NCLEX RN uworld #06 Exam Latest Updated Graded A+

The labor and delivery (L&D) nurse is floated to a medical-surgical floor for a shift. Which client is MOST APPROPRIATE for the charge nurse to assign to the L&D nurse? # (14) 1. Child with an occluded arteriovenous fistula receiving IV heparin infusion. 2. Client with cirrhosis and ascites who requires bedside paracentesis. 3. Client with diabetes who is one day postoperative below-the-knee amputation. 4. Client with pyelonephritis who is febrile and receiving IV antibiotics - ANSWER 4 frequently care for pregnant woman with urinary tract infections and would be familiar with the management of a client with pyelonephritis. # (14) - ANSWER labor and delivery (L&D) A client is admitted with SICKLE CELL CRISIS has a hemoglobin level of 9 g/dL. The client reports severe pain in the back and leg joints. The nurse would anticipate which of the following ?"SELECT ALL THAT APPLY " # (15) 1. Folic acid supplements 2. Folic high in Iron 3. Ice packs to painful joints 4. Intravenous hydration 5. Intravenous morphine - ANSWER 1,4,5 treatment are narcotic analgesia, aggressive hydration, oxygenation and folic acid, not iron supplementation. - ANSWER sickle cell crisis reduces the viscosity of the blood and prevent sickling. Ice pack should not be applied to swollen joints. #(15) - ANSWER Hydration The nurse is performing a physical examination on a 10 year old client with abdominal discomfort. Which actions would be APPROPRIATE during the examination? "SELECT ALL THAT APPLY" # ( 16) 1. Ask the accompany parent to rate and describe the client's pain. 2. Ask the client to describe the the chief symptom. 3. Conduct a head-to-toe assessment in the same manner as an adult assessment 4. Explain the outcome of the examination to the parent without the child present 5. Honor the client's request to be examined without a parent consent. - ANSWER 2,3,5 The client screams at the nurse, "you are all incompetent here , I have been waiting for 2 hours"How should the nurse respond "INITIALLY"? 1. "I know you are upset, but I will have to call security if you continue to scream." # (17) 2. "I see that you are upset. Let's focus on how I can help you." 3. "I want you to know that the health care providers (HCP) are all well-qualified professionals." 4. "It is frustrating to wait so long, and I am sorry for the delay." - ANSWER 4 The school nurse creates a cafeteria menu for a newly enrolled child with CELIAC DISEASE. Which lunches would be APPROPRIATE for this child? "SELECT ALL THAT APPLY" # (18) 1. Beef barley soup with mixed vegetables and French bread. 2. Grilled chicken, baked potato, and strawberry yogurt. 3. Mexican corn tacos with ground beef and cheese 4. Peanut butter and jelly on rice cakes with an oatmeal cookie 5. Rice needles with chicken and broccoli - ANSWER 2,3,5 is an autoimmne disorder in which an individual cannot tolerate gluten, a protein found in barley, rye, oats and wheat (BROW). Rice, corn and potatoes are allowed in the diet and can be used as grain substitutes. # (18) - ANSWER Celiac disease The mother of a 6 year old child with CYSTIC FIBROSIS (CF) has received instruction on the use of pancreatic enzymes. Which statement made by the mother indicates a "NEED FOR FURTHER TEACHING" # (19) 1. "I need to monitor the total amount of this medication that I give to my child everyday." 2. "I should give this medication with or just before my child has a meal or snack." 3. "It is okay for my child to chew this medication." 4. "It is okay to open the capsule and sprinkle the medicine on a tablespoon of applesauce." - ANSWER 3 are used to aid the absorption of carbohydrates, fats and proteins in a child with CF. They are taken with or just before every meal ( not as needed) , should be swallowed whole or sprinkled on an acidic food and should not be crushed or chewed. They should not be taken with milk. Excessive intake could result in fibrosing colonopathy. # (19) - ANSWER Pancreatic enzyme supplements A nurse cares for a frail, elderly client with osteoporosis in a nursing home. Which interventions are APPROPRIATE to include in the client's care plan to help prevent a hip fracture? "SELECT ALL THAT APPLY" # (20) 1. Calcium supplement 2. Encourage bed rest 3. Use of full bed rails during the night 4. Vitamin D supplements 5. Weight-bearing exercises. - ANSWER 1,4,5 related fall is the most common cause of hip fracture in the elderly. # (20) - ANSWER osteoporosis Intervention to reduce the risk of ___and ____ fracture include bisphosphonate medication, calcium and vitamin D supplements, mobility and weight bearing exercise, smoking cessation and avoiding excessive use of alcohol # (20) - ANSWER fall and hip A nurse auscultates a loud cardiac murmur on a newborn with suspected trisomy 21 (Down syndrome). A genetic screen and an echocardiogram are scheduled that day. The neonate's vital signs are shown in the exhibit. What would be an APPROPRIATE action for the nurse to complete "NEXT"? # (21) Vital sign: Temperature--- 98.6, Heart rate--- 146/min, Respirations ---42/min , O2 saturation --- 98% 1. Call the health care provider (HCP) immediately 2. Document the assessment finding 3. Place the neonate in a knee-chest position 4. Provide oxygen to the neonate. - ANSWER 2 is a cardiac anomaly often associated with trisomy 21 (Down syndrome). As an echocardiogram is already scheduled for that day, documenting the assessment finding would be the appropriate action for the nurse to complete at this time.# (21) - ANSWER Atrioventricular (AV) canal defect is often associated with the cardiac anomaly AV canal defect. Assessment typically includes a loud murmur that requires no immediate action when vital signs are stable. Surgery will correct the anomaly when the neonate grows in size and can tolerate the invasive procedure better .# (21) - ANSWER Trisomy 21 (Down syndrome) The nurse cares for a client following a percutaneous coronary intervention via the right groin. The client received an IV infusion of abciximab during the procedure. Which ACTIONS should the nurse implement? "SELECT ALL THAT APPLY" # (22) 1. Assess invasive procedure sites for bleeding 2. Check hemoglobin and platelet count 3. Initiate a second large-bore IV line 4. Place the client on continuous cardiac monitoring 5. Report black tarry stools to the health care provider - ANSWER 1,2,4,5