NCLEX-PN (STRAIGHT FROM ATI) PREP
EXAM QUESTIONS WITH CORRECT
ANSWERS
A nurse is assigned care of a client who has HIV. Which of the following infection
control precautions should the nurse plan to use while caring for this client? - Answer-
Standard precautions. HIV is not spread through cough or casual contact.
A nurse is contributing to the plan of care for a client who has a pressure ulcer on his
heel. Should the nurse: keep the ulcer bed dry, clean the ulcer with hydrogen peroxide,
provide the client a diet high in vitamin C, or reposition them every 4 hours? - Answer-
Provide the client a diet that's high in vitamin C in order to promote wound healing and
development of new tissue.
A nurse is caring for a client who has urinary incontinence. What should the nurse do to
prevent the development of skin breakdown? - Answer-Apply a moisture barrier
ointment to the skin to prevent further contact of the skin with urine.
A nurse is planning to perform passive range of motion to a client who is immobilized.
Should the nurse: support extremities above and below joints, stretch the body part just
beyond the existing range of motion, or continue moving body parts if muscle spasticity
occurs? - Answer-Support extremities above and below the joints to prevent muscle
strain or injury.
Identify Erikson's stages of psychosocial development from birth through 18 years of
age. - Answer-trust vs mistrust,
autonomy vs shame and doubt,
initiative vs guilt,
industry vs inferiority,
identify vs role confusion
A nurse is collecting data from a client who has hypokalemia as a result of nausea,
vomiting, and diarrhea. Should the nurse expect: hyperactive reflexes, extreme thirst,
weak irregular pulse, or hyperactive bowel sounds? - Answer-A weak, irregular pulse.
Common manifestations of potassium depletion include: a weak and irregular pulse,
muscle weakness, fatigue, and ventricular dysrhythmias.
A nurse is contributing to the plan of care for a client who has a gastrostomy tube
through which he is receiving continuous enteral feedings. Which of the following
interventions should the nurse include in the plan? - Answer--The nurse should flush the
gastrostomy tube with 30 to 60 mL of water every four hours to provide free water to the
client and prevent dehydration.
, -The nurse should change the feeding bag and tubing every 24 hr to limit the growth of
bacteria within the system.
-The nurse should elevate the head of the bed to 45 degrees (semi-Fowler's position)
for a client who is receiving continuous enteral feedings to limit the risk of aspiration of
the formula.
-The nurse should limit the quantity in the feeding bag to provide feeding for a 4 hr time
frame to limit bacterial growth within the system.
A nurse is verifying that a client is giving informed consent to undergo electroconvulsive
therapy. Which of the following actions should the nurse take? - Answer-Confirm the
client's signature is authentic.
When verifying that a client is giving informed consent, the nurse's responsibilities
include: identifying if the client's signature is authentic, that the client gave consent
voluntarily, and that the client appears to be competent to give consent.
A nurse is caring for a client who presents to urgent care with a laceration on his
forearm. Which of the following activities is an example of primary prevention? -
Answer-Administering a tetanus shot is an example of primary prevention. (Primary
prevention is true prevention of the manifestations of illness through health promotion
and disease prevention. This level of prevention includes immunizations because they
provide protection against specific infections and diseases.)
[Secondary prevention focuses on prompt intervention for health problems or issues.]
-Suturing the client's wound is an example of secondary prevention.
-Applying a sterile dressing to the client's wound is an example of secondary prevention.
-Client teaching is an example of secondary prevention.
-If the client's laceration has caused nerve damage and functional disability, follow-up
care would include tertiary prevention activities, such as rehabilitation.
A nurse is reinforcing teaching about complete or incomplete protein. Which of the
following is a complete protein: yogurt, fresh vegetables, nuts, or dried beans? -
Answer-Yogurt is a complete protein. All nine essential amino acids in the quantities
needed by the body are found in a complete protein for protein synthesis.
A nurse is caring for an older adult client who has constipation. Which of the following
actions should the nurse take? - Answer-To help relieve constipation, the nurse should
instruct the client to drink more water, hot liquids such as water with lemon juice, and
eat foods that are high in fiber, such as whole-grain bread, bran, and raw fruits.
-Establishing a regular aerobic exercise program, not merely putting joints through their
range of motion, will help promote healthy defecation.
-Gas-producing foods such as beans, broccoli, corn, and cabbage can help promote
defecation.
