NCLEX PN PRACTICE EXAM 25

NCLEX PN PRACTICE EXAM |25

QUESTIONS WITH CORRECT

ANSWETRS AND EXPLANATIONS.

• A 4-year old child is brought by her grandmother in the emergency room

due to fever, chills, and difficulty walking. The nurse tries to remove the excessive clothing of the child but is reluctant. After a thorough assessment, the nurse also noted bruises around the genital area. Which of the following interventions should the nurse do first?• A. Collect the clothing and underwear of the child • B. Provide privacy and disregard the behavior of the child • C. Inform the law enforcement for a possible child abuse • D. Record all the findings

Correct Answer: C. Inform the law enforcement for a possible child abuse

• Option C: Calling law enforcement is a priority action and a legal

responsibility of the nurse in cases of suspected child abuse. Signs of sexual abuse in children 0-5 years of age include unexplained genital injury, avoidance to remove clothing, insist on wearing multiple garments, difficulty walking or sitting due to genital or anal pain, and signs of sexually transmitted infections.

• Options A and D: Documenting and collecting evidence is an important

aspect of a suspected child sexual abuse but is not the first action.• Option B: It is the responsibility of the nurse to protect the welfare of the child.

• A client receiving hydrochlorothiazide is instructed to increase her dietary

intake of potassium. The best snack for the client requiring increased

potassium is:

• A. Pear • B. Apple

• C. Orange • D. Avocado

Correct Answer: D. Avocado

• Option D: The fruit which packs the most potassium among the

choices is the avocado which contains 487 mg per half serving of the fruit.

• Option A: A pear contains 280 mg of potassium.

• Option B: An apple contains 165 mg of potassium.

• Option C: An orange contains 235 mg of potassium.

• The nurse is caring for a client following the 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

Correct Answer: A. Maintain the client in a semi-Fowler’s position with the

head and neck supported by pillows.

• Option A: Following a thyroidectomy, the client should be placed in

semi-Fowler’s position to decrease swelling that would place pressure on the airway.

• Options B, C, and D: These positions would increase the chances of

post-operative complications that include bleeding, swelling, and airway obstruction.

• A client hospitalized with chronic dyspepsia is diagnosed with gastric

cancer. Which of the following is associated with an increased incidence of gastric cancer?• A. Dairy products • B. Carbonated beverages

• C. Refined sugars • D. Luncheon meats

Correct Answer: D. Luncheon meats

• Option D: Luncheon meats contain preservatives such as nitrites that

have been linked to gastric cancer.

• Options A, B, and C: Dairy products, carbonated beverages, and

refined sugars have not been found to increase the risk of gastric cancer; therefore, they are incorrect.

• 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 would 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

Correct Answer: C. A history of cruelty to animals

• Option C: A history of cruelty to people and animals, truancy, and

setting fires with a diagnosis of conduct disorder in children, which becomes a diagnosis of antisocial personality disorder in adults.

• Option A: A client with an antisocial personality disorder does not

hold consistent employment.

• Option B: IQ is usually higher than average.

• Option D: A client with antisocial personality disorder lacks guilt or

remorse for wrong-doing.

6. The licensed vocational nurse may not assume the primary care for a client:

• A. In the fourth stage of labor • B. Two days post-appendectomy • C. With a venous access device • D. With bipolar disorder

Correct Answer: C. With a venous access device.

• Option C: Only a trained nurse with experience and background in

caring for a venous access device can assume the primary care of the client.

• Options A, B, and D: The licensed vocational nurse may care for the

client in labor, the client post-operative client, and the client with bipolar disorder.

• The physician has ordered dressings with Sulfinyl cream for a client with

full-thickness burns of the hands and arms. Before dressing changes, the

nurse should give priority to:

• A. Administering pain medication • B. Checking the adequacy of urinary output • C. Requesting a daily complete blood count • D. Obtaining a blood glucose by finger stick

Correct Answer: A. Administering pain medication

• Option A: Sulfinyl produces a painful sensation when applied to the

burn wound; therefore, the client should receive pain medication before dressing changes.

• Options B, C, and D: These do not pertain to dressing changes for

the client with burns, so they are incorrect.

• 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

Correct Answer: A. She can pull a toy behind her

• Option A: The Denver Developmental Screening Test (DDST) is a tool

used to screen for the development of gross motor, language, fine- motor, and personal- social in infants and preschool children.