NCLEX-PN Test Prep Questions and Answers with Explanations V3 PRACTICE EXAM 1 (STUDY MODE), Exams of Nursing

Download NCLEX-PN Test Prep Questions and Answers with Explanations V3 PRACTICE EXAM 1 (STUDY MODE) and more Exams Nursing in PDF only on Docsity! 2020/2021 NCLEX-PN Test Prep Questions and Answers with Explanations V3 PRACTICE EXAM 1 (STUDY MODE) 1. A client hospitalized with severe depression and suicidal ideation refuses to talk with the nurse. The nurse recognizes that the suicidal client has difficulty: A. Expressing feelings of low self-worth B. Discussing remorse and guilt for actions C. Displaying dependence on others D. Expressing anger toward others Answer D: The suicidal client has difficulty expressing anger toward others. The depressed suicidal client frequently expresses feelings of low self-worth, feelings of remorse and guilt, and a dependence on others; therefore, answers A, B, and C are incorrect. 2. A client receiving HydroDIURIL (hydrochlorothiazide) is instructed to increase her dietary intake of potassium. The best snack for the client requiring increased potassium is: A. Pear B. Apple C. Orange D. Banana Answer D: Answers A, B, and C are incorrect because they contain lower amounts of potassium. (Note that the banana contains 450mg K+, the orange contains 235mg K+, the pear contains 208mg K+, and the apple contains 165mg K+.) 3. The nurse is caring for a client following removal of the thyroid. Immediately post-op, the nurse should: A. Maintain the client in a semi-Fowler’s position with the head and neck supported by pillows B. Encourage the client to turn her head side to side, to promote drainage of oral secretions C. Maintain the client in a supine position with sandbags placed on either side of the head and neck D. Encourage the client to cough and breathe deeply every 2 hours, with the neck in a flexed position Answer A: Following a thyroidectomy, the client should be placed in semiFowler’s position to decrease swelling that would place pressure on the airway. Answers B, C, and D are incorrect because they would increase the chances of post-operative complications that include bleeding, swelling, and airway obstruction. 4. A client hospitalized with chronic dyspepsia is diagnosed with gastric cancer. Which of the following is associated with an increased incidence of gastric cancer? A. Dairy products B. Carbonated beverages C. Refined sugars D. Luncheon meats Answer D: Luncheon meats contain preservatives such as nitrites that have been linked to gastric cancer. Answers A, B, and C have not been found to increase the risk of gastric cancer; therefore, they are incorrect. 5. A client is sent to the psychiatric unit for forensic evaluation after he is accused of arson. His tentative diagnosis is antisocial personality disorder. In reviewing the client’s record, the nurse could expect to find: A. A history of consistent employment B. A below-average intelligence C. A history of cruelty to animals D. An expression of remorse for his actions Answer C: A history of cruelty to people and animals, truancy, setting fires, and lack of guilt or remorse are associated with a diagnosis of conduct disorder in children, which becomes a diagnosis of antisocial personality disorder in adults. Answer A is incorrect because the client with antisocial personality disorder does not hold consistent employment. Answer B is Answer B: Chelating agents are used to treat the client with poisonings from heavy metals such as lead and iron. Answers A and D are used to remove noncorrosive poisons; therefore, they are incorrect. Answer C prevents vomiting; therefore, it is an incorrect response. 12. An 18-month-old is scheduled for a cleft palate repair. The usual type of restraints for the child with a cleft palate repair are: A. Elbow restraints B. Full arm restraints C. Wrist restraints D. Mummy restraints Answer A: The least restrictive restraint for the infant with cleft lip and cleft palate repair is elbow restraints. Answers B, C, and D are more restrictive and unnecessary; therefore, they are incorrect. 13. A client with glaucoma has been prescribed Timoptic (timolol) eyedrops. Timoptic should be used with caution in the client with a history of: A. Diabetes B. Gastric ulcers C. Emphysema D. Pancreatitis Answer C: Beta blockers such as timolol (Timoptic) can cause bronchospasms in the client with chronic obstructive lung disease. Timoptic is not contraindicated for use in clients with diabetes, gastric ulcers, or pancreatitis; therefore, answers A, B, and C are incorrect. 14. An elderly client who experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help decrease the client’s confusion by: A. Assigning a nursing assistant to sit with him until he falls asleep B. Allowing the client to room with another elderly client C. Administering a bedtime sedative D. Leaving a nightlight on during the evening and night shifts Answer D: Leaving a nightlight on during the evening and night shifts helps the client remain oriented to the environment and fosters independence. Answers A and B will not decrease the client’s confusion. Answer C will increase the likelihood of confusion in an elderly client. 