Kaplan NCLEX Prep Test Questions and Answers

Kaplan NCLEX Prep Test Questions and Answers

Which of the following actions, if performed by the nurse would be considered negligence?

• The nurse obtains a Guthrie blood test on a 4 day old infant.
• The nurse massages lotion on the abdomen of a 3 year old diagnosed with Wilm's tumor.
• The nurse instructs a 5 year old asthmatic to blow on a pinwheel.
• The nurse plays kickball with a 10 year old with juvenile arthritis (JA).
• The nurse massages lotion on the abdomen of a 3 year old diagnosed with Wilm's tumor. Correct - manipulation of

mass may cause dissemination of cancer cells The nurse in the same day surgery department cares for a 77 year old woman after a sigmoidoscopy. Which of the following symptoms, if exhibited by the woman an hour after the procedure, would most concern the nurse?

• The client complains of fullness and pressure in her abdomen
• The client complains of grogginess and thirst.
• The client complains of lightheadedness and dizziness
• The client complains of mild pain and cramping in her abdomen
• The client complains of lightheadedness and dizziness. Correct - could signify hypovolemic shock due to bowel

perforation

00:0201:36

The nurse is discharging a pt from an inpt alcohol treatment unit. Which of the following statements, if made by the pt's wife indicates to the nurse that the family is coping adaptively?

• My husband will do well as long as I keep him engaged in activities that he likes.
• My focus is learning how to live my life.
• I am so glad that our problems are behind us.
• I'll make sure that the children don't give my husband any problems.
• My focus is learning how to live my life. Correct - wife is working to change codependent patterns.

The nurse is caring for a pt with cervical cancer. The nurse notes that the radium implant has become dislodged.Which of the following actions should the nurse take first?

• Stay with the pt and contact radiology.
• Wrap the implant in a blanket and place it behind the lead shield.
• Pick up the implant with long handled forceps and place it in a lead container.
• Obtain a dosimeter reading on the pt and report it to the physician.
• Pick up the implant with long handled forceps and place it in a lead container. Correct - never touch implant with

bare hand; forceps and container should be kept in pt's room.

The nurse has reviewed the charts of four antepartal women. Which woman is at greater risk for having a child with a cleft lip and palate?

• a 22 yr old Oriental woman who is having a girl.
• a 25 yr old Native American female who is having a boy
• a 35 yr old African American woman who is having a boy
• a 40 yr old Caucasian who is having a girl.
• a 25 yr old Native American female who is having a boy. Correct - Native Americans have the highest incidence of

cleft lip and palate; males are more likely than females to have both.A 22 yr old woman in her second trimester of pregnancy tells the clinic nurse that her child has been asking questions about sex. The client asks the nurse what she should tell her 5 year old son. Which of the following statements, if made by the nurse is best?

• buy a book about sex designed for young children and read it with your son.
• answer your son's questions in a matter of fact manner, in words that he will understand.
• tell your son that his subject is complicated, and you will discuss it with him as he gets older.
• Have your son touch your abdomen and tell him about your pregnancy.
• answer your son's questions in a matter of fact manner, in words that he will understand. Correct - helps child

understand his concerns, allows for answering exact question that is being asked.The nurse is observing a LPN/LVN administer iron dextran IM. It is most important for the nurse to give which of the following instructions?

• massage the injection site for one minute after the injection of the medicine.
• tap out the air bubble prior to administering the medication.
• release the skin prior to withdrawing the needle.
• change the needle after drawing up the medication.
• change the needle after drawing up the medication. Correct - ensures that no solution remains on outside of

needle.A nurse is caring for clients in the mental health clinic. A woman comes to the clinic complaining of insomnia and anorexia. The patient tearfully tells the nurse that she was laid off from a job that she had held for 15 years. Which of the following responses, if made by the nurse, is most appropriate?

• did your company give you a severance package?
• Focus on the fact that you have a healthy, happy family.
• Tell me what happened.
• Losing a job is common nowadays.
• Tell me what happened. Correct - explore situation. Allows patient to verbalize.

The nurse is teaching a 45 yr old woman how to increase the K in her diet. The woman says she knows bananas are high in K, but she doesn't like their taste. What foods should the nurse recommend the client include in her diet?

• carrots, broccoli, yogurt
• rhubarb, tofu, celery
• potatoes, spinach, raisins
• onions, corn, oatmeal

• potatoes, spinach, raisins Correct - potatoes 610 mg, spinach 838mg, raisins 1089mg for a total of 2537mg.

A 68 yr old woman diagnosed with thrombocytopenia due to acute lymphocytic leukemia is admitted to the hospital.