EXAM QUESTIONS WITH CORRECT
ANSWERS
A nurse is assigned care of a client who has HIV. Which of the following infection
control precautions should the nurse plan to use while caring for this client? - Answer-
Standard precautions. HIV is not spread through cough or casual contact.
A nurse is contributing to the plan of care for a client who has a pressure ulcer on his
heel. Should the nurse: keep the ulcer bed dry, clean the ulcer with hydrogen peroxide,
provide the client a diet high in vitamin C, or reposition them every 4 hours? - Answer-
Provide the client a diet that's high in vitamin C in order to promote wound healing and
development of new tissue.
A nurse is caring for a client who has urinary incontinence. What should the nurse do to
prevent the development of skin breakdown? - Answer-Apply a moisture barrier
ointment to the skin to prevent further contact of the skin with urine.
A nurse is planning to perform passive range of motion to a client who is immobilized.
Should the nurse: support extremities above and below joints, stretch the body part just
beyond the existing range of motion, or continue moving body parts if muscle spasticity
occurs? - Answer-Support extremities above and below the joints to prevent muscle
strain or injury.
Identify Erikson's stages of psychosocial development from birth through 18 years of
age. - Answer-trust vs mistrust,
autonomy vs shame and doubt,
initiative vs guilt,
industry vs inferiority,
identify vs role confusion
A nurse is collecting data from a client who has hypokalemia as a result of nausea,
vomiting, and diarrhea. Should the nurse expect: hyperactive reflexes, extreme thirst,
weak irregular pulse, or hyperactive bowel sounds? - Answer-A weak, irregular pulse.
Common manifestations of potassium depletion include: a weak and irregular pulse,
muscle weakness, fatigue, and ventricular dysrhythmias.
A nurse is contributing to the plan of care for a client who has a gastrostomy tube
through which he is receiving continuous enteral feedings. Which of the following
interventions should the nurse include in the plan? - Answer--The nurse should flush the
gastrostomy tube with 30 to 60 mL of water every four hours to provide free water to the
client and prevent dehydration.
, -The nurse should change the feeding bag and tubing every 24 hr to limit the growth of
bacteria within the system.
-The nurse should elevate the head of the bed to 45 degrees (semi-Fowler's position)
for a client who is receiving continuous enteral feedings to limit the risk of aspiration of
the formula.
-The nurse should limit the quantity in the feeding bag to provide feeding for a 4 hr time
frame to limit bacterial growth within the system.
A nurse is verifying that a client is giving informed consent to undergo electroconvulsive
therapy. Which of the following actions should the nurse take? - Answer-Confirm the
client's signature is authentic.
When verifying that a client is giving informed consent, the nurse's responsibilities
include: identifying if the client's signature is authentic, that the client gave consent
voluntarily, and that the client appears to be competent to give consent.
A nurse is caring for a client who presents to urgent care with a laceration on his
forearm. Which of the following activities is an example of primary prevention? -
Answer-Administering a tetanus shot is an example of primary prevention. (Primary
prevention is true prevention of the manifestations of illness through health promotion
and disease prevention. This level of prevention includes immunizations because they
provide protection against specific infections and diseases.)
[Secondary prevention focuses on prompt intervention for health problems or issues.]
-Suturing the client's wound is an example of secondary prevention.
-Applying a sterile dressing to the client's wound is an example of secondary prevention.
-Client teaching is an example of secondary prevention.
-If the client's laceration has caused nerve damage and functional disability, follow-up
care would include tertiary prevention activities, such as rehabilitation.
A nurse is reinforcing teaching about complete or incomplete protein. Which of the
following is a complete protein: yogurt, fresh vegetables, nuts, or dried beans? -
Answer-Yogurt is a complete protein. All nine essential amino acids in the quantities
needed by the body are found in a complete protein for protein synthesis.
A nurse is caring for an older adult client who has constipation. Which of the following
actions should the nurse take? - Answer-To help relieve constipation, the nurse should
instruct the client to drink more water, hot liquids such as water with lemon juice, and
eat foods that are high in fiber, such as whole-grain bread, bran, and raw fruits.
-Establishing a regular aerobic exercise program, not merely putting joints through their
range of motion, will help promote healthy defecation.
-Gas-producing foods such as beans, broccoli, corn, and cabbage can help promote
defecation.
