NCLEX-PN Review Quiz 4 (50 Questions)

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NCLEX Practical Nursing Exam Review - 50 Questions
NCLEX Practical Nursing Exam Review - 50 Questions
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Introduction

Another set of 50 questions for your NCLEX-PN review.

Topics

Topics or concepts included in this exam are:

  • Various questions

Guidelines

  • Read each question carefully and choose the best answer.
  • You are given one minute per question. Spend your time wisely!
  • Answers and rationales (if any) are given below. Be sure to read them.
  • If you need more clarifications, please direct them to the comments section.

Questions

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NCLEX-PN Review Quiz 4 (50 Questions)

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NCLEX-PN Review Quiz 4 (50 Questions)

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In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.

1. The physician has ordered Stadol (butorphanol) for a postoperative 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

2. 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

3. 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)

4. The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that 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

5. 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 to decrease pain.
c. Diapering should be avoided for 1–2 weeks.
d. The child will need a special diet to promote healing.

6. 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

7. The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. 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.

8. 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.

9. A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:

a. At bedtime
b. With breakfast
c. Before lunch
d. After dinner

10. The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia 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

11. The nurse is teaching the parents of a newborn with osteogenesis imperfecta. The nurse should tell the parents:

a. That the baby will need daily calcium supplements
b. To lift the baby by the buttocks when diapering
c. That the condition is a temporary one
d. That only the bones are affected by the disease

12. Physician’s orders for a client with acute pancreatitis include the following: strict NPO, NG tube to low intermittent suction. The nurse recognizes that these interventions will:

a. Reduce the secretion of pancreatic enzymes
b. Decrease the client’s need for insulin
c. Prevent secretion of gastric acid
d. Eliminate the need for analgesia

13. A client with diverticulitis is admitted with nausea, vomiting, and dehydration. Which finding suggests a complication of diverticulitis?

a. Pain in the left lower quadrant
b. Board-like abdomen
c. Low-grade fever
d. Abdominal distention

14. The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:

a. Pyridostigmine (neostigmine)
b. Atropine (atropine sulfate)
c. Didronel (etidronate)
d. Tensilon (edrophonium)

15. 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

16. 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 strengthen the 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

17. 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

18. 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

19. The nurse is teaching the mother of a child with cystic fibrosis how to do postural drainage. 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
c. Do percussion after the child eats and at bedtime
d. Use cupped hands during percussion

20. 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 ventrogluteal muscle and one in the vastus lateralis muscle
d. Give the medication in one injection in the ventrogluteal muscle

21. A client with schizophrenia is receiving depot injections of Haldol Decanoate (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

22. A 3-year-old is immobilized in a hip spica cast. Which discharge instruction 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

23. 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

24. When assessing the urinary output of a client who has had extracorporeal 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

25. 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

26. Which finding is the best indication that a client with ineffective airway clearance needs suctioning?

a. Oxygen saturation
b. Respiratory rate
c. Breath sounds
d. Arterial blood gases

27. A client with tuberculosis has a prescription for Myambutol (ethambutol HCl). The nurse should tell the client to notify the doctor immediately if he notices:

a. Gastric distress
b. Changes in hearing
c. Red discoloration of bodily fluids
d. Changes in color vision

28. The primary cause of anemia in a client with chronic renal failure is:

a. Poor iron absorption
b. Destruction of red blood cells
c. Lack of intrinsic factor
d. Insufficient erythropoietin

29. Which of the following nursing interventions has the highest priority for the client scheduled for an intravenous pyelogram?

a. Providing the client with a favorite meal for dinner
b. Asking if the client has allergies to shellfish
c. Encouraging fluids the evening before the test
d. Telling the client what to expect during the test

30. The doctor has prescribed aspirin 325 mg daily for a client with transient ischemic attacks. The nurse knows that aspirin was prescribed to:

a. Prevent headaches
b. Boost coagulation
c. Prevent cerebral anoxia
d. Keep platelets from clumping together

31. A client with tuberculosis asks the nurse how long he will have to take medication. The nurse should tell the client that:

a. Medication is rarely needed after 2 weeks.
b. He will need to take medication the rest of his life.
c. The course of therapy is usually 18–24 months.
d. He will be re-evaluated in 1 month to see if further medication is needed.