The nurse should assign the pt to a:

• private room so she will not infect other patients and health care workers
• private room so she will not be infected by other pts and health care workers
• semiprivate room so she will have stimulation during her hospitalization
• semiprivate room so she will have the opportunity to express her feelings about her illness.
• private room so she will not be infected by other pts and health care workers

Correct - protects patient from exogenous bacteria, risk for developing infection from others due to depressed WBC count, alters ability to fight infection.The nurse cares for a 46 yr old woman after a traditional cholecystectomy. The pt has a nasogastric tube connected to suction, an IV of D5W infusing into her right arm, and a T-tube and Penrose drain in place. The nurse would be most concerned by which of the following findings?

• The systolic blood pressure is 10mmHg, lower that is was preoperatively.
• There is 250cc of bloody drainage from the T-tube during the first 24 hours
• There is 30 cc of serosanguineous drainage in the Penrose drain during the first 24 hours
• The pt experiences a 4 degree temp elevation the evening after surgery
• There is 250cc of bloody drainage from the T-tube during the first 24 hours. Correct - would expect drainage of

400ml/day with gradual decrease in amount, will be bloody initially and change to greenish brown.The nurse is leading an inservice about management issues. The nurse would intervene if a nurse made which of the following statements?

• It is my responsibility to ensure that the consent form has been signed and attached to the pt's chart prior to

surgery.

• It is my responsibility to witness the signature of the client before surgery is performed.
• It is my responsibility to provide a detailed description of the surgery and ask the pt to sign the consent form.
• It is my responsibility to answer questions that the pt may have prior to surgery.
• It is my responsibility to provide a detailed description of the surgery and ask the pt to sign the consent form.

Correct-physician should provide explanation and obtain signature.

00:0201:36

A pt with a history of alcoholism is brought to the emergency room in an agitated state. He is vomiting and diaphoretic. He had his last drink five hours ago. The nurse would expect to administer which of the following medications.

• Chlordiazepoxide hydrochloride (Librium).
• Disulfiram (Antabuse)
• Methadone Hydrochloride (Dolophine)
• Naloxone hydrochloride (Narcan)
• Chlordiazepoxide hydrochloride (Librium) Correct - antianxiety; used to treat symptoms of acute alcohol

withdrawal; SE lethargy, hangover, agranulocytosis

The nurse is caring for a pt with an acute myocardial infarction. Which of the following laboratory findings would most concern the nurse?

• Erthrocyte sedimentation rate 10mm/h.
• Hematocrit 42%
• Creatine kinase 350U/ml
• Serum glucose 100mg/dL
• Creatine kinase 350U/ml

Correct - enzyme specific to brain, myocardium and skeletal muscle; indicate tissue necrosis or injury normal: men 12 -70 U/ml, women: 10-55U/ml The nurse has completed discharge instructions for a primigravida woman at 29 weeks gestation who is hospitalized for treatment of deep vein thrombosis. Which of the following statements, if made by the patient to the nurse, indicates that teaching has been successful?

• I will give myself heparin everyday.
• I should check my leg once a week
• I will massage my leg nightly
• I can take Pepto-Bismol for diarrhea
• I will give myself heparin everyday. Correct - heparin doesn't cross the placenta; considered safe during

pregnancy.The nurse is caring for clients in an orthopedic clinic. The nurse would be most concerned if which of the following was observed?

• a teenager who is 6-4, places the crutches about 6" to the side of his feet when ambulating with crutches.
• a school aged child who is 4-8, flexes her elbows about 20 degrees when ambulating with crutches
• a middle aged adult who is 5-10, advances the crutches first when walking down the stairs
• An older adult 5-6, uses a 4 pt gait when ambulating with crutches.
• a teenager who is 6-4, places the crutches about 6" to the side of his feet when ambulating with crutches.

Correct - taller person requires a broader base of support At the advice of the physician, a client with hypertension attends classes to help him quit smoking. One month later the client visits the clinic, and the nurse notes a package of cigarettes in his pocket. Which of the following statements, if made by the nurse, is most appropriate?

• I see that you have cigarettes in your pocket.
• Please give me the cigarettes.
• I'll have to report this to the physician.
• You'll have to enroll in another class.
• I see that you have cigarettes in your pocket.

Correct - encourages client to verbalize issues and concerns.A 65-year-old woman recovering from a right below-knee amputation (BKA) asks the nurse why the bandage is applied in a "figure-eight." Which of the following explanations, if made by the nurse, is MOST accurate?

• "It decreases the possibly of infection."