15. Which of the following is a common complaint of the client with endstage renal failure? A. Weight loss B. Itching C. Ringing in the ears D. Bruising Answer B: Pruritis or itching is caused by the presence of uric acid crystals on the skin, which is common in the client with end-stage renal failure. Answers A, C, and D are not associated with end-stage renal failure. 16. Which of the following medication orders needs further clarification? A. Darvocet (propoxyphene) 65mg PO every 4–6 hrs. PRN B. Mysoline (primidone) 250mg PO TID C. Coumadin (warfarin sodium) 10mg PO D. Premarin (conjugated estrogen) .625mg PO daily Answer C: There is no specified time or frequency for the ordered medication. Answers A, B, and D contain specified time and frequency, therefore they do not require further clarification. 17. The best diet for the client with Meniere’s syndrome is one that is: A. High in fiber B. Low in sodium C. High in iodine D. Low in fiber Answer B: A low-sodium diet is best for the client with Meniere’s syndrome. Answers A, C, and D do not relate to the care of the client with Meniere’s syndrome; therefore, they are incorrect. 18. Which of the following findings is associated with right-sided heart failure? A. Shortness of breath B. Nocturnal polyuria C. Daytime oliguria D. Crackles in the lungs Answer B: Increased voiding at night is a symptom of right-sided heart failure. Answers A and D are incorrect because they are symptoms of leftsided heart failure. Answer C does not relate to the client’s diagnosis; therefore, it is incorrect. 19. An 8-year-old admitted with an upper-respiratory infection has an order for O2 saturation via pulse oximeter. To ensure an accurate reading, the nurse should: A. Place the probe on the child’s abdomen B. Recalibrate the oximeter at the beginning of each shift C. Apply the probe and wait 15 minutes before obtaining a reading D. Place the probe on the child’s finger Answer D: The pulse oximeter should be placed on the child’s finger or earlobe because blood flow to these areas is most accessible for measuring oxygen concentration. Answer A is incorrect because the probe cannot be secured to the abdomen. Answer B is incorrect because it should be recalibrated before application. Answer C is incorrect because a reading is obtained within seconds, not minutes. 20. An infant with Tetralogy of Fallot is discharged with a prescription for lanoxin elixir. The nurse should instruct the mother to: A. Administer the medication using a nipple B. Administer the medication using the calibrated dropper in the bottle C. Administer the medication using a plastic baby spoon D. Administer the medication in a baby bottle with 1oz. of water Answer B: The medication should be administered using the calibrated dropper that comes with the medication. Answers A and C are incorrect 27. Which instruction should be included in the discharge teaching for the client with cataract surgery? A. Over-the-counter eyedrops can be used to treat redness and irritation. B. The eye shield should be worn at night. C. It will be necessary to wear special cataract glasses. D. A prescription for medication to control post-operative pain will be needed. Answer B: The eye shield should be worn at night or when napping, to prevent accidental trauma to the operative eye. Prescription eyedrops, not over-the-counter eyedrops, are ordered for the client; therefore, Answer A is incorrect. The client might or might not require glasses following cataract surgery; therefore, answer C is incorrect. Answer D is incorrect because cataract surgery is pain free. 28. An 8-year-old is admitted with drooling, muffled phonation, and a temperature of 102°F. The nurse should immediately notify the doctor because the child’s symptoms are suggestive of: A. Strep throat B. Epiglottitis C. Laryngotracheobronchitis D. Bronchiolitis Answer B: The child’s symptoms are consistent with those of epiglottitis, an infection of the upper airway that can result in total airway obstruction. Symptoms of strep throat, laryngotracheobronchitis, and bronchiolitis are different than those presented by the client; therefore, answers A, C, and D are incorrect. 29. Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should: A. Offer the baby sterile water between feedings of formula B. Apply an emollient to the baby’s skin to prevent drying C. Wear a gown, gloves, and a mask while caring for the infant D. Place the baby on enteric isolation Answer A: Providing additional fluids will help the newborn eliminate excess bilirubin in the stool and urine. Answer B is incorrect because oils and lotions should not be used with phototherapy. Physiologic jaundice is not associated with infection; therefore, answers C and D are incorrect. 