32. Which development milestone puts the 4-month-old infant at greatest risk for injury?

a. Switching objects from one hand to another
b. Crawling
c. Standing
d. Rolling over

33. A client taking Dilantin (phenytoin) for grand mal seizures is preparing for discharge. Which information should be included in the client’s discharge care plan?

a. The medication can cause dental staining.
b. The client will need to avoid a high-carbohydrate diet.
c. The client will need a regularly scheduled CBC.
d. The medication can cause problems with drowsiness.

34. Assessment of a newborn male reveals that the infant has hypospadias. The nurse knows that:

a. The infant should not be circumcised.
b. Surgical correction will be done by 6 months of age.
c. Surgical correction is delayed until 6 years of age.
d. The infant should be circumcised to facilitate voiding.

35. The nurse is providing dietary teaching for a client with elevated cholesterol levels. Which cooking oil is not suggested for the client on a low-cholesterol diet?

a. Safflower oil
b. Sunflower oil
c. Coconut oil
d. Canola oil

36. The nurse is caring for a client with stage III Alzheimer’s disease. A characteristic of this stage is:

a. Memory loss
b. Failing to recognize familiar objects
c. Wandering at night
d. Failing to communicate

37. The doctor has prescribed Cortisone (cortisone) for a client with systemic lupus erythematosus. Which instruction should be given to the client?

a. Take the medication 30 minutes before eating.
b. Report changes in appetite and weight.
c. Wear sunglasses to prevent cataracts.
d. Schedule a time to take the influenza vaccine.

38. The nurse is caring for a client with an above-the-knee amputation (AKA). To prevent contractures, the nurse should:

a. Place the client in a prone position 15–30 minutes twice a day
b. Keep the foot of the bed elevated on shock blocks
c. Place trochanter rolls on either side of the affected leg
d. Keep the client’s leg elevated on two pillows

39. The mother of a 6-month-old asks when her child will have all his baby teeth. The nurse knows that most children have all their primary teeth by age:

a. 12 months
b. 18 months
c. 24 months
d. 30 months

40. While caring for a client with cervical cancer, the nurse notes that the radioactive implant is lying in the bed. The nurse should:

a. Place the implant in a biohazard bag and return it to the lab
b. Give the client a pair of gloves and ask her to reinsert the implant
c. Use tongs to pick up the implant and return it to a lead-lined container
d. Discard the implant in the commode and double-flush

41. The nurse is preparing to discharge a client following a laparoscopic cholecystectomy. The nurse should:

a. Tell the client to avoid a tub bath for 48 hours
b. Tell the client to expect clay-colored stools
c. Tell the client that she can expect lower abdominal pain for the next week
d. Tell the client that she can resume a regular diet in the next 24 hours

42. A high school student returns to school following a 3-week absence due to mononucleosis. The school nurse knows it will be important for the client:

a. To drink additional fluids throughout the day
b. To avoid contact sports for 1–2 months
c. To have a snack twice a day to prevent hypoglycemia
d. To continue antibiotic therapy for 6 months

43. A 6-year-old with cystic fibrosis has an order for Creon (pancrelipase). The nurse knows that the medication will be given:

a. At bedtime
b. With meals and snacks
c. Twice daily
d. Daily in the morning

44. The doctor has prescribed a diet high in vitamin B12 for a client with pernicious anemia. Which foods are highest in B12?

a. Meat, eggs, dairy products
b. Peanut butter, raisins, molasses
c. Broccoli, cauliflower, cabbage
d. Shrimp, legumes, bran cereals

45. A client with hypertension has begun an aerobic exercise program. The nurse should tell the client that the recommended exercise regimen should begin slowly and build up to:

a. 20–30 minutes three times a week
b. 45 minutes two times a week
c. 1 hour four times a week
d. 1 hour two times a week

46. 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

47. A neurological consult has been ordered for a pediatric client with suspected petit mal seizures. The client with petit mal seizures can be expected to have:

a. Short, abrupt muscle contraction
b. Quick, bilateral severe jerking movements
c. Abrupt loss of muscle tone
d. A brief lapse in consciousness

48. A client with schizoaffective disorder is exhibiting Parkinsonian symptoms. Which medication is responsible for the development of Parkinsonian symptoms?

a. Zyprexa (olanzapine)
b. Cogentin (benztropine mesylate)
c. Benadryl (diphenhydramine)
d. Depakote (divalproex sodium)

49. 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

50. The glycosylated hemoglobin of a 40-year-old client with diabetes mellitus 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.

