NCLEX-PN Test Prep: Practice Exam 1 (Study Mode), Exams of Nursing

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NCLEX-PN Test Prep

Questions and Answers

with ExplanationsV

PRACTICE EXAM 1

UPDATE

NCLEX PN V

NCLEX-PN Test Prep

Questions and Answers with Explanations

V1 PRACTICE EXAM 1 (STUDY MODE)

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.
14. The nurse is caring for a client following a right nephrolithotomy. Postoperatively, the client should be positioned: A. On the right side B. Supine C. On the left side D. Prone Answer C: Following a nephrolithotomy, the client should be positioned on the unoperative side. Answers A, B, and D are incorrect positions for the client following a nephrolithotomy.
15. A nursing assistant is referred to the employee health office with symptoms of latex allergy. The first symptom usually noticed by those with latex allergy is: A. Oral itching after eating bananas B. Swelling of the eyes and mouth C. Difficulty breathing D. Swelling and itching of the hands

Answer D: The first sign of a latex allergy is usually contact dermatitis, which includes swelling and itching of the hands. Answers A, B, and C can also occur but are not the first signs of latex allergy; therefore, they are incorrect.

16. Acticoat (silver nitrate) dressings are applied to the arms and chest of a client with full-thickness burns. The nurse should: A. Change the dressings once per shift B. Moisten the dressings with sterile water C. Change the dressings only when they become soiled D. Moisten the dressings with normal saline Answer B: The dressings should be moistened with sterile water. Answer A is incorrect because Acticoat dressings remain in place up to 5 days. Answer C is incorrect because the dressings should be changed every 4 or 5 days. Answer D is incorrect because normal saline should not be used to moisten the dressing.
17. A client is diagnosed with stage III Hodgkin’s lymphoma. The nurse recognizes that the client has involvement: A. In a single lymph node or single site B. In more than one node or single organ on the same side of the diaphragm C. In lymph nodes on both sides of the diaphragm D. In disseminated organs and tissues Answer C: Stage III Hodgkin’s lymphoma is characterized by lymph node involvement on both sides of the diaphragm. Answer A refers to stage I Hodgkin’s lymphoma; therefore, it is incorrect. Answer B refers to stage II Hodgkin’s lymphoma; therefore, it is incorrect. Answer D refers to stage IV Hodgkin’s lymphoma; therefore, it is incorrect.
18. A client has been receiving Rheumatrex (methotrexate) for severe rheumatoid arthritis. The nurse should tell the client to avoid taking: A. Aspirin B. Multivitamins

C. Omega 3 and omega 6 fish oils D. Acetaminophen Answer B: The client taking methotrexate should avoid multivitamins because they contain folic acid. Folic acid is the antidote for methotrexate. Answers A and D are incorrect because aspirin and acetaminophen are given to relieve pain and inflammation associated with rheumatoid arthritis. Answer C is incorrect because omega 3 and omega 6 fish oils have proven beneficial for the client with rheumatoid arthritis.

19. A suitable diet for a client with cirrhosis and abdominal ascites is one that is: A. High in sodium, low in calories B. Low in potassium, high in calories C. High in protein, high in calories D. Low in calcium, low in calories Answer C: The client with ascites requires additional protein and calories unless the client’s condition deteriorates because of renal involvement. In that case, protein intake is restricted. Answer A is incorrect because the client needs a low-sodium diet. Answer B is incorrect because the client does not need to decrease his intake of potassium. Answer D is incorrect because the client needs adequate amounts of calcium-rich foods that are also excellent sources of protein.
20. A client with gallstones in the gall bladder is scheduled for lithotripsy. For the procedure, the client will be placed: A. In a prone position B. In a supine position C. In a side-lying position D. In a recumbent position Answer A is correct because it is the position used for lithotripsy for the client with gallstones in the gall bladder. Answer B is incorrect because it is the position used for lithotripsy for the client with gallstones in the common bile duct. Answers C and D are incorrect because side-lying and recumbent positions do not allow the maximum effect of therapy.