30. A teen hospitalized with anorexia nervosa is now permitted to leave her room and eat in the dining room. Which of the following nursing interventions should be included in the client’s plan of care? A. Weighing the client after she eats B. Having a staff member remain with her for 1 hour after she eats C. Placing high-protein foods in the center of the client’s plate D. Providing the client with child-size utensils Answer B: Having a staff member remain with the client for 1 hour after meals will help prevent self-induced vomiting. Answer A is incorrect because the client will weigh more after meals, which can undermine treatment. Answer C is incorrect because the client will need a balanced diet and excess protein might not be well tolerated at first. Answer D is incorrect because it treats the client as a child rather than as an adult. 31. According to Erickson’s stage of growth and development, the developmental task associated with middle childhood is: A. Trust B. Initiative C. Independence D. Industry Answer D: According to Erikson’s Psychosocial Developmental Theory, the developmental task of middle childhood is industry versus inferiority. Answer A is incorrect because it is the developmental task of infancy. Answer B is incorrect because it is the developmental task of the school-age child. Answer C is incorrect because it is not one of Erikson’s developmental stages. 32. The nurse should observe for side effects associated with the use of bronchodilators. A common side effect of bronchodilators is: A. Tinnitus B. Nausea C. Ataxia D. Hypotension Answer B: A side effect of bronchodilators is nausea. Answers A and C are not associated with bronchodilators; therefore, they are incorrect. Answer D is incorrect because hypotension is a sign of toxicity, not a side effect. 33. The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is: A. The mottled appearance of the trunk B. The presence of conjunctival hemorrhages C. Cyanosis of the hands and feet D. Respiratory rate of 20–28 per minute Answer C: Although cyanosis of the hands and feet is common in the newborn, it accounts for an Apgar score of less than 10. Answer B suggests cooling, which is not scored by the Apgar. Answer B is incorrect because conjunctival hemorrhages are not associated with the Apgar. Answer D is incorrect because it is within normal range as measured by the Apgar. 34. A 5-month-old infant is admitted to the ER with a temperature of 103.6°F and irritability. The mother states that the child has been listless for the past several hours and that he had a seizure on the way to the hospital. A lumbar puncture confirms a diagnosis of bacterial meningitis. The nurse should assess the infant for: A. Periorbital edema B. Tenseness of the anterior fontanel C. Positive Babinski reflex D. Negative scarf sign Answer B: Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Answer A is incorrect because periorbital edema is not associated with meningitis. Answer C is incorrect because a positive Babinski Answer D: A common side effect of prednisone is gastric ulcers. Cimetadine is given to help prevent the development of ulcers. Answers A, B, and C do not relate to the use of cimetadine; therefore, they are incorrect. 41. Which of the following meal choices is suitable for a 6-month-old infant? A. Egg white, formula, and orange juice B. Apple juice, carrots, whole milk C. Rice cereal, apple juice, formula D. Melba toast, egg yolk, whole milk Answer C: Rice cereal, apple juice, and formula are suitable foods for the 6- month-old infant. Whole milk, orange juice, and eggs are not suitable for the young infant; therefore, they are incorrect. 42. The LPN is preparing to administer an injection of vitamin K to the newborn. The nurse should administer the injection in the: A. Rectus femoris muscle B. Vastus lateralis muscle C. Deltoid muscle D. Dorsogluteal muscle Answer B: The nurse should administer the injection in the vastus lateralis muscle. Answers A and C are not as well developed in the newborn; therefore, they are incorrect. Answer D is incorrect because the dorsogluteal muscle is not used for IM injections until the child is 3 years of age. 43. The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephotic syndrome. The nurse should: A. Encourage the client to drink extra fluids B. Request a low-protein diet for the client C. Bathe the client using only mild soap and water D. Provide additional warmth for swollen, inflamed joints Answer A: The client taking Cytoxan should increase his fluid intake to prevent hemorrhagic cystitis. Answers B, C, and D do not relate to the question; therefore, they are incorrect. 