This is part 4 of NCLEX-PN Practice exam. Click on this link to get NCLEX-PN Practice Exam Part 1 and NCLEX-PN Practice Exam Part 2 and NCLEX-PN Practice Exam Part 3. This exam series will have 8 parts and each will have a total of 25 questions with answers and rationales. If you want to practice more questions like this, we strongly suggest to get a copy of NCLEX-PN Practice Questions and NCLEX-PN Exam Cram from informit.com.
1. The nurse is caring for an 8-year-old following a routine tonsillectomy. Which finding should be reported immediately?
a. Reluctance to swallow
b. Drooling of blood-tinged saliva
c. An axillary temperature of 99°F
d. Respiratory stridor
2. The nurse is admitting a client with a suspected duodenal ulcer. The client will most likely report that his abdominal discomfort lessens when he:
a. Skips a meal
b. Rests in recumbent position
c. Eats a meal
d. Sits upright after eating
3. Which of the following meal selections is appropriate for the client with celiac disease?
a. Toast, jam, and apple juice
b. Peanut butter cookies and milk
c. Rice Krispies bar and milk
d. Cheese pizza and Kool-Aid
4. A client with hyperthyroidism is taking lithium carbonate to inhibit thyroid hormone release. Which complaint by the client should alert the nurse to a problem with the client’s medication?
a. The client complains of blurred vision.
b. The client complains of increased thirst and increased urination.
c. The client complains of increased weight gain over the past year.
d. The client complains of ringing in the ears.
5. A 2-month-old infant has just received her first Tetramune injection. The nurse should tell the mother that the immunization:
a. Will need to be repeated when the child is 4 years of age
b. Is given to determine whether the child is susceptible to pertussis
c. Is one of a series of injections that protects against dpt and Hib
d. Is a one-time injection that protects against MMR and varicella
6. The nurse is caring for a client hospitalized with bipolar disorder, manic phase. Which of the following snacks would be best for the client with mania?
a. Potato chips
b. Diet cola
7. A 2-year-old is hospitalized with suspected intussusception. Which finding is associated with intussusception?
a. "Currant jelly" stools
b. Projectile vomiting
c. "Ribbonlike" stools
d. Palpable mass over the flank
8. A client is being treated for cancer with linear acceleration radiation. The physician has marked the radiation site with a blue marking pen. The nurse should:
a. Remove the unsightly markings with acetone or alcohol
b. Cover the radiation site with loose gauze dressing
c. Sprinkle baby powder over the radiated area
d. Refrain from using soap or lotion on the marked area
9. The nurse is caring for a client with acromegaly. Following a transphenoidal hypophysectomy, the nurse should:
a. Monitor the client’s blood sugar
b. Suction the mouth and pharynx every hour
c. Place the client in low Trendelenburg position
d. Encourage the client to cough
10. A client newly diagnosed with diabetes is started on Precose (acarbose). The nurse should tell the client that the medication should be taken:
a. 1 hour before meals
b. 30 minutes after meals
c. With the first bite of a meal
d. Daily at bedtime
11. A client with a deep decubitus ulcer is receiving therapy in the hyperbaric oxygen chamber. Before therapy, the nurse should:
a. Apply a lanolin-based lotion to the skin
b. Wash the skin with water and pat dry
c. Cover the area with a petroleum gauze
d. Apply an occlusive dressing to the site
12. A client with a laryngectomy returns from surgery with a nasogastric tube in place. The primary reason for placement of the nasogastric tube is to:
a. Prevent swelling and dysphagia
b. Decompress the stomach via suction
c. Prevent contamination of the suture line
d. Promote healing of the oral mucosa
13. The chart indicates that a client has expressive aphasia following a stroke. The nurse understands that the client will have difficulty with:
a. Speaking and writing
b. Comprehending spoken words
c. Carrying out purposeful motor activity
d. Recognizing and using an object correctly
14. A camp nurse is applying sunscreen to a group of children enrolled in swim classes. Chemical sunscreens are most effective when applied:
a. Just before sun exposure
b. 5 minutes before sun exposure
c. 15 minutes before sun exposure
d. 30 minutes before sun exposure
15. A post-operative client has an order for Demerol (meperidine) 75mg and Phenergan (promethazine) 25mg IM every 3–4 hours as needed for pain. The combination of the two medications produces a/an:
a. Agonist effect
b. Synergistic effect
c. Antagonist effect
d. Excitatory effect
16. Before administering a client’s morning dose of Lanoxin (digoxin), the nurse checks the apical pulse rate and finds a rate of 54. The appropriate nursing intervention is to:
a. Record the pulse rate and administer the medication
b. Administer the medication and monitor the heart rate
c. Withhold the medication and notify the doctor
d. Withhold the medication until the heart rate increases
17. What information should the nurse give a new mother regarding the introduction of solid foods for her infant?
a. Solid foods should not be given until the extrusion reflex disappears, at 8–10 months of age.
b. Solid foods should be introduced one at a time, with 4- to 7-day intervals.
c. Solid foods can be mixed in a bottle or infant feeder to make feeding easier.
d. Solid foods should begin with fruits and vegetables.
18. A client with schizophrenia is started on Zyprexa (olanzapine). Three weeks later, the client develops severe muscle rigidity and elevated temperature. The nurse should give priority to:
a. Withholding all morning medications
b. Ordering a CBC and CPK
c. Administering prescribed anti-Parkinsonian medication
d. Transferring the client to a medical unit
19. A client with human immunodeficiency syndrome has gastrointestinal symptoms, including diarrhea. The nurse should teach the client to avoid:
a. Calcium-rich foods
b. Canned or frozen vegetables
c. Processed meat
d. Raw fruits and vegetables
20. A 4-year-old is admitted with acute leukemia. It will be most important to monitor the child for:
a. Abdominal pain and anorexia
b. Fatigue and bruising
c. Bleeding and pallor
d. Petechiae and mucosal ulcers
21. A 5-month-old is diagnosed with atopic dermatitis. Nursing interventions will focus on:
a. Preventing infection
b. Administering antipyretics
c. Keeping the skin free of moisture
d. Limiting oral fluid intake
22. The nurse is caring for a client with a history of diverticulitis. The client complains of abdominal pain, fever, and diarrhea. Which food was responsible for the client’s symptoms?
a. Mashed potatoes
b. Steamed carrots
c. Baked fish
d. Whole-grain cereal
23. The physician has scheduled a Whipple procedure for a client with pancreatic cancer. The nurse recognizes that the client’s cancer is located in:
a. The tail of the pancreas
b. The head of the pancreas
c. The body of the pancreas
d. The entire pancreas
24. A child with cystic fibrosis is being treated with inhalation therapy with Pulmozyme (dornase alfa). A side effect of the medication is:
a. Weight gain
b. Hair loss
c. Sore throat
d. Brittle nails
25. The doctor has ordered Percocet (oxycodone) for a client following abdominal surgery. The primary objective of nursing care for the client receiving an opiate analgesic is to:
a. Prevent addiction
b. Alleviate pain
c. Facilitate mobility
d. Prevent nausea