LCSW NEWEST ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) | ALREADY GRADED A+.
The nurse admits a 2-month-old infant for surgical correction of hypospadias. Which
assessment does the nurse complete?
a. Check the scrotal sac and palpate the testes
b. Inspect the position of the urinary meatus
c. Obtain a urine sample for analysis
d. Measure intake and output hourly
CORRECT ANS: B
Expert Rationale
Hypospadias is a congenital condition in which the urethral meatus (opening) is located
on the ventral surface (underside) of the penis, rather than at the tip. The primary
assessment for a patient with hypospadias is to inspect the position of the urinary
meatus to determine the severity of the defect and its location. This assessment is
critical for planning the surgical correction and for post-operative evaluation. While
checking the scrotal sac and testes (option A) is a component of a male infant's
assessment, the specific condition of hypospadias directly relates to the urethral
opening. Obtaining a urine sample (option C) and measuring intake and output (option
D) are standard nursing care activities but are not the specific assessment related to the
diagnosis.
DIF: Cognitive Level: Apply (Application) TOP: Pediatric Urology
MSC: NCLEX: Health Promotion and Maintenance
The parent of an 18-month-old toddler asks the nurse, "Which toy is most appropriate
for my child?" The nurse should recommend which toy?
a. A story book
b. A stuffed animal
,c. A colorful mobile
d. A large yo-yo
CORANS: B
Expert Rationale
At 18 months of age, toddlers are developing their gross and fine motor skills, and they
enjoy toys that are soft, safe, and encourage interactive play. A stuffed animal is an
appropriate toy for this age group because it is soft, safe, and can be used for hugging,
cuddling, and imaginative play. A storybook (option A) is more appropriate for an older
toddler or preschooler who can sit and listen to a story. A colorful mobile (option C) is
appropriate for an infant, as it is visually stimulating and helps with visual tracking, but it
is not interactive for a toddler. A large yo-yo (option D) presents a choking hazard and a
risk of injury for an 18-month-old child.
DIF: Cognitive Level: Apply (Application) TOP: Pediatric Growth and Development
MSC: NCLEX: Health Promotion and Maintenance
The nurse cares for the client prior to cataract surgery. The nurse administers the
preoperative medication. Ten minutes later, the nurse finds the client on the floor at the
foot of the bed. Which action does the nurse take initially?
a. Notifies the healthcare provider, and receive new orders
b. Complete accident report documenting the fall
c. Stays with the client and calls for assistance
d. Moves the client back onto the bed providing support to the cervical area
CORANS: C
Expert Rationale
The nurse's first priority in this situation is to ensure the client's safety and assess for any
immediate injuries. The initial action is to stay with the client to prevent further harm
and call for assistance. This ensures that help is on the way while the nurse provides
support and assesses the client's condition. Notifying the healthcare provider (option A)
and completing an accident report (option B) are important but secondary to immediate
safety and assessment. Moving the client (option D) without a proper assessment could
,exacerbate a potential spinal injury and should be avoided until the client has been
evaluated.
DIF: Cognitive Level: Apply (Application) TOP: Safety
MSC: NCLEX: Safe and Effective Care Environment
The nurse cares for the client diagnosed as being in the manic phase of bipolar disorder.
Which behavior indicates to the nurse the client's condition is improving?
a. The client offers suggestions to other clients on the unit
b. The client begins to write a book about life
c. The client sits and eats with other clients on the unit
d. The client talks with other clients at a group meeting
CORANS: C
Expert Rationale
In the manic phase of bipolar disorder, clients often exhibit hyperactivity, impulsivity,
and difficulty maintaining social interactions. Improvement is indicated when the client
can engage in calm, structured social activities, such as sitting and eating with others.
This behavior demonstrates a reduction in hyperactivity and an ability to participate in
normal daily activities. Offering suggestions (option A) and writing a book (option B)
could still reflect grandiose thinking or pressured speech, which are signs of mania.
Talking with others at a group meeting (option D) is a positive sign but is less indicative
of improvement than the ability to sit calmly and eat with others, which requires
sustained attention and social interaction without the typical manic agitation.