Answers and Rationale

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

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

3. Answer D is correct. Lipid-lowering agents are contraindicated in the client with active liver disease. Answers A, B, and C are incorrect because they are not contraindicated in the client with active liver disease.

4. Answer C is correct. Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure. Answer A is incorrect because cornflakes and whole milk are higher in sodium and are poor sources of fiber. Answers B and D are incorrect because they contain animal proteins that are high in both cholesterol and sodium.

5. Answer A is correct. The child will need to avoid straddle toys, swimming, and rough play until allowed by the surgeon. Answers B, C, and D do not relate to the post-operative care of the child with hypospadias; therefore, they are incorrect.

6. Answer A is correct. Eating a carbohydrate source such as dry crackers or toast before arising helps alleviate symptoms of morning sickness. Answer B is incorrect because the additional fat might increase the client’s nausea. Answer C is incorrect because the client does not need to skip meals. Answer D is the treatment of hypoglycemia, not morning sickness; therefore, it is incorrect.

7. Answer A is correct. The stethoscope should be left in the client’s room for future use. The stethoscope should not be returned to the exam room or the nurse’s station; therefore, answers B and D are incorrect. The stethoscope should not be used to assess other clients; therefore, answer C is incorrect.

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

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

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

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

12. Answer A is correct. Placing the client on strict NPO status will stop the inflammatory process by reducing the secretion of pancreatic enzymes. The use of low, intermittent suction prevents release of secretion in the duodenum. Answer B is incorrect because the client requires exogenous insulin. Answer C is incorrect because it does not prevent the secretion of gastric acid. Answer D is incorrect because it does not eliminate the need for analgesia.

13. Answer B is correct. A rigid or boardlike abdomen is suggestive of peritonitis, which is a complication of diverticulitis. Answers A, C, and D are common findings in diverticulitis; therefore, they are incorrect.

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

15. Answer D is correct. The suggested diet for the client with AIDS is one that is high calorie, high protein, and low fat. Clients with AIDS have a reduced tolerance to fat because of the disease as well as side effects from some antiviral medications; therefore, answers A and C are incorrect. Answer B is incorrect because the client needs a high-protein diet.

16. Answer B is correct. The nurse can help ready the child with cerebral palsy for speech therapy by providing activities that help the child develop tongue control. Most children with cerebral palsy have visual and auditory difficulties that require glasses or hearing devices rather than rehabilitative training; therefore, answers A and C are incorrect. Answer D is incorrect because video games are not appropriate for the age or developmental level of the child with cerebral palsy.

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

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

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

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

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

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

23. Answer B is correct. Coolness and discoloration of the reimplanted digits indicates compromised circulation, which should be reported immediately to the physician. The temperature should be monitored, but the client would receive antibiotics to prevent infection; therefore, answer A is incorrect. Answers C and D are expected following amputation and reimplantation; therefore, they are incorrect.

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

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

26. Answer C is correct. Changes in breath sounds are the best indication of the need for suctioning in the client with ineffective airway clearance. Answers A, B, and D are incorrect because they can be altered by other conditions.

27. Answer D is correct. An adverse reaction to Myambutol is change in visual acuity or color vision. Answer A is incorrect because it does not relate to the medication. Answer C is incorrect because it is an adverse reaction to Streptomycin. Answer C is incorrect because it is a side effect of Rifampin.

28. Answer D is correct. Insufficient erythropoietin production is the primary cause of anemia in the client with chronic renal failure. Answers A, B, and C do not relate to the anemia seen in the client with chronic renal failure; therefore, they are incorrect.

29. Answer B is correct. The contrast media used during an intravenous pyelogram contains iodine, which can result in an anaphylactic reaction. Answers A, C, and D do not relate specifically to the test; therefore, they are incorrect.

30. Answer D is correct. Aspirin prevents the platelets from clumping together to prevent clots. Answer A is incorrect because the low-dose aspirin will not prevent headaches. Answers B and C are untrue statements; therefore, they are incorrect.

31. Answer C is correct. The usual course of treatment requires that medication be given for 18 months to 2 years. Answers A and D are incorrect because the treatment time is too brief. Answer B is incorrect because the medication is not needed for life.

