NCLEX-PN Test Bank: 200 Questions with Answers and Explanations, Exams of Pneumatics

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NCLEX-PN Test-Bank (200 Questions with Answers and

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 The nurse is caring for a client scheduled for removal of a pituitary tumor using thetranssphenoidal approach. The nurse should be particularly alert for: A. Nasal congestion B. Abdominal tenderness C. Muscle tetany D. Oliguria Answer A: Removal of the pituitary gland is usually done by a transsphenoidal approach, through the nose. Nasal congestion further interferes with the

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airway. Answers B, C, and D arenot correct because they are not directly associated with the pituitary gland.  A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that theclient is experiencing which of the following? A. Hypernatremia B. Hypokalemia C. Myelosuppression D. Leukocytosis Answer B: Hypokalemia is evident from the lab values listed. The other

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laboratory findings arewithin normal limits, making answers A, C, and D incorrect.

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 A 24-year-old female client is scheduled for surgery in the morning. Which of thefollowing is the primary responsibility of the nurse? A. Taking the vital signs B. Obtaining the permit C. Explaining the procedure D. Checking the lab work Answer A: The primary responsibility of the nurse is to take the vital signs before any surgery.The actions in answers B, C, and D are the responsibility of the doctor and, therefore, are incorrect for this question.  The nurse is working in the emergency room when a client arrives with severe burns ofthe left arm, hands, face, and neck. Which action should

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receive priority? A. Starting an IV B. Applying oxygen C. Obtaining blood gases D. Medicating the client for pain Answer B: The client with burns to the neck needs airway assessment and supplemental oxygen, so applying oxygen is the priority. The next action should be to start an IV and medicate for pain, making answers A and C incorrect. Answer D, obtaining blood gases, is ordered by the doctor.

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 The nurse is performing discharge teaching on a client with diverticulitis who has been placed on a low-roughage diet. Which food would have to be eliminated from this client’s diet? A. Roasted chicken B. Noodles C. Cooked broccoli D. Custard Answer C: The client with diverticulitis should avoid eating foods that are gas forming and that increase abdominal discomfort, such as cooked broccoli. Foods such asthose listed in answers A, B, and D are allowed.

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 The nurse is caring for a new mother. The mother asks why her baby has lost weightsince he was born. The best explanation of the weight loss is: A. The baby is dehydrated due to polyuria. B. The baby is hypoglycemic due to lack of glucose. C. The baby is allergic to the formula the mother is giving him. D. The baby can lose up to 10% of weight due to meconium stool, loss of extracellular fluid,and initiation of breast-feeding.

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Answer D: After birth, meconium stool, loss of extracellular fluid, and initiation of breastfeedingcause the infant to lose body mass. There is no evidence to indicate dehydration, hypoglycemia, or allergy to the infant formula; thus, answers A, B, and C are incorrect.  The nurse is caring for a client with laryngeal cancer. Which finding ascertained in thehealth history would not be common for this diagnosis? A. Foul breath B. Dysphagia C. Diarrhea D. Chronic hiccups

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Answer C: Diarrhea is not common in clients with mouth and throat cancer. All the findings inanswers A, B, and D are expected findings.  A removal of the left lower lobe of the lung is performed on a client with lung cancer.Which post-operative measure would usually be included in the plan? A. Closed chest drainage B. A tracheostomy C. A mediastinal tube D. Percussion vibration and drainage Answer A: The client with a lung resection will have chest tubes and a drainage-collection device. He probably will not have a tracheostomy or mediastinal tube, and he will not have anorder for percussion, vibration, or

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drainage. Therefore, answers B, C, and D are incorrect.

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 Six hours after birth, the infant is found to have an area of swelling over the right parietalarea that does not cross the suture line. The nurse should chart this finding as: A. A cephalohematoma B. Molding C. Subdural hematoma D. Caput succedaneum Answer A: A swelling over the right parietal area is a cephalohematoma, an area of bleeding outside the cranium. This type of hematoma does not cross the suture line because it is outside the cranium but beneath the periosteum. Answer B, molding, is overlapping of the bones of thecranium and, thus, incorrect. In answer C, a subdural hematoma, or intracranial bleeding, is ominous and can be seen only on a CAT scan or x-ray. A caput succedaneum, in answer D, crosses the suture line and is edema.

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 The nurse is assisting the RN with discharge instructions for a client with an implantabledefibrillator. What discharge instruction is essential? A. “You cannot eat food prepared in a microwave.” B. “You should avoid moving the shoulder on the side of the pacemaker site for 6 weeks.” C. “ You should use your cellphone on your right side.” D. “You will not be able to fly on a commercial airliner with the defibrillator in place.” Answer C: The client with an internal defibrillator should learn to use any battery-operatedmachinery on the opposite side. He should also take his pulse rate and report dizziness or fainting. Answers A, B, and D are incorrect because the client can eat food prepared in the microwave, move his shoulder on the

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affected side, and fly in an airplane.  A client in the cardiac step-down unit requires suctioning for excess mucous secretions.The nurse should be most careful to monitor the client for which dysrhythmia during this procedure?