44. The nurse is caring for a client with detoxification from alcohol. Which medication is used in the treatment of alcohol withdrawal? A. Antabuse (disulfiram) B. Romazicon (flumazenil) C. Dolophine (methodone) D. Ativan (lorazepam) Answer D: Benzodiazepines are ordered for the client in alcohol withdrawal to prevent delirium tremens. Answer A is incorrect because it is a medication used in aversive therapy to maintain sobriety. Answer B is incorrect because it is used for the treatment of benzodiazepine overdose. Answer C is incorrect because it is the treatment for opiate withdrawal. 45. A client with insulin-dependent diabetes takes 20 units of NPH insulin at 7 a.m. The nurse should observe the client for signs of hypoglycemia at: A. 8 a.m. B. 10 a.m. C. 3 p.m. D. 5 a.m. Answer C: The client taking NPH insulin should have a snack midafternoon to prevent hypoglycemia. Answers A and B are incorrect because the times are too early for symptoms of hypoglycemia. Answer D is incorrect because the time is too late and the client would be in severe hypoglycemia. 46. The licensed practical nurse is assisting the charge nurse in planning care for a client with a detached retina. Which of the following nursing diagnoses should receive priority? A. Alteration in comfort B. Alteration in mobility C. Alteration in skin integrity D. Alteration in O2 perfusion Answer B: The client with a detached retina will have limitations in mobility before and after surgery. Answer A is incorrect because a detached retina produces no pain or discomfort. Answers C and D do not apply to the client with a detached retina; therefore, they are incorrect. 47. The primary purpose for using a CPM machine for the client with a total knee repair is to help: A. Prevent contractures B. Promote flexion of the artificial joint C. Decrease the pain associated with early ambulation D. Alleviate lactic acid production in the leg muscles Answer B: The primary purpose for the continuous passive-motion machine is to promote flexion of the artificial joint. The device should be placed at the foot of the client’s bed. Answers A, C, and D do not describe the purpose of the CPM machine; therefore, they are incorrect. 48. Which of the following statements reflects Kohlberg’s theory of the moral development of the preschool-age child? A. Obeying adults is seen as correct behavior. B. Showing respect for parents is seen as important. C. Pleasing others is viewed as good behavior. D. Behavior is determined by consequences. Answer D: According to Kohlberg, in the preconventional stage of development, the behavior of the preschool child is determined by the consequences of the behavior. Answers A, B, and C describe other stages of moral development; therefore, they are incorrect. 49. A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to: A. Determine whether the ear infection has affected her hearing B. Make sure that she has taken all the antibiotic C. Document that the infection has completely cleared D. Obtain a new prescription in case the infection recurs Answer C: The client should be assessed following completion of antibiotic therapy to determine whether the infection has cleared. Answer A would be done if there are repeated instances of otitis media; therefore, it is incorrect. C. Dried fruits D. Nuts Answer A: Tomatoes are a poor source of iron, although they are an excellent source of vitamin C, which increases iron absorption. Answers B, C, and D are good sources of iron; therefore, they are incorrect. 56. The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to: A. Periodically lie prone without a neck pillow B. Sleep only in dorsal recumbent position C. Rest in supine position with his head elevated D. Sleep on either side but keep his back straight Answer A: Periodically lying in a prone position without a pillow will help prevent the flexion of the spine that occurs with Parkinson’s disease. Answers B and C flex the spine; therefore, they are incorrect. Answer D is not realistic because of position changes during sleep; therefore, it is incorrect. 57. The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client? A. Low calorie, low carbohydrate B. High calorie, low fat C. High protein, high fat D. Low protein, high carbohydrate Answer B: The client recovering from pancreatitis needs a diet that is high in calories and low in fat. Answers A, C, and D are incorrect because they can increase the client’s discomfort. 58. A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she: A. Uses an electric blanket at night B. Dresses in extra layers of clothing C. Applies a heating pad to her feet D. Takes a hot bath morning and evening Answer B: Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns, making answers A and C incorrect. Answer D is incorrect because the client with hypothyroidism has dry skin, and a hot bath morning and evening would make her condition worse. 