The nurse should not offer false reassurances, such as “everything will be alright”; therefore, answer C is incorrect.
39. Answer B is correct. Following a generalized seizure, the client frequently experiences drowsiness and postictal sleep. Answer A is incorrect because the client is able to move the extremities. Answer C is incorrect because the client can remember events before the seizure. Answer D is incorrect because the blood pressure is elevated.
40. Answer A is correct. The client with oxylate renal calculi should avoid sources of oxylate, which include strawberries, rhubarb, and spinach. Answers B, C, and D are incorrect because they are not sources of oxylate.
41. Answer D is correct. The child with Legg-Calve Perthes disease should be prevented from bearing weight on the affected extremity until revascularization has occurred. Answer A is incorrect because it does not relate to the condition. Answers B and C are incorrect choices because the condition does not involve the muscles or the joints.
42. Answer B is correct. The child with Hirschsprung’s disease will have a scaphoid or hollowed abdomen. Answers A, C, and D do not apply to the condition; therefore, they are incorrect.
43. Answer B is correct. Iron supplements should be taken with a source of vitamin C to promote absorption. Answer A is incorrect because iron should not be taken with milk. Answer C is incorrect because high-fiber sources prevent the absorption of iron. Answer D is an inaccurate statement; therefore, it is incorrect.
44. Answer A is correct. The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus. Answers B, C, and D indicate that the client understands the nurse’s dietary teaching regarding obesity and hypertension; therefore, they are incorrect.
45. Answer B is correct. Confusion, disorientation, behavioral changes, and alterations in judgment are early signs of dementia. Answers A, C, and D do not relate to the question; therefore, they are incorrect.
46. Answer C is correct. In the left occipital posterior position, the heart sounds will be heard loudest through the fetal back. Answers A, B, and D are incorrect locations.
47. Answer B is correct. Benzodiazepines such as clonazepam and lorazepam are given to the client withdrawing from alcohol. Answer A is incorrect because methodone is given to the client withdrawing from opiates. Answer C is incorrect because naloxone is an antidote for narcotic overdose. Answer D is incorrect because disufiram is used in aversive therapy for alcohol addiction.
48. Answer C is correct. The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular insulin.
49. Answer C is correct. The nurse should administer 0.7mL of the medication. Answers A, B, and D are incorrect because the dosage is incorrect.
50. Answer A is correct. Tetracycline is contraindicated for use in infants and young children because it stains the teeth and arrests bone development. Answers B, C, and D are incorrect because they can be used to treat infections in infants and children.