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A. Bradycardia B. Tachycardia C. Premature ventricular beats D. Heart block Answer A: Suctioning can cause a vagal response and bradycardia. Answer B is unlikely and,therefore, not most important, although it can occur. Answers C and D can occur as well, but they are less likely.  The nurse is caring for a client scheduled for a surgical repair of a sacular abdominalaortic aneurysm. Which assessment is most crucial during the preoperative period? A. Assessment of the client’s level of anxiety

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B. Evaluation of the client’s exercise tolerance C. Identification of peripheral pulses D. Assessment of bowel sounds and activity Answer C: The assessment that is most crucial to the client is the identification of peripheralpulses because the aorta is clamped during surgery. This decreases blood circulation to the kidneys and lower extremities. The nurse must also assess for the return of circulation to the lower extremities. Answer A is of lesser concern, answer B is not advised at this time, and answer D is of lesser concern than answer A.  A client with suspected renal disease is to undergo a renal biopsy. The nurse plans toinclude which statement in the teaching session?

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A. “You will be sitting for the examination procedure.” B. “ Portions of the procedure will cause pain or discomfort.” C. “You will be given some medication to anesthetize the area.”

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D. “You will not be able to drink fluids for 24 hours before the study.” Answer B: Portions of the exam are painful, especially when the sample is being withdrawn, sothis should be included in the session with the client. Answer A is incorrect because the client will be positioned prone, not in a sitting position, for the exam. Anesthesia is not commonly given before this test, making answer C incorrect. Answer D is incorrect because the client caneat and drink following the test.  The nurse is performing an assessment on a client with possible pernicious anemia.Which data would support this diagnosis? A. A weight loss of 10 pounds in 2 weeks B. Complaints of numbness and tingling in the extremities C. A red, beefy tongue

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D. A hemoglobin level of 12.0gm/dL Answer C: A red, beefy tongue is characteristic of the client with pernicious anemia. Answer A, aweight loss of 10 pounds in 2 weeks, is abnormal but is not seen in pernicious anemia. Numbness and tingling, in answer B, can be associated with anemia but are not particular to pernicious anemia. This is more likely associated with peripheral vascular diseases involvingvasculature. In answer D, the hemoglobin is low normal.  A client arrives in the emergency room with a possible fractured femur. The nurse shouldanticipate an order for: A. Trendelenburg position B. Ice to the entire extremity

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C. Buck’s traction D. An abduction pillow

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Answer C: The client with a fractured femur will be placed in Buck’s traction to realign the leg and to decrease spasms and pain. The Trendelenburg position is the wrong position for this client, so answer A is incorrect. Ice might be ordered after repair, but not for the entire extremity,so answer B is incorrect. An abduction pillow is ordered after a total hip replacement, not for a fractured femur; therefore, answer D is incorrect.  A client with cancer is to undergo an intravenous pyelogram. The nurse should: A. Force fluids 24 hours before the procedure B. Ask the client to void immediately before the study C. Hold medication that affects the central nervous system for 12 hours pre- and post-test D. Cover the client’s reproductive organs with an x-ray shield

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Answer B: The client having an intravenous pyelogram will have orders for laxatives or enemas,so asking the client to void before the test is in order. A full bladder or bowel can obscure the visualization of the kidney ureters and urethra. In answers A, C, and D, there is no need to force fluids before the procedure, to withhold medications, or to cover the reproductive organs.  The nurse is caring for a client with a malignancy. The classification of the primary tumoris Tis. The nurse should plan care for a tumor: A. That cannot be assessed B. That is in situ C. With increasing lymph node involvement D. With distant metastasis

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Answer B: Cancer in situ means that the cancer is still localized to the primary site. Cancer isgraded in terms of tumor, grade, node involvement, and mestatasis. Answer A is incorrect because it is an untrue statement. Answer C is incorrect because T indicates tumor, not node involvement. Answer D is incorrectbecause a tumor that is in situ is not metastasized.

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 A client is 2 days post-operative colon resection. After a coughing episode, the client’s wound eviscerates. Which nursing action is most appropriate? A. Reinsert the protruding organ and cover with 4×4s B. Cover the wound with a sterile 4×4 and ABD dressing C. Cover the wound with a sterile saline-soaked dressing D. Apply an abdominal binder and manual pressure to the wound Answer C: If the client eviscerates, the abdominal content should be covered with a sterile saline-soaked dressing. Reinserting the content should not be the action and will require that theclient return to surgery; thus, answer A is incorrect. Answers B and D are incorrect because theyare not appropriate to this case.

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 The nurse is preparing a client for surgery. Which item is most important to removebefore sending the client to surgery? A. Hearing aid B. Contact lenses C. Wedding ring D. Artificial eye Answer B: It is most important to remove the contact lenses because leaving them in can lead to corneal drying, particularly with contact lenses that are not extended-wear lenses. Leaving in the hearing aid or artificial eye will not harm the client. Leaving the wedding ring on is also allowed;usually, the ring is covered with tape. Therefore, answers A, C, and D are incorrect.

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 The nurse on the 3 – 11 shift is assessing the chart of a client with an abdominal aneurysmscheduled for surgery in the morning and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action?