21. A client with rheumatoid arthritis is being treated with daily steroid medication. Which food should the client avoid? A. Raw oysters B. Cottage cheese C. Baked chicken D. Green beans Answer A: Persons receiving steroids should eat only cooked or processed foods. Raw oysters carry hepatitis A as well as E. coli. Answers B, C, and D are all suitable foods for the client taking steroid medication; therefore, they are incorrect.
22. A client tells the nurse that she takes St. John’s wort (hypericum perforatum) three times a day for mild depression. The nurse should tell the client that: A. St. John’s wort seldom relieves depression. B. She should avoid eating cold cuts and aged cheese. C. Skin reactions increase with the use of sunscreens. D. St. John’s wort will increase the amount of medication needed. Answer B: St. John’s wort has properties similar to those of monoamine oxidase inhibitors (MAOI). Eating foods high in tryramine (aged cheese, chocolate, salami, liver, and so on) can result in a hypertensive crisis. Answer A is incorrect because it can relieve mild to moderate depression. Answer C is incorrect because use of a sunscreen prevents skin reactions to sun exposure. Answer D is incorrect because the use of St. John’s wort decreases the amount of medication needed.
23. The physician has instructed the client with gout to avoid protein sources of purine. Which protein source is high in purine? A. Dried beans B. Nuts C. Cheese D. Eggs Answer A: Foods high in purine include dried beans, peas, spinach, oatmeal,

poultry, fish, liver, lobster, and oysters. Answers B, C, and D are incorrect because they are low in purine. Other sources low in purine include most vegetables, milk, and gelatin.

24. The nurse is caring for a client with a long history of bulimia. The nurse would expect the client to have: A. Extreme weight loss B. Dental caries C. Hair loss D. Lanugo Answer B: The client with bulimia is prone to dental caries due to erosion of the tooth enamel from frequent bouts of self-induced vomiting. Answers A, C, and D are findings associated with anorexia nervosa, not bulimia; therefore, they are incorrect.
25. A client with paranoid schizophrenia has an order for Thorazine (chlorpromazine) 400mg orally twice daily. Which of the following symptoms should be reported to the physician immediately? A. Muscle spasms of the neck, difficulty in swallowing B. Dry mouth, constipation, blurred vision C. Lethargy, slurred speech, thirst D. Fatigue, drowsiness, photosensitivity Answer A: Adverse reactions to Thorazine include dystonia. Spasms of the neck and difficulty swallowing can lead to airway compromise. Answers B, C, and D are expected side effects that occur with the use of Thorazine. They do not require that the physician be notified immediately; therefore, they are incorrect.
26. The nurse is applying a Transderm Nitro (nitrogycerin) patch to a client with angina. When applying the patch, the nurse should: A. Shave the area before applying a new patch B. Remove the old patch and clean the skin with alcohol C. Cover the patch with plastic wrap and tape it in place D. Avoid cutting the patch because it will alter the dose

Answer D: Transderm Nitro is a reservoir patch that releases the medication via a semipermeable membrane. Cutting the patch allows too much of the drug to be released. Answer A is incorrect because the area should not be shaved because it can cause skin irritation. Answer B is incorrect because the skin is cleaned with soap and water. Answer C is incorrect because the patch is not covered with plastic wrap.

27. A client with myasthenia gravis is admitted with a diagnosis of cholinergic crisis. The nurse can expect the client to have: A. Decreased blood pressure and pupillary meiosis B. Increased heart rate and increased respirations C. Increased respirations and increased blood pressure D. Anoxia and absence of the cough reflex Answer A: Cholinergic crisis is the result of overmedication with anticholinesterase inhibitors. Clients with cholinergic crisis have the following symptoms: nausea, vomiting, diarrhea, blurred vision, pallor, decreased blood pressure, and pupillary meiosis. Myasthenia crisis is the result of under medication with cholinesterase inhibitors. Answers B, C, and D are incorrect because they are symptoms of myasthenia crisis.
28. The nurse is providing dietary teaching regarding low-sodium diets for a client with hypertension. Which food should be avoided by the client on a low-sodium diet? A. Dried beans B. Swiss cheese C. Peanut butter D. American cheese Answer D: The client should avoid eating American and processed cheeses such as Colby and Cheddar because they are high in sodium. Dried beans, peanut butter, and Swiss cheese are low in sodium; therefore, answers A, B, and C are incorrect.
29. A client is admitted to the emergency room with partial-thickness burns of his head and both arms. According to the Rule of Nines, the nurse

calculates that the TBSA (total body surface area) involved is: A. 20% B. 27% C. 35% D. 50% Answer B: According to the Rule of Nines, the arms (18%) + the head (9%) = 27% TBSA burn injury. Answers A, B, and D are inaccurate percentages for the TBSA; therefore, they are incorrect.

