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EXAM CRAM NCLEX-RN Practice Questions - 4Th Edition

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20. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority interven- tion for this client is: Quick Check Quick Answer: 223 Detailed Answer: 227 Quick Answer: 223 Detailed Answer: 227 Quick Answer: 223 Detailed Answer: 227 Quick Answer: 223 Detailed Answer: 227 A. B. C. D. Measure the urinary output. Check the vital signs. Encourage increased fluid intake. Weigh the client. 21. A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding? A. B. C. D. Place the client in a sitting position. Administer acetaminophen (Tylenol). Pinch the soft lower part of the nose. Apply ice packs to the forehead. 22. A client has had a unilateral adrenalectomy to remove a tumor. The most important measurement in the immediate post-operative period for the nurse to take is: A. B. C. D. The blood pressure The temperature The urinary output The specific gravity of the urine 23. A client with Addison’s disease has been admitted with a history of nausea and vomiting for the past three days. The client is receiving IV glucocorticoids (Solu-Medrol). Which of the following interventions would the nurse implement? A. B. C. D. Glucometer readings as ordered Intake/output measurements Evaluating the sodium and potassium levels Daily weights 24. A client had a total thyroidectomy yesterday. The client is com- plaining of tingling around the mouth and in the fingers and toes. What would the nurses’ next action be? Quick Answer: 223 Detailed Answer: 227 A. B. C. D. Obtain a crash cart. Check the calcium level. Assess the dressing for drainage. Assess the blood pressure for hypertension. 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in four months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority? Quick Check Quick Answer: 223 Detailed Answer: 227 A. B. C. D. Impaired physical mobility related to decreased endurance Hypothermia r/t decreased metabolic rate Disturbed thought processes r/t interstitial edema Decreased cardiac output r/t bradycardia 26. The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor). Which instruc- tion should be given to the client taking rosuvastatin (Crestor)? Quick Answer: 223 Detailed Answer: 227 Quick Answer: 223 Detailed Answer: 227 Quick Answer: 223 Detailed Answer: 227 Quick Answer: 223 Detailed Answer: 228 A. B. C. D. Report muscle weakness to the physician. Allow six months for the drug to take effect. Take the medication with fruit juice. Report difficulty sleeping. 27. The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should: A. B. C. D. Utilize an infusion pump. Check the blood glucose level. Place the client in Trendelenburg position. Cover the solution with foil. 28. The six-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor? A. Blood pressure of 126/80 B. Blood glucose of 110mg/dL C. Heart rate of 60bpm D. Respiratory rate of 30 per minute 29. The client admitted with angina is given a prescription for nitro- glycerine. The client should be instructed to: A. B. C. D. Replenish his supply every three months. Take one every 15 minutes if pain occurs. Leave the medication in the brown bottle. Crush the medication and take with water. 30. The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats? Quick Check Quick Answer: 223 Detailed Answer: 228 Quick Answer: 223 Detailed Answer: 228 Quick Answer: 223 Detailed Answer: 228 Quick Answer: 223 Detailed Answer: 228 Quick Answer: 223 Detailed Answer: 228 A. B. C. D. Macaroni and cheese Shrimp with rice Turkey breast Spaghetti with meat sauce 31. The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the: A. Feet B. Neck C. Hands D. Sacrum 32. The nurse is checking the client’s central venous pressure. The nurse should place the zero of the manometer at the: A. B. C. D. Phlebostatic axis PMI Erb’s point Tail of Spence 33. The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should: A. B. C. D. Question the order. Administer the medications. Administer separately. Contact the pharmacy. 34. The best method of evaluating the amount of peripheral edema is: A. B. C. D. Weighing the client daily Measuring the extremity Measuring the intake and output Checking for pitting Practice Exam 3 and Rationales 175 176 Chapter 3 35. A client with vaginal cancer is being treated with a radioactive vaginal implant. The client’s husband asks the nurse if he can spend the night with his wife. The nurse should explain that: Quick Check Quick Answer: 223 Detailed Answer: 228 A. B. C. D. Overnight stays by family members is against hospital policy. There is no need for him to stay because staffing is adequate. His wife will rest much better knowing that he is at home. Visitation is limited to 30 minutes when the implant is in place. 36. The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client? Quick Answer: 223 Detailed Answer: 228 Quick Answer: 223 Detailed Answer: 229 A. B. C. D. Roast beef sandwich, potato chips, pickle spear, iced tea Split pea soup, mashed potatoes, pudding, milk Tomato soup, cheese toast, Jello, coffee Hamburger, baked beans, fruit cup, iced tea 37. The physician has prescribed Novalog insulin for a client with dia- betes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs? A. B. C. D. “I will make sure I eat breakfast within 10 minutes of taking my insulin.” “I will need to carry candy or some form of sugar with me all the time.” “I will eat a snack around three o’clock each after- noon.” “I can save my dessert from supper for a bedtime snack.” 