DIF: Cognitive Level: Evaluate (Evaluation) TOP: Psychiatric Nursing
MSC: NCLEX: Psychosocial Integrity
The healthcare provider orders a continuous intravenous aminophylline infusion for a
two-year-old client. It is most important for the nurse to intervene for which situation?
a. The client's heart rate is 100 bpm
b. The client's blood pressure is 100/60 mmHg
, c. The client's serum theophylline level is 25 mcg/mL
d. The client is sleepy
CORANS: C
Expert Rationale
Aminophylline is a bronchodilator used to treat asthma and other respiratory conditions.
It is metabolized to theophylline, and the therapeutic range for serum theophylline
levels is typically 10-20 mcg/mL. A level of 25 mcg/mL indicates toxicity, which can lead
to serious side effects such as tachycardia, cardiac arrhythmias, and seizures. A heart
rate of 100 bpm (option A) is within the normal range for a two-year-old (80-130 bpm).
A blood pressure of 100/60 mmHg (option B) is within normal limits for a toddler.
Sleepiness (option D) is a common side effect of aminophylline but is not as critical as a
toxic theophylline level. Therefore, the nurse must intervene immediately for a
theophylline level of 25 mcg/mL.
DIF: Cognitive Level: Analyze (Analysis) TOP: Pediatric Pharmacology
MSC: NCLEX: Physiological Integrity
The nurse teaches the client about the scheduled cardiac catheterization. Which
statement, if made by the client to the nurse, indicates that the teaching was effective?
a. "I understand that there is little or no risk associated with this procedure."
b. "I may experience a little pounding sensation in my chest during the procedure."
c. "I will be in and out of the procedure room in about 30 minutes."
d. "I will be able to walk in the hall soon after the procedure is completed."
CORANS: B
Expert Rationale
During a cardiac catheterization, the client may experience various sensations as the
catheter is advanced through the blood vessels. A pounding sensation in the chest is a
common and expected finding, which indicates that the client understands the
procedure. Option A is incorrect because cardiac catheterization carries risks, including
bleeding, infection, and arrhythmias. Option C is incorrect because the procedure
typically takes longer than 30 minutes. Option D is incorrect because the client will need
to remain on bed rest for several hours to prevent bleeding at the insertion site.
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) | ALREADY GRADED A+.
The nurse admits a 2-month-old infant for surgical correction of hypospadias. Which
assessment does the nurse complete?
a. Check the scrotal sac and palpate the testes
b. Inspect the position of the urinary meatus
c. Obtain a urine sample for analysis
d. Measure intake and output hourly
CORRECT ANS: B
Expert Rationale
Hypospadias is a congenital condition in which the urethral meatus (opening) is located
on the ventral surface (underside) of the penis, rather than at the tip. The primary
assessment for a patient with hypospadias is to inspect the position of the urinary
meatus to determine the severity of the defect and its location. This assessment is
critical for planning the surgical correction and for post-operative evaluation. While
checking the scrotal sac and testes (option A) is a component of a male infant's
assessment, the specific condition of hypospadias directly relates to the urethral
opening. Obtaining a urine sample (option C) and measuring intake and output (option
D) are standard nursing care activities but are not the specific assessment related to the
diagnosis.
DIF: Cognitive Level: Apply (Application) TOP: Pediatric Urology
MSC: NCLEX: Health Promotion and Maintenance
The parent of an 18-month-old toddler asks the nurse, "Which toy is most appropriate
for my child?" The nurse should recommend which toy?
a. A story book
b. A stuffed animal
,c. A colorful mobile
d. A large yo-yo
CORANS: B
Expert Rationale
At 18 months of age, toddlers are developing their gross and fine motor skills, and they
enjoy toys that are soft, safe, and encourage interactive play. A stuffed animal is an
appropriate toy for this age group because it is soft, safe, and can be used for hugging,
cuddling, and imaginative play. A storybook (option A) is more appropriate for an older
toddler or preschooler who can sit and listen to a story. A colorful mobile (option C) is
appropriate for an infant, as it is visually stimulating and helps with visual tracking, but it
is not interactive for a toddler. A large yo-yo (option D) presents a choking hazard and a
risk of injury for an 18-month-old child.
