NCLEX Preparation Course - Critical Thinking Exercises VI (Answers 1-10)

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Here are the Questions to NCLEX Preparation Course - Critical Thinking VI (1-10) -->

1) A
- in multiple myeloma, bone destruction causes hypercalcemia. Therefore, giving calcium supplement is inappropriate. Hypercalcemia causes polyuria. The client should increase his fluid intake to prevent dehydration and renal stone formation. The client with multiple myeloma is at high risk for fracture and infection. Falls and infection should be avoided.

2) C
- in a client with AV-fistula, arm precaution should be observed. This means no BP taking or any from of puncturing on the affected arm. Therefore, the RN should intervene when a CNA takes the BP on the affected arm.

3) B
- Hawthorn promotes peripheral vasodilation, increases coronary circulation, acts as antioxidant. It is indicated for treatment of mild hypertension, early CHF, stable angina.

4) A
- echinacea is immune enhancer. It is also used to treat respiratory tract infections and urinary tract infections.

5) C
- caloric testing is also called Caloric Ice Water testing. Primarily, it involves introducing cold water into the ear. It is also called oculovestibular test. The normal result is conjugate nystagmus of the eyes away from the ear stimulated.

6) C
- the dead client's arms should be positioned on the side, not across his chest. The client should be wrapped with linen/shroud (according to the institution's policy).

7) C
- dehydration is primarily characterized by dark, concentrated urine. Urine output is one of the most accurate indicator of fluid balance. Skin turgor is not used as an indicator for dehydration among the elderly because their skin is normally wrinkled.

8) C
- when a client receives heparin, inspect site of injection for hematoma. This indicates bleeding at the area and should not be used as injection site. When administering heparin subcutaneous, do not aspirate, do not massage the site after injection. This is to prevent hematoma formation at the site. Needle gauge used be the same as intradermal (gauge 25, 26, 27).

9) B
- application of tourniquet above the area bitten by a rattle snake is the most appropriate immediate action while waiting for the emergency rescue team. This is to prevent spread of the venom in the blood circulation.

10) D
- pericardial friction rub indicates pericardial effusion, a dangerous complication of SLE.


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NCLEX Secrets - Neurology Board Review (41-45)

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NCLEX Secrets - Neurology Board Review

41. When lumbar puncture is done, the needle is inserted into which of the following intervertebral spaces?

a) cervical 4 and 5
b) thoracic 4 and 5
c) lumbar 4 and 5
d) sacral 4 and 5

42. The cerebral cortex is responsible for regulating which of the following functions?

a) motor activities, speech
b) touch, temperature
c) hearing, taste
d) vision, reading

43. A client with Alzheimer's disease lives in a board and care facility. The client frequently wanders outside the care facility. Which of the following is the most essential measure to avoid injury in the client?

a) the staff members should frequently orient the client
b) the staff members should go for a walk with the client several times a day
c) the staff members should assign a nursing assistant to stay with the client in her room during an entire shift
d) the staff members should allow the client to go out of his room only during meals times

44. Which of the following questions would evaluate that the client suffered from frontal lobe defect?

a) what would you do if your house is on fire?
b) what is the color of this flower?
c) what sound do you hear now?
d) what is the temperature of this fluid?

45. The charge nurse assigned the RN to a client with increased intracranial pressure. Which action by the RN needs intervention by the charge nurse?

a) the RN places the client in semi-fowler's position
b) the RN places the client in side-lying position with the neck flexed
c) the RN places the client in supine position
d) the RN places the client in side-lying, semi-fowler's position





NCLEX Secrets - Neurology Board Review:
ANSWERS AND RATIONALE

41) C
- the spinal needle is inserted in L3 and L4, L4 and L5, L5 ans S1 intervertebral spaces to prevent trauma to the spinal cord, which ends at L1.

42) A
- the cerebral cortex regulates motor activities, speech, logical operations (number skills, reasoning, scientific skills), insights, art awareness, imagination, music awareness, personality development, future planning.
Choice B - parietal lobe is responsible for touch and temