NCLEX PN V4 EXAM 1 QUESTIONS & ANSWERS WITH RATIONALE 2023/2024 UPDATE

V4 EXAM 1 NCLEX PN V4 EXAM 1 QUESTIONS & ANSWERS WITH RATIONALE 2023/2024 UPDATE 1. A client with AIDS asks the nurse why he can’t have a pitcher of water at his bedside so he can drink whenever he likes. The nurse should tell the client that: A. It would be best for him to drink tap water. B. He should drink less water and more juice. C. Leaving a glass of water makes it easier to calculate his intake. D. He shouldn’t drink water that has been sitting longer than 15 minutes. Answer D: The client with AIDS should not drink water that has been sitting longer than 15 minutes because of bacterial contamination. Answer A is incorrect because tap water is not better for the client. Answer B is incorrect because juices should not replace water intake. Answer C is not an accurate statement; therefore, it is incorrect. 2. The mother of a male child with cystic fibrosis tells the nurse that she hopes her son’s children won’t have the disease. The nurse is aware that: A. There is a 25% chance that his children would have cystic fibrosis. B. Most of the males with cystic fibrosis are sterile. C. There is a 50% chance that his children would be carriers. D. Most males with cystic fibrosis are capable of having children, so genetic counseling is advised. Answer B: Approximately 99% of males with cystic fibrosis are sterile because of obstruction of the vas deferens. Answers A, C, and D are incorrect because most males with cystic fibrosis are incapable of reproduction. 3. An infant is hospitalized for treatment of botulism. Which factor is associated with botulism in the infant? A. The infant sucks on his fingers and toes. B. The mother sweetens the infant’s cereal with honey. C. The infant was switched to soy-based formula. D. The infant’s older sibling has an aquarium. Answer B: Infants under the age of 2 years should not be fed honey because of the danger of infection with Clostridium botulinum. Answers A, C, and D have no relationship to the situation; therefore, they are incorrect. 4. A nurse is assessing a client hospitalized with peptic ulcer disease. Which finding should be reported to the charge nurse immediately? A. BP 82/60, pulse 120 B. Pulse 68, respirations 24 C. BP 110/88, pulse 56 D. Pulse 82, respirations 16 Answer A: Decreased blood pressure and increased pulse rate are signs of bleeding. Answers B, C, and D are within normal limits; therefore, they are incorrect. 5. The nurse is teaching the client with AIDS regarding proper food preparation. Which statement indicates that the client needs further teaching? A. “I should avoid adding pepper to food after it is cooked.” B. “I can still have an occasional medium-rare steak.” C. “Eating cheese and yogurt won’t help prevent AIDS-related diarrhea.” D. “I should eat fruits and vegetables that can be peeled.” Answer B: Undercooked meat is a source of toxoplasmosis cysts. Toxoplasmosis is a major cause of encephalitis in clients with AIDS. Answers A, C, and D are accurate statements reflecting the client’s understanding of the nurse’s teaching; therefore, they are incorrect. 6. A client taking Laniazid (isoniazid) asks the nurse how long she must take the medication before her sputum cultures will return to normal. The nurse recognizes that the client should have a negative sputum culture within: A. 2 weeks B. 6 weeks C. 2 months D. 3 months Answer D: The client taking isoniazid should have a negative sputum culture within 3 months. Answers A, B, and C are incorrect because there has not been sufficient time for the medication to be effective. 7. Which person is at greatest risk for developing Lyme’s disease? A. Computer technician B. Middle-school teacher C. Dog trainer D. Forestry worker Answer D: Lyme’s disease is transmitted by ticks found on deer and mice in wooded areas. Answers A and B have little risk for the disease. Dog trainers are exposed to dog ticks that carry Rocky Mountain Spotted Fever but not Lyme’s disease; therefore, answer C is incorrect. 8. Following eruption of the primary teeth, the mother can promote chewing by giving the toddler: A. Pieces of hot dog B. Celery sticks C. Melba toast D. Grapes Answer C: Melba toast promotes chewing and is easily managed by the toddler. Pieces of hot dog, celery sticks, and grapes are unsuitable for the toddler because of the risk of aspiration. 9. A client scheduled for an exploratory laparotomy tells the nurse that she takes kava-kava (piper methysticum) for sleep. The nurse should notify the doctor because kava-kava: A. Increases the effects of anesthesia and post-operative analgesia B. Eliminates the need for antimicrobial therapy following surgery C. Increases urinary output, so a urinary catheter will be needed postoperatively D. Depresses the immune system, so infection is more of a problem Answer A: Kava-kava increases the effects of central nervous system depressants. Answers B, C, and D are not related to the use of kava-kava; therefore, they are incorrect. 10. The nurse is teaching circumcision care to the mother of a newborn. Which statement indicates that the mother needs further teaching? A. “I will apply a petroleum gauze to the area once a day.” B. “I will clean the area carefully with each diaper change.” C. “I can place a heat lamp next to the area to speed up the healing process.” D. “I should carefully observe the area for signs of infection.” Answer C: The mother does not need to place an external heat source near the infant. It will not promote healing, and there is a chance that the newborn could be burned; therefore, the mother needs further teaching. Answers A, B, and D indicate correct care of the newborn who has been circumcised; therefore, they are incorrect. 11. The chart of a client hospitalized with a fractured femur reveals that the client is colonized with MRSA. The nurse knows that the client: A. Will not display symptoms of infection B. Is less likely to have an infection C. Can be placed in the room with others D. Cannot colonize others with MRSA Answer A: The client who is colonized with MRSA will have no symptoms associated with infection. Answer B is incorrect because the client is more likely to develop an infection with MRSA following invasive procedures. Answer C is incorrect because the client should not be placed in the room with others. Answer D is incorrect because the client can colonize others, including healthcare workers, with MRSA. 12. A client is admitted with Clostridium difficile. The nurse would expect the client to have: A. Diarrhea containing blood and mucus B. Cough, fever, and shortness of breath C. Anorexia, weight loss, and fever D. Development of deep leg ulcers Answer A: Pseudomembranous colitis results from infection with Clostridium difficile. Symptoms of pseudomembranous colitis include diarrhea containing blood, mucus, and white blood cells. Answers B, C, and D are incorrect because they are not symptoms of infection with Clostridium difficile. 13. An elderly client asks the nurse how often he will need to receive immunizations against pneumonia. The nurse should tell the client that she will need an immunization against pneumonia: A. Every year B. Every 2 years C. Every 5 years D. Every 10 years Answer C: Immunization against pneumonia is recommended every 5 years for persons over age 65, as well as for those with a chronic illness. Answers A and B are incorrect because the client still has immunity from the vaccine. Answer D is incorrect because the client should have received the booster immunization much sooner.