59. A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer? A. A family history of laryngeal cancer B. Chronic inhalation of noxious fumes C. Frequent straining of the vocal cords D. A history of alcohol and tobacco use Answer D: A history of frequent alcohol and tobacco use is the most significant factor in the development of cancer of the larynx. Answers A, B, and C are also factors in the development of laryngeal cancer, but they are not the most significant; therefore, they are incorrect. 60. The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia? A. Difficulty in breathing after exertion B. Numbness and tingling in the extremities C. A faster-than-usual heart rate D. Feelings of lightheadedness Answer B: Numbness and tingling in the extremities is common in the client with pernicious anemia, but not those with other types of anemia. Answers A, C, and D are incorrect because they are symptoms of all types of anemia. 61. The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to: A. Speak using words that rhyme B. Repeat words or phrases used by others C. Include irrelevant details in conversation D. Make up new words with new meanings Answer B: The client with echolalia repeats words or phrases used by others. Answer A is incorrect because it refers to clang association. Answer C is incorrect because it refers to circumstantiality. Answer D is incorrect because it refers to neologisms. 62. Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis? A. Brushing the teeth B. Drinking a glass of juice C. Drinking a cup of coffee D. Brushing the hair Answer C: Holding a cup of coffee or hot chocolate helps to relieve the pain and stiffness of the hands. Answers A, B, and D do not relieve the symptoms of rheumatoid arthritis; therefore, they are incorrect. 63. A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh: A. 14 pounds B. 18 pounds C. 25 pounds D. 30 pounds Answer A: The infant’s birth weight should double by 6 months of age. Answers B, C, and D are incorrect because they are greater than the expected weight gain by 6 months of age. 64. A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms? A. Tossed salad with oil and vinegar dressing B. Baked potato with sour cream and chives 70. An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately? A. Hourly urinary output of 40–50cc B. Bright red urine with many clots C. Dark red urine with few clots D. Requests for pain med q 4 hrs. Answer B: Bright red bleeding with many clots indicates arterial bleeding that requires surgical intervention. Answer A is within normal limits; therefore, it is incorrect. Answer C indicates venous bleeding, which can be managed by nursing intervention; therefore, it is incorrect. Answer D does not indicate excessive need for pain management that requires the doctor’s attention; therefore, it is incorrect. 71. A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of polymigratory arthritis? A. Irregular movements of the extremities and facial grimacing B. Painless swelling over the extensor surfaces of the joints C. Faint areas of red demarcation over the back and abdomen D. Swelling, inflammation, and effusion of the joints Answer D: The child with polymigratory arthritis will exhibit swollen, painful joints. Answer B is incorrect because it describes subcutaneous nodules. Answer C is incorrect because it describes erythema marginatum. Answer A is incorrect because it describes Syndeham’s chorea. 72. A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to: A. Prevent insensible water loss B. Provide a moist environment with oxygen at 30% C. Prevent dehydration and reduce fever D. Liquefy secretions and relieve laryngeal spasm Answer D: The primary reason for placing a child with croup under a mist tent is to liquefy secretions and relieve laryngeal spasms. Answer A is incorrect because it does not prevent insensible water loss. Answer B is incorrect because the oxygen concentration is too high. Answer C is incorrect because the mist tent does not prevent dehydration or reduce fever. 73. A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal: A. Slow pulse rate, weight loss, diarrhea, and cardiac failure B. Weight gain, lethargy, slowed speech, and decreased respiratory rate C. Rapid pulse, constipation, and bulging eyes D. Decreased body temperature, weight loss, and increased respirations Answer B: Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations. Answers A and D do not describe symptoms associated with myxedema; therefore, they are incorrect. Answer C describes symptoms associated with Graves’s disease; therefore, it is incorrect. 