38. The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath is recom- mended for the first two weeks of life because: Quick Answer: 223 Detailed Answer: 229 A. B. C. D. New parents need time to learn how to hold the baby. The umbilical cord needs time to separate. Newborn skin is easily traumatized by washing. The chance of chilling the baby outweighs the benefits of bathing. 39. AclientwithleukemiaisreceivingTrimetrexate.Afterreviewing the client’s chart, the physician orders Wellcovorin (leucovorin cal- cium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to: Quick Check QuickAnswer:223 Detailed Answer: 229 A. B. C. D. Treat iron-deficiency anemia caused by chemothera- peutic agents Create a synergistic effect that shortens treatment time Increase the number of circulating neutrophils Reverse drug toxicity and prevent tissue damage 40. A four-month-old is brought to the well-baby clinic for immuniza- tion. In addition to the DPT and polio vaccines, the baby should receive: Quick Answer: 223 Detailed Answer: 229 Quick Answer: 223 Detailed Answer: 229 Quick Answer: 223 Detailed Answer: 229 A. B. C. D. Hibtiter Mumps vaccine Hepatitis B vaccine MMR 41. The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication: A. B. C. D. 30 minutes before a meal With each meal In a single dose at bedtime 30 minutes after meals 42. A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take? A. B. C. D. Call security for assistance and prepare to sedate the client. Tell the client to calm down and ask him if he would like to play cards. Tell the client that if he continues his behavior he will be punished. Leave the client alone until he calms down. Practice Exam 3 and Rationales 177 178 Chapter 3 43. When the nurse checks the fundus of a client on the first postpar- tum day, she notes that the fundus is firm, is at the level of the umbilicus, and is displaced to the right. The next action the nurse should take is to: Quick Check Quick Answer: 223 Detailed Answer: 229 A. B. C. D. Check for the expulsion of small clots. Check the client for bladder distention. Assess the blood pressure for hypotension. Determine whether an oxytocic drug was given. 44. A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood-tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are consistent with a diagnosis of: Quick Answer: 223 Detailed Answer: 229 Quick Answer: 223 Detailed Answer: 229 A. B. C. D. Superinfection due to low CD4 count Pneumonia Reaction to antiviral medication Tuberculosis 45. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client’s history should be reported to the doctor? A. B. C. D. Cluster headaches Diabetes Prinzmetal’s angina Cancer 46. The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irrita- tion and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes: Quick Answer: 223 Detailed Answer: 229 A. B. C. D. Dizziness when changing positions Pain on flexion of the hip and knee Nuchal rigidity on flexion of the neck Pain when the head is turned to the left side 47. The client with Alzheimer’s disease is being assisted with activities of daily living when the nurse notes that the client uses her tooth- brush to brush her hair. The nurse is aware that the client is exhibiting: Quick Check Quick Answer: 223 Detailed Answer: 229 A. B. C. D. Agnosia Apraxia Anomia Aphasia 48. The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as: Quick Answer: 223 Detailed Answer: 230 Quick Answer: 223 Detailed Answer: 230 A. B. C. D. Chronic fatigue syndrome Normal aging Sundowning Delusions 49. The client with confusion says to the nurse, “I haven’t had any- thing to eat all day long. When are they going to bring breakfast?” The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this conversation. Which response would be best for the nurse to make? A. B. “You know you had breakfast 30 minutes ago.” “I am so sorry that they didn’t get you breakfast. I’ll report it to the charge nurse.” C. D. “You will have to wait a while; lunch will be here in a “I’ll get you some juice and toast. Would you like something else?” little while.” 50. The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s disease. Which side effect is most often associated with this drug? Quick Answer: 223 Detailed Answer: 230 A. B. C. D. Urinary incontinence Headaches Confusion Nausea Practice Exam 3 and Rationales 179 180 Chapter 3 51. A client is admitted to the labor and delivery unit in active labor. During examination, the nurse notes a papular lesion on the per- ineum. Which initial action is most appropriate? Quick Check Quick Answer: 223 Detailed Answer: 230 Quick Answer: 223 Detailed Answer: 230 Quick Answer: 223 Detailed Answer: 230 A. B. C. D. Document the finding. Report the finding to the doctor. Prepare the client for a C-section. Continue primary care as prescribed. 52. A client with a diagnosis of HPV is at risk for which of the following? A. B. C. D. A. B. C. D. Venereal Disease Research Lab (VDRL) Rapid plasma reagin (RPR) Fluorescent treponemal antibody (FTA) Thayer-Martin culture (TMC) Hodgkin’s lymphoma Cervical cancer Multiple myeloma Ovarian cancer 53. During the initial interview, the client report

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