DIF: Cognitive Level: Apply (Application) TOP: Pediatric Growth and Development
MSC: NCLEX: Health Promotion and Maintenance
The nurse cares for the client prior to cataract surgery. The nurse administers the
preoperative medication. Ten minutes later, the nurse finds the client on the floor at the
foot of the bed. Which action does the nurse take initially?
a. Notifies the healthcare provider, and receive new orders
b. Complete accident report documenting the fall
c. Stays with the client and calls for assistance
d. Moves the client back onto the bed providing support to the cervical area
CORANS: C
Expert Rationale
The nurse's first priority in this situation is to ensure the client's safety and assess for any
immediate injuries. The initial action is to stay with the client to prevent further harm
and call for assistance. This ensures that help is on the way while the nurse provides
support and assesses the client's condition. Notifying the healthcare provider (option A)
and completing an accident report (option B) are important but secondary to immediate
safety and assessment. Moving the client (option D) without a proper assessment could
,exacerbate a potential spinal injury and should be avoided until the client has been
evaluated.
DIF: Cognitive Level: Apply (Application) TOP: Safety
MSC: NCLEX: Safe and Effective Care Environment
The nurse cares for the client diagnosed as being in the manic phase of bipolar disorder.
Which behavior indicates to the nurse the client's condition is improving?
a. The client offers suggestions to other clients on the unit
b. The client begins to write a book about life
c. The client sits and eats with other clients on the unit
d. The client talks with other clients at a group meeting
CORANS: C
Expert Rationale
In the manic phase of bipolar disorder, clients often exhibit hyperactivity, impulsivity,
and difficulty maintaining social interactions. Improvement is indicated when the client
can engage in calm, structured social activities, such as sitting and eating with others.
This behavior demonstrates a reduction in hyperactivity and an ability to participate in
normal daily activities. Offering suggestions (option A) and writing a book (option B)
could still reflect grandiose thinking or pressured speech, which are signs of mania.
Talking with others at a group meeting (option D) is a positive sign but is less indicative
of improvement than the ability to sit calmly and eat with others, which requires
sustained attention and social interaction without the typical manic agitation.
DIF: Cognitive Level: Evaluate (Evaluation) TOP: Psychiatric Nursing
MSC: NCLEX: Psychosocial Integrity
The healthcare provider orders a continuous intravenous aminophylline infusion for a
two-year-old client. It is most important for the nurse to intervene for which situation?
a. The client's heart rate is 100 bpm
b. The client's blood pressure is 100/60 mmHg
, c. The client's serum theophylline level is 25 mcg/mL
d. The client is sleepy
CORANS: C
Expert Rationale
Aminophylline is a bronchodilator used to treat asthma and other respiratory conditions.
It is metabolized to theophylline, and the therapeutic range for serum theophylline
levels is typically 10-20 mcg/mL. A level of 25 mcg/mL indicates toxicity, which can lead
to serious side effects such as tachycardia, cardiac arrhythmias, and seizures. A heart
rate of 100 bpm (option A) is within the normal range for a two-year-old (80-130 bpm).
A blood pressure of 100/60 mmHg (option B) is within normal limits for a toddler.
Sleepiness (option D) is a common side effect of aminophylline but is not as critical as a
toxic theophylline level. Therefore, the nurse must intervene immediately for a
theophylline level of 25 mcg/mL.
DIF: Cognitive Level: Analyze (Analysis) TOP: Pediatric Pharmacology
MSC: NCLEX: Physiological Integrity
The nurse teaches the client about the scheduled cardiac catheterization. Which
statement, if made by the client to the nurse, indicates that the teaching was effective?
a. "I understand that there is little or no risk associated with this procedure."
b. "I may experience a little pounding sensation in my chest during the procedure."
c. "I will be in and out of the procedure room in about 30 minutes."
d. "I will be able to walk in the hall soon after the procedure is completed."
CORANS: B
Expert Rationale
During a cardiac catheterization, the client may experience various sensations as the
catheter is advanced through the blood vessels. A pounding sensation in the chest is a
common and expected finding, which indicates that the client understands the
procedure. Option A is incorrect because cardiac catheterization carries risks, including
bleeding, infection, and arrhythmias. Option C is incorrect because the procedure
typically takes longer than 30 minutes. Option D is incorrect because the client will need
to remain on bed rest for several hours to prevent bleeding at the insertion site.