74. Which statement describes the contagious stage of varicella? A. The contagious stage is 1 day before the onset of the rash until the appearance of vesicles. B. The contagious stage lasts during the vesicular and crusting stages of the lesions. C. The contagious stage is from the onset of the rash until the rash disappears. D. The contagious stage is 1 day before the onset of the rash until all the lesions are crusted. Answer D: The contagious stage of varicella begins 24 hours before the onset of the rash and lasts until all the lesions are crusted. Answers A, B, and C are inaccurate regarding the time of contagion; therefore, they are incorrect. 75. A client admitted to the psychiatric unit claims to be the Son of God and insists that he will not be kept away from his followers. The most likely explanation for the client’s delusion is: A. A religious experience B. A stressful event C. Low self-esteem D. Overwhelming anxiety Answer C: Delusions of grandeur are associated with low self-esteem. Answer A is incorrect because conversion is expressed as sensory or motor deficits. Answers B and D can cause an increase in the client’s delusions but do not explain their purpose; therefore, they are incorrect. 76. 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 Answer D: Respiratory stridor is a symptom of partial airway obstruction. Answers A, B, and C are expected with a tonsillectomy; therefore, they are incorrect. 77. 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 Answer C: Pain associated with duodenal ulcers is lessened if the client eats a meal or snack. Answer A is incorrect because it makes the pain worse. Answer B refers to dumping syndrome; therefore, it is incorrect. Answer D refers to gastroesophageal reflux; therefore, it is incorrect. 78. 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 Answer C: Foods containing rice or millet are permitted on the diet of the B. Suction the mouth and pharynx every hour C. Place the client in low Trendelenburg position D. Encourage the client to cough Answer A: Growth hormone levels generally fall rapidly after a hypophysectomy, allowing insulin levels to rise. The result is hypoglycemia. Answer B is incorrect because it traumatizes the oral mucosa. Answer C is incorrect because the client’s head should be elevated to reduce pressure on the operative site. Answer D is incorrect because it increases pressure on the operative site that can lead to a leak of cerebral spinal fluid. 85. 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 Answer C: Precose (acarbose) is to be taken with the first bite of a meal. Answers A, B, and D are incorrect because they specify the wrong schedule for medication administration. 86. 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 Answer B: The client going for therapy in the hyperbaric oxygen chamber requires no special skin care; therefore, washing the skin with water and patting it dry are suitable. Lotions, petroleum products, perfumes, and occlusive dressings interfere with oxygenation of the skin; therefore, answers A, C, and D are incorrect. 87. 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 Answer C: The primary reason for the NG to is to allow for nourishment without contamination of the suture line. Answer A is not a true statement; therefore, it is incorrect. Answer B is incorrect because there is no mention of suction. Answer D is incorrect because the oral mucosa was not involved in the laryngectomy. 88. 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 Answer A: The client with expressive aphasia has trouble forming words that are understandable. Answer B is incorrect because it describes receptive aphasia. Answer C refers to apraxia; therefore, it is incorrect. Answer D is incorrect because it refers to agnosia. 89. 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 Answer D: Sunscreens of at least an SPF of 15 should be applied 20–30 minutes before going into the sun. Answers A, B, and C are incorrect because they do not allow sufficient time for sun protection. 90. 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 Answer B: The combination of the two medications produces an effect greater than that of either drug used alone. Agonist effects are similar to those produced by chemicals normally present in the body; therefore, answer A is incorrect. Antagonist effects are those in which the actions of the drugs oppose one another; therefore, answer C is incorrect. Answer D is incorrect because the drugs would have a combined depressing, not excitatory, effect. 91. 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 Answer C: The medication should be withheld and the doctor should be notified. Answers A, B, and D are incorrect because they do not provide for the client’s safety. 92. 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. Answer B: Solid foods should be added to the diet one at a time, with 4- to 7-day intervals between new foods. The extrusion reflex fades at 3–4 months of age; therefore, answer A is incorrect. Answer C is incorrect because solids should not be added to the bottle and the use of infant feeders is discouraged.