NCLEX NGN RN EXAM 2023-2024 ACTUAL EXAM 300

NCLEX NGN RN EXAM 2023-2024 ACTUAL EXAM 300

QUESTIONS AND CORRECT DETAILED ANSWERS

WITH RATIONALES (VERIFIED ANSWERS)

|ALREADY GRADED A+

A one-year-old child who goes to daycare is recovering from an episode of otitis media. Which intervention is most important for the nurse to recommend to the parents in order to prevent reoccurrence?Exclusive breastfeeding not sending the child to daycare preventing water from entering their ear smoking cessation by the parents - ANSWER- ANS D

Rationale: OTITIS MEDIA is the inflammation or infection in the middle ear

resulting from dysfunction of the eustachian tube. OM Typically occurs in infants and children under two years old, sometimes following a respiratory tract infection.The eustachian tubes and infants and younger children are short, straight and fairly horizontal, which results in ineffective drainage and protection from respiratory secretions. In friends with exposure to tobacco smoke or at high risk forOM due to the resulting respiratory inflammation. OM risk is also higher with activities such as using a pacifier or drinking from a bottle when laying down as these allow fluid to pull in the mouth and then reach the eustachian tubes.he preventative measures include eliminating exposure to smoke, obtaining routine immunizations to prevent infection, and reducing or eliminating use of a pacifier after age of 6 months.Option 1 breastfed infants have a decreased risk forOM possibly due to the semi vertical position used for breastfeeding which reduces reflux to the eustachian tubes. exclusive breastfeeding is recommended for the first 6 months. however this client is age one and should be receiving a very healthy and take up solid food at this time. 1 / 4

Option 2 take your attendance is a significant respecter to the development of OM.however this recommendation to avoid daycares usually not practical as many parents must work outside of the home.Opton 3 excessive water and the ears from bathing or swimming can alter protective environment up the external ear and contribute to otitis externa, known as swimmer's ear; however this does not contribute to OM.

During a camping trip a camp counselor falls and gets a small Splinter of wood embedded in the right eye. What action should the volunteer camp nurse take first?Gently flush the eye with cool water Instill optic antibiotic ointment Patch both eyes with eye Shields Remove this winter using tweezers - ANSWER- ANS C

Rationale: The camp nurse protects the injured using an eye shield (e.g. small

styrofoam or paper cup), ensuring the shield does not touch the foreign body. the eyes work in synchrony with each other; therefore the non-injured eyes patched to prevent further movement. The nurse also facilitates transport to the nearest emergency care center for assessment and treatment by an ophthalmologist.Option 1 flushing the eye with Cool Waters contraindicated as it may cause further damage by moving the Splinter and or introducing potential wound pathogens Option 2 instilling optic antibiotic ointment will interfere with ophthalmic medical examination. Optic antibiotic ointment may be prescribed by the healthcare provider to reduce their risk of infection once the object is removed from the eye.Option 4 the nurse should not attempt to remove a foreign body embedded in the eye. and ophthalmologist, a healthcare providr specializing in the surgical and non- surgical evaluation and treatment of eye conditions should remove the embedded object as soon as possible.

education objective: when a foreign body becomes accidentally embedded in the

eye both eyes should be shielded to prevent eye movement and additional injury.the nurse should immediately refer the client to an ophthalmologist for further evaluation and treatment 2 / 4

The nurse is making follow-up phone calls to clients who had cataract surgery with intraocular lens implantation the previous day. the nurse receives which client report that requires priority intervention?

• blurry vision and the affected eye
• Constipation
• itchy in the affected eye
• sleeping on two pillows at night - ANSWER- ANS B

Rationale: Following cataract surgery The client will be instructed that for several days or until approved by the surgeon activities that may increase intraocular pressure should be avoided to decrease the risk of damage to sutures or surgical site. these include bending (eg vacuuming floors, playing golf), lifting more than 5 lb, sneezing, coughing, rubbing or placing pressure on the eye, restraining during a bowel movement.the nurse should encourage this client to increase fluids and fiber in the diet as well as consider an over-the-counter stool softener or laxative.Option 1 it may take one to two weeks before visual Acuity is improved Option 3 it is common for the client to experience itching("sand in the eye), photophobia, and mild pain for several days following surgery. Purulent drainage increase redness and severe pain should be reported Option 4 sleeping on two pillows will elevate the head of the bed and decrease interocular pressure

The nurse is reinforcing education about lifestyle modifications for a client newly diagnosed with Meniere disease. which statement by the client indicates a need for further teaching?

• I need to enroll in a smoking cessation program
• I need to restrict the amount of potassium in my diet
• I will lie down and avoid walking unassisted during acute attacks 3 / 4

• I will limit the amount of caffeine and alcohol that I consume - ANSWER- ANS

2

Rationale: Meniere disease (endolymphatic hydros) Results from excess fluid

accumulation in the inner ear clients have episodic attacks of vertigo, tinnitus, hearing loss, feelings of fullness or pressure in the ear. the disorder typically affects only one year and can lead to permanent hearing loss. attacks of meniere disease can result in a total loss of proprioception, and clients often feel feeling pulled to the ground drop attacks making client safety a priority. vertigo can be severe and associated with nausea vomiting and feelings of anxiety. self-care for

Meniere disease may include:

consuming a low sodium diet to decrease potential for fluid excess within the inner ear. intake of potassium and other electrolytes does not need to be restricted (option 2) limiting or avoiding aggravating substances (eg nicotine, caffeine, alcohol) and stimuli (eg flickering lights, watching television) options 1 and 4 adhering to prescribe therapies for relief of symptoms (eg antiemetics, antihistamines, sedatives, and Mild diuretics) avoiding sudden changes in the position of the head (eg bending over) during vertigo spells participating in this vestibular Rehabilitation therapy Implementing safety measures during attacks (eg assistance with walking, bed rest) option 3 educational objective: Meniere disease results from excess fluid accumulation in the inner ear. attacks involve severe vertigo, nausea, and hearing loss. clients with Meniere disease should be taught to adhere to a low sodium diet; eliminate tobacco products; limit caffeine and alcohol, and limit or avoid exacerbating factors (eg flickering lights)

The nurse is caring for an elderly client who has Type 2 diabetes and has just been diagnosed with diabetic retinopathy. Which statement by the client requires the most immediate action by the nurse?

• Half of my vision looks like it's being blocked by a curtain
• / 4