32. Answer D is correct. At 4 months of age, the infant can roll over, which makes it vulnerable to falls from dressing tables or beds without rails. Answer A is incorrect because it does not prove a threat to safety. Answers B and C are incorrect because the 4-month-old is not capable of crawling or standing.

33. Answer C is correct. Adverse side effects of Dilantin include agranulocytosis and aplastic anemia; therefore, the client will need frequent CBCs. Answer A is incorrect because the medication does not cause dental staining. Answer B is incorrect because the medication does not interfere with the metabolism of carbohydrates. Answer D is incorrect because the medication does not cause drowsiness.

34. Answer A is correct. The infant with hypospadias should not be circumcised because the foreskin is used in reconstruction. Answer B and C are incorrect because reconstruction is done between 16 and 18 months of age, before toilet training. Answer D is incorrect because the infant with hypospadias should not be circumcised.

35. Answer C is correct. Coconut oil is high in saturated fat and is not appropriate for the client on a low-cholesterol diet. Answers A, B, and D are incorrect because they are suggested for the client with elevated cholesterol levels.

36. Answer B is correct. In stage III of Alzheimer’s disease, the client develops agnosia, or failure to recognize familiar objects. Answer A is incorrect because it appears in stage I. Answer C is incorrect because it appears in stage II. Answer D is incorrect because it appears in stage IV.

37. Answer D is correct. The client taking steroid medication should receive an annual influenza vaccine. Answer A is incorrect because the medication should be taken with food. Answer B is incorrect because increased appetite and weight gain are expected side effects of the medication. Answer C is incorrect because wearing sunglasses will not prevent cataracts.

38. Answer A is correct. The client with an above-the-knee amputation should be placed prone 15–30 minutes twice a day to prevent contractures. Answers B and D are incorrect because elevating the extremity after the first 24 hours will promote the development of contractures. Use of a trochanter roll will prevent rotation of the extremity but will not prevent contracture; therefore, answer D is incorrect.

39. Answer D is correct. All 20 primary, or deciduous, teeth should be present by age 30 months. Answers A, B, and C are incorrect because the ages are wrong.

40. Answer C is correct. The radioactive implant should be picked up with tongs and returned to the lead-lined container. Answer A is incorrect because radioactive materials are placed in lead-lined containers, not plastic ones, and are returned to the radiation department, not the lab. Answer B is incorrect because the client should not touch the implant or try to reinsert it. Answer D is incorrect because the implant should not be placed in the commode for disposal.

41. Answer A is correct. Following a laparoscopic cholecystectomy, the client should avoid a tub bath for 48 hours. Answer B is incorrect because the stools should not be clay colored. Answer C is incorrect because pain is usually located in the shoulders. Answer D is incorrect because the client should not resume a regular diet until clear liquids have been tolerated.

42. Answer B is correct. The client recovering from mononucleosis should avoid contact sports and other activities that could result in injury or rupture of the spleen. Answer A is incorrect because the client does not need additional fluids. Hypoglycemia is not associated with mononucleosis; therefore, answer C is incorrect. Answer D is incorrect because antibiotics are not usually indicated in the treatment of mononucleosis.

43. Answer B is correct. Pancreatic enzyme replacement is given with each meal and each snack. Answers A, C, and D do not specify a relationship to meals; therefore, they are incorrect.

44. Answer A is correct. Meat, eggs, and dairy products are foods high in vitamin B12. Answer B is incorrect because peanut butter, raisins, and molasses are sources rich in iron. Answer C is incorrect because broccoli, cauliflower, and cabbage are sources rich in vitamin K. Answer D is incorrect because shrimp, legumes, and bran cereals are high in magnesium.

45. Answer A is correct. The client’s aerobic workout should be 20–30 minutes long three times a week. Answers B, C, and D exceed the recommended time for the client beginning an aerobic program; therefore, they are incorrect.

46. Answer A is correct. A total mastectomy involves removal of the entire breast and some or all of the axillary lymph nodes. Following surgery, the client’s right arm should be elevated on pillows, to facilitate lymph drainage. Answers B, C, and D are incorrect because they would not help facilitate lymph drainage and would create increased edema in the affected extremity.

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

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

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

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

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics and finding help online is near to impossible. His situation drove his passion for helping student nurses through the creation of content and lectures that is easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire students in nursing. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, breakdown complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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