30. The physician has ordered a paracentesis for a client with severe ascites. Before the procedure, the nurse should: A. Instruct the client to void B. Shave the abdomen C. Encourage extra fluids D. Request an abdominal x-ray Answer A: The client should void before the paracentesis to prevent accidental trauma to the bladder. Answer B is incorrect because the abdomen is not shaved. Answer C is incorrect because the client does not need extra fluids, which would cause bladder distention. Answer D is incorrect because the physician, not the nurse, would request an x-ray, if needed.
31. The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching? A. Zovirax (acyclovir) B. Varivax (varicella vaccine) C. VZIG (varicella-zoster immune globulin) D. Periactin (cyproheptadine) Answer A: Acyclovir shortens the course of chickenpox, but the American Academy of Pediatrics does not recommend it for healthy children because of the cost. Answer B is incorrect because it is the vaccine used to prevent chickenpox. Answer C is incorrect because it is the immune globulin given to

those who have been exposed to chickenpox. Answer D is incorrect because it is an antihistamine used to control itching associated with chickenpox.

32. Which of the following clients is most likely to be a victim of elder abuse? A. A 62-year-old female with diverticulitis B. A 76-year-old female with right-sided hemiplegia C. A 65-year-old male with a hip replacement D. A 72-year-old male with diabetes mellitus Answer B: Females with chronic debilitating conditions who are dependent on others for most or all of their care are most likely to be the victims of elder abuse. Answers A, C, and D are incorrect because the clients are less likely to be dependent on others for their care; therefore, they are less likely to be victims of elder abuse. Although they might also be victims, men are less likely to report abuse than women.
33. A hospitalized client with severe anemia is to receive a unit of blood. Which facet of care is most appropriate for the newly licensed practical nurse? A. Initiating the IV of normal saline B. Monitoring the client’s vital signs C. Initiating the blood transfusion D. Notifying the physician of a reaction Answer B: The most appropriate facet of care for the newly licensed practical nurse is the monitoring of the client’s vital signs. Answers A and C are incorrect because initiation of IV fluids and administration of blood is the responsibility of the registered nurse. Answer D is incorrect because in the hospital setting, the registered nurse would be responsible for notifying the physician of a reaction.
34. To reduce the possibility of having a baby with a neural tube defect, the client should be told to increase her intake of folic acid. Dietary sources of folic acid include: A. Meat, liver, eggs B. Pork, fish, chicken

C. Oranges, cabbage, cantaloupe D. Dried beans, sweet potatoes, Brussels sprouts Answer C: Dark-green, leafy vegetables; the cabbage family; beets; kidney beans; cantaloupe; and oranges are good sources of folic acid (B9). Meat, liver, eggs, dried beans, sweet potatoes, and Brussels sprouts are good sources of B12; therefore, answers A and D are incorrect. Pork, fish, and chicken are good sources of B6; therefore, answer B is incorrect.

35. A client is admitted for suspected bladder cancer. Which one of the following factors is most significant in the client’s diagnosis? A. Smoking a pack of cigarettes a day for 30 years B. Taking hormone-replacement therapy C. Eating foods with preservatives D. Past employment involving asbestos Answer A: Cigarette smoking is the number-one cause of bladder cancer. Answer B is incorrect because it is associated with breast cancer, not bladder cancer. Answer C is wrong because it is a primary cause of gastric cancer. Answer D is incorrect because it is a cause of certain types of lung cancer.
36. The physician has prescribed nitroglycerin buccal tablets as needed for a client with angina. The nurse should tell the client to take the tablets: A. After engaging in strenuous activity B. Every 4 hours to prevent chest pain C. When he first feels chest discomfort D. At bedtime to prevent nocturnal angina Answer C: Nitrogycerin tablets should be used as soon as the client first notices chest pain or discomfort. Answer A is incorrect because the medication should be used before engaging in activity. Strenuous activity should be avoided. Answer B is incorrect because the medication should be used when pain occurs, not on a regular schedule. Answer D is incorrect because the medication will not prevent nocturnal angina.
37. The nurse is caring for an infant who is on strict intake and output. The used diaper weighs 90.5 grams. The diaper’s dry weight was 62 grams. The

