NCLEX-RN Practice Quiz Test Bank #9 (75 Questions)

NCLEX-RN Practice Quiz Test Bank #9 (75 Questions) 1. 1. Question Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell’s traction? o A. 16-year-old female with scoliosis o B. 12-year-old male with a fractured femur o C. 10-year-old male with sarcoma o D. 6-year-old male with osteomyelitis Incorrect Correct Answer: B. 12-year-old male with a fractured femur The 6-year-old should have a roommate as close to the same age as possible, so the 12-year-old is the best match. A bed is available and the patient gets assigned. There are certain constraints—sex, semi-private versus private, isolation issues, acuity, telemetry and specialty needs. All need to be taken into account to ensure that each patient goes to the right place and receives the proper care. But good capacity management demands that bed assignment be carefully considered and executed. • Option A: The client is too old and is female. Bed assignment simply provides the proper location based on specific patient attributes like sex, isolation, telemetry, acuity, and specialty needs. • Option C: The 10-year-old with sarcoma has cancer and will be treated with chemotherapy that makes him immune suppressed. Bed managers aim at finding an assignment of patients to rooms that strikes a balance between patients’ preferences and comfort on the one hand, and patients’ clinical conditions and the resulting required room facilities on the other. • Option D: The 6-year-old with osteomyelitis is infectious. Rooms and beds belong to the critical assets of just any hospital. They account for a considerable part of a hospital’s infrastructure, and a large amount of financial resources are invested in equipping them with medical apparatus to facilitate patient care. Furthermore, they also represent the place where most patients will spend a large part of their stay, as they recover from surgery, wait for examinations to take place, etc. 2. 2. Question A client with osteoarthritis has a prescription for celebrex (Celecoxib). Which instruction should be included in the discharge teaching? • A. Take the medication with milk. • B. Report chest pain. • C. Remain upright after taking for 30 minutes. • D. Allow 6 weeks for optimal effects. Incorrect Correct Answer: B. Report chest pain. Cox II inhibitors have been associated with heart attacks and strokes. Any changes in cardiac status or signs of a stroke should be reported immediately, along with any changes in bowel or bladder habits because bleeding has been linked to use of Cox II inhibitors. Like all NSAIDs, celecoxib carries an FDA boxed warning for cardiovascular risk, including the increased risk of heart attacks and strokes. As a selective COX-2 inhibitor, celecoxib also faces scrutiny for increased cardiovascular risk, since another selective COX-2 inhibitor, rofecoxib, was withdrawn from production in 2004 due to cardiovascular risk concerns. • Options A: The medication can be taken with water. Celecoxib is a medication that is taken orally and comes in 50, 100, 200, and 400 mg doses. In rare cases, celecoxib can also be added to customized compounds for topical administration with or without the use of iontophoresis or other topical delivery mechanisms. It is not available via any other route of administration. • Option C: The client may remain upright but not necessarily for 30 minutes. Symptoms of celecoxib overdose would likely be similar to overdoses of other NSAIDs, which include lethargy, drowsiness, nausea, vomiting, and epigastric pain. Activated charcoal may be administered for overdose treatment at the discretion of emergency medical providers if the patient presents within 4 hours of known or suspected ingestion of significant amounts of celecoxib. • Option D: Allow 6 weeks for optimal effect. In the inpatient setting, as mentioned above, celecoxib is increasingly being used as part of pre-operative and post-operative multimodal pain management algorithms. Research has shown in several small randomized trials that administering celecoxib peri-operatively for elective procedures such as total hip arthroplasties, total knee arthroplasties, and other procedures with some success in reducing pain and improving functionality such as early ambulation. 3. 3. Question A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates an understanding of a plaster-of-Paris cast? The nurse: • A. Handles the cast with the fingertips • B. Petals the cast • C. Dries the cast with a hair dryer • D. Allows 24 hours before bearing weight Incorrect Correct Answer: D. Allows