NURSING STUDENTS - heart defect. The nurse auscultates an apical p...

NCLEX-PN

ASSESSMENT FOR

NURSING STUDENTS

VERSION 2

2023/2024

• The nurse is to administer digoxin (Lanoxin) elixir to a 6-month-old with a congenital

heart defect. The nurse auscultates an apical pulse rate of 100. The nurse should: Record the heart rate and administer the medication;

• Which of the following observations in a 4-year-old suggests the possibility of child

abuse The presence of “rainbow” bruises

• A client arrives in the emergency room with a possible fractured femur. The nurse should

anticipate an order for: Buck’s traction

• The nurse is caring for a client with epilepsy who is being treated with carbamazepine

(Tegretol). Which laboratory value might indicate a serious side effect of this drug WBC 2,000 per cubic millimeter

• Which observation in the newborn of a mother who is alcohol dependent would require

immediate nursing intervention? Jitteriness

• . 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: Chelating agents

• A client with a history of alcoholism cannot remember the events of the past week even

though he has receipts from various places of business. The client’s inability to recall events is known as A blackout

• The nurse is caring for a client with a malignancy. The classification of the primary

tumor is Tis. The nurse should plan care for a tumor That is in situ

• The nurse is assisting a client with diverticulosis to select appropriate foods. Which food

should be avoided? Cucumber salad

• The 57-year-old male client has elected to have epidural anesthesia as the anesthetic

during a hernia repair. If the client experiences hypotension, the nurse would: Speed the IV infusion of normal saline

• A client with glaucoma has been prescribed Timoptic (timolol) eyedrops. Timoptic

should be used with caution in the client with a history of: Emphysema

• The nurse is preparing a client with Addison’s disease for discharge. The nurse should

explain that the client can help prevent complications by Staying out of crowds

• A client is 2 days post-operative colon resection. After a coughing episode, the client’s

wound eviscerates. Which nursing action is most appropriate Cover the wound with a sterile saline-soaked dressing

• A client has rectal cancer and is scheduled for an abdominal perineal resection. What

should be the priority nursing care during the post-op period? Facilitating perineal wound drainage

• The nurse is caring for a client with ascites. Which is the best method to use for

determining early ascites Daily measurement of abdominal girth