infant’s urine output was: A. 10mL B. 28.5mL C. 10 grams D. 152.5 grams Answer B: To obtain the urine output, the weight of the dry diaper ( grams) is subtracted from the weight of the used diaper (90.5 grams), for a urine output of 28.5 grams, or 28.5mL (1 gram = 1mL). Answer A is an inaccurate amount; therefore, it is incorrect. Output is measured in milliliters, not grams; therefore, answers C and D are incorrect.

38. The nurse is teaching the parents of an infant with osteogenesis imperfecta. The nurse should explain the need for: A. Additional calcium in the infant’s diet B. Careful handling to prevent fractures C. Providing extra sensorimotor stimulation D. Frequent testing of visual function Answer B: The infant with osteogenesis imperfecta (ribbon bones) should be handled with care to prevent fractures. Adding calcium to the infant’s diet will not improve the condition; therefore, answer A is incorrect. Answers C and D are not related to the disorder; therefore, they are incorrect.
39. The nurse is preparing a client with gastroesophageal reflux disease (GERD) for discharge. The nurse should tell the client to: A. Eat a small snack before bedtime B. Sleep on his right side C. Avoid colas, tea, and coffee D. Increase his intake of citrus fruits Answer C: The client with gastroesophageal reflux disease (GERD) should avoid beverages containing caffeine because they increase the production of hydrochloric acid, which erodes the esophagus. Answer A is incorrect because the client should not eat for 3–4 hours before going to bed. The client should sleep on his left side, not his right side; therefore, answer B is

incorrect. Citrus juices are acidic, which can contribute to reflux and esophageal erosion; therefore, answer D is incorrect.

40. The nurse is administering Dilantin (phenytoin) via nasogastric (NG) tube. When giving the medication, the nurse should: A. Flush the NG tube with 2–4mL of water before giving the medication B. Administer the medication, flush with 5mL of water, and clamp the NG tube C. Flush the NG tube with 5mL of normal saline and administer the medication D. Flush the NG tube with 2–4oz. of water before and after giving the medication Answer D: The nurse should flush the NG tube with 2–4oz. of water before and after giving the medication. Answers A and B are incorrect because they do not use sufficient amounts of water. Answer C is incorrect because water, not normal saline, is used to flush the NG tube
41. The nurse is caring for a 3-year-old in a wet hip spica cast made from plaster of Paris. When turning the 3-year-old with a wet cast, the nurse should: A. Grasp the cast by the hand B. Use an assistive sling C. Use the palms of the hands D. Obtain a lifting device Answer C: The nurse should handle the cast using the palms of the hands, to prevent indentations in the cast. Answer A is incorrect because grasping the cast with the hands will produce indentations that cause pressure points. Answers B and D are incorrect choices because assistive slings and lifting devices would frighten the 3-year-old and are not needed.
42. A client has a diagnosis of discoid lupus. The primary difference in discoid lupus and systemic lupus is that discoid lupus: A. Produces changes in the kidneys B. Is confined to the skin

C. Results in damage to the heart and lungs D. Affects both joints and muscles Answer B: Discoid lupus is confined to the skin, producing “coinlike” lesions on the skin. Answers A, C, and D refer to systemic lupus; therefore, they are incorrect.

43. The nurse is preparing to walk the post-operative client for the first time since surgery. Before walking the client, the nurse should: A. Give the client pain medication B. Assist the client in dangling his legs C. Have the client breathe deeply D. Provide the client with additional fluids Answer B: Before walking the client for the first time since surgery, the nurse should ask the client to sit on the side of the bed and dangle his legs, to prevent postural hypotension. Pain medication should not be given before walking; therefore, answer A is incorrect. Answers C and D have no relationship to walking the client; therefore, they are incorrect.
44. While performing a neurological assessment on a client with a closed head injury, the licensed practical nurse notes a positive Babinski reflex. The nurse should: A. Recognize that the client’s condition is improving B. Reposition the client and check reflexes again C. Do nothing because the finding is an expected one D. Notify the charge nurse of the finding Answer D: A positive Babinski reflex in adults should be reported to the charge nurse because it indicates an abnormal finding. Answer A is incorrect because a positive Babinski sign in the adult is abnormal, therefore it does not indicate that the client’s condition is improving. Answer B is incorrect because changing the position will not alter the finding. Answer C is incorrect because a positive Babinski reflex is an expected finding in the infant but not in adults.
45. The physician has prescribed Gantrisin (sulfasoxazole) 1 gram in divided

doses for a client with a urinary tract infection. The nurse should administer the medication: A. With meals or a snack B. 30 minutes before meals C. 30 minutes after meals D. At bedtime Answer B: Gantrisin and other sulfa drugs should be given 30 minutes before meals to enhance absorption. Answer A is incorrect because the medication should be given before eating. Answer C is incorrect because the medication should be given on an empty stomach. Answer D is incorrect because the medication is to be given in divided doses throughout the day.

46. A client hospitalized with renal calculi complains of severe pain in the right flank. In addition to complaints of pain, the nurse can expect to see changes in the client’s vital signs, which include: A. Decreased pulse rate B. Increased blood pressure C. Decreased respiratory rate D. Increased temperature Answer B: The client in pain usually has an increased blood pressure. Answers A and C are incorrect because the client in pain will have an increase in the pulse rate and respirations. Temperature is not affected by pain; therefore, answer D is incorrect.
47. A 3-year-old is diagnosed with diarrhea caused by an infection with salmonella. Which of the following most likely contributed to the child’s illness? A. Brushing the family dog B. Playing with a pet turtle C. Taking a pony ride D. Feeding the family cat Answer B: Salmonella infection is commonly associated with turtles. Answers A, C, and D are incorrect because they are not sources of salmonella infection.

48. The nurse is administering Pyridium (phenazopyridine) to a client with cystitis. The nurse should tell the client that: A. The urine will have a strong odor of ammonia. B. The urinary output will increase in amount. C. The urine will have a red–orange color. D. The urinary output will decrease in amount. Answer C: The medication will cause the urine to become red-orange in color. Answers A, B, and D are not associated with the use of Pyridium; therefore, they are incorrect.
49. The nurse is caring for an infant with atopic dermatitis. An important part of the infant’s care will be: A. Keeping the infant warm B. Trimming the fingernails C. Using soap for bathing D. Applying peroxide to dry areas Answer B: The infant’s fingernails should be kept short to prevent scratching the skin. Keeping the infant warm will increase itching; therefore, answer A is incorrect. Soap should not be used because it dries the skin; therefore, answer C is incorrect. Peroxide is damaging to the tissues; therefore, answer D is incorrect.
50. The nurse is providing care for a 10-month-old infant diagnosed with a Wilms tumor. Most parents report feeling a mass when: A. The infant is diapered or bathed B. The infant raises his arms C. The infant has finished a bottle D. The infant tries to sit Answer A: A Wilms tumor is found by most parents when the infant is being diapered or bathed. Answers B, C, and D are not associated with a Wilms tumor; therefore, they are incorrect.
51. The LPN is assigned to care for a client with a fractured femur. Which of

the following should be reported to the charge nurse immediately? A. The client complains of chest pain and feelings of apprehension B. Ecchymosis is noted on the side of the injured leg C. The client’s oral temperature of 99.2°F D. The client complains of Level 2 pain on a scale of 1 to 5 Answer A: Complaints of chest pain and feelings of apprehension are associated with pulmonary emboli, which can occur after the fracture of long bones. These findings should be reported immediately so that interventions can begin. Answer B is incorrect because ecchymosis is common following fractures. Answer C is incorrect because a low-grade temperature is expected because of the inflammatory response. Answer D is incorrect because Level 2 pain is expected in the client with a recent fracture.

52. The Joint Commission for Accreditation of Hospital Organizations (JCAHO) specifies that two client identifiers are to be used before medication administration. Which method is best for identifying patients using two patient identifiers? A. Take the medication administration record (MAR) to the room and compare it with the name and medical number recorded on the armband B. Compare the medication administration record (MAR) with the client’s room number and name on the armband C. Request that a family member identify the client, and then ask the client to state his name D. Ask the client to state his full name and then to write his full name
53. Answer A: JCAHO guidelines state that at least two client identifiers should be used whenever administering medications or blood products, whenever samples or specimens are taken, and when providing treatments. Neither of the identifiers is to be the client’s room number. Answer B is incorrect because the client’s room number is not used as an identifier. Answer C and D are incorrect because the best identifiers according to JCAHO are the client’s armband, medical record number, and/or date of birth.
54. A nurse finds her neighbor lying unconscious in the doorway of her bathroom. After determining that the victim is unresponsive, the nurse should:

A. Start cardiac compression B. Give two slow deep breaths C. Open the airway using the head-tilt chin-lift maneuver D. Call for help Answer D: According to the American Heart Association, the nurse should call for help before instituting CPR. Answer A is incorrect because the nurse would first call for help. The nurse would not start cardiac compressions before evaluating the client’s carotid pulse. Answer B is incorrect because the nurse would first call for help. The nurse would not administer rescue breathing until she established that the client was not breathing on her own. Answer C is incorrect because the nurse would open the airway after calling for help.

54. A client with AIDS-related cytomegalovirus has been started on Cytovene (ganciclovir). The client asks the nurse how long he will have to take the medication. The nurse should tell the client that the medication will be needed: A. Until the infection clears B. For 6 months to a year C. Until the cultures are normal D. For the remainder of life Answer D: The medication must be taken for the remainder of the client’s life to prevent the reoccurrence of CMV infection. Answers A, B, and C are inaccurate statements; therefore, they are incorrect.
55. The nurse is caring for a client with a basal cell epithelioma. The nurse recognizes that the risk factors for basal cell carcinoma include having fair skin and: A. Sun exposure B. Smoking C. Ingesting alcohol D. Ingesting food preservatives Answer A: Basal cell epithelioma, skin cancer, is related to sun exposure.

Answers B, C, and D are incorrect because they are not associated with the development of basal cell epithelioma.

56. While caring for a client following a Whipple procedure, the LPN notices that the drainage has become bile tinged and has increased over the past hour. The LPN should: A. Document the finding and continue to monitor the client B. Irrigate the drainage tube with 10mL of normal saline C. Decrease the amount of intermittent suction D. Notify the RN regarding changes in the drainage Answer D: The appearance of increased drainage that is clear, colorless, or bile tinged indicates disruption or leakage at one of the anastamosis sites, which requires immediate attention. Answer A is incorrect because the client’s condition will worsen without prompt intervention. Answers B and C are incorrect choices because they cannot be performed without a physician’s order.
57. A client with AIDS tells the nurse that he regularly takes Echinacea to boost his immune system. The nurse should tell the client that: A. Herbals can interfere with the action of antiviral medication. B. Supplements have proven effective in prolonging life. C. Herbals have been shown to decrease the viral load. D. Supplements appear to prevent replication of the virus. Answer A: Herbals such as Echinacea can interfere with the action of antiviral medications; therefore, the client should discuss the use of herbals with his physician. Answer B is incorrect because supplements have not been shown to prolong life. Answer C is incorrect because herbals have not been shown to be effective in decreasing the viral load. Answer D is incorrect because supplements do not prevent replication of the virus.
58. A client receiving chemotherapy has Sjogren’s syndrome. The nurse can help relieve the discomfort caused by Sjogren’s syndrome by: A. Providing cool, noncarbonated beverages B. Instilling eyedrops

C. Administering prescribed antiemetics D. Providing small, frequent meals Answer B: The client with Sjogren’s syndrome complains of dryness of the eyes. The nurse can help relieve the client’s discomfort by instilling eyedrops. Answers A, B, and C do not relieve the symptoms of Sjogren’s syndrome; therefore, they are incorrect.

59. Which one of the following symptoms is common in the client with duodenal ulcers? A. Vomiting shortly after eating B. Epigastric pain following meals C. Frequent bouts of diarrhea D. Presence of blood in the stools Answer D: Melena, or blood in the stool, is common in the client with duodenal ulcers. Answers A and B are symptoms of gastric ulcers; therefore, they are incorrect. Diarrhea is not a symptom of duodenal ulcers; therefore, answer C is incorrect.
60. The physician has prescribed a Flovent (fluticasone) inhaler two puffs twice a day for a client with chronic obstructive pulmonary disease. The nurse should tell the client to report: A. Increased weight B. A sore throat C. Difficulty in sleeping D. Changes in mood Answer B: Clients who use steroid medications, such as fluticasone, can develop adverse side effects, including oral infections with candida albicans. Symptoms of candida albicans include sore throat and white patches on the oral mucosa. Increased weight, difficulty in sleeping, and changes in mood are expected side effects; therefore, answers A, C, and D are incorrect.
61. A client treated for depression is admitted with a diagnosis of serotonin syndrome. The nurse recognizes that serotonin syndrome can be caused by: A. Concurrent use of two SSRIs

B. Eating foods that are high in tyramine C. Drastic decrease in dopamine levels D. Use of medications containing pseudoephedrine Answer A: Concurrent use of two SSRIs can result in serotonin syndrome, a potentially lethal condition. Answer B is incorrect because it refers to the “Parnate-cheese” reaction or hypertension that results when the client taking an MAO inhibitor ingests sources of tyramine. Answer C in incorrect because it refers to neuroleptic malignant syndrome or elevations in temperature caused by antipsychotic medication. Answer D is incorrect because it refers to the hypertension that results when MAO inhibitors are used with cold and hayfever medications containing pseudoephedrine.

62. A client is admitted with suspected pernicious anemia. Which finding is common in the client with pernicious anemia? A. Complaints of feeling tired and listless B. Waxy, pale skin C. Loss of coordination and position sense D. Rapid pulse rate and heart murmur Answer C: Pernicious anemia is characterized by changes in neurological function such as loss of coordination and loss of position sense. Answers A, B, and D are applicable to all types of anemia; therefore, they are incorrect.
63. Which finding is associated with secondary syphilis? A. Painless, popular lesions on the perineum, fingers, and eyelids B. Absence of lesions C. Deep asymmetrical granulomatous lesions D. Well-defined generalized lesions on the palms, soles, and perineum Answer D: Secondary syphilis is characterized by well-defined generalized lesions on the palms, soles, and perineum. Lesions can enlarge and erode, leaving highly contagious pink or grayish white lesions. Answer A describes the chancre associated with primary syphilis; therefore, it is incorrect. Answer B describes the latent stage of syphilis; therefore, it is incorrect. Answer C describes late syphilis; therefore, it is incorrect.

64. The physician has ordered an injection of morphine for a client with postoperative pain. Before administering the medication, it is essential that the nurse assess the client’s: A. Heart rate B. Respirations C. Temperature D. Blood pressure Answer B: Morphine can severely depress the client’s respirations. Answer A is incorrect because the assessment of heart rate, a part of pain assessment, is not an essential assessment for administering morphine. Answer C is incorrect because temperature is not affected by the administration of morphine. Answer D is incorrect because assessment of blood pressure, a part of pain assessment, is not an essential assessment for administering morphine.
65. The nurse is assessing a client following a subtotal thyroidectomy. Part of the assessment is asking the client to state her name. The primary reason for asking the client to state her name is to check for: A. Post-operative bleeding B. Decreased calcium C. Laryngeal stridor D. Laryngeal nerve damage Answer D: Hoarseness and weak voice are signs of laryngeal nerve damage. These would be evident when the client states her name. Answer A is incorrect because it is not assessed by having the client state her name. The nurse would check the client’s dressing and check behind the neck for signs of post-operative bleeding. Answer B is incorrect because it is not assessed by having the client state her name. Signs of decreased calcium include tingling around the mouth and muscle twitching. Answer C is incorrect because it is not assessed by having the client state her name. Signs of laryngeal stridor include harsh, high-pitched respirations.
66. A client is admitted for treatment of essential hypertension. Essential hypertension exists when the client maintains a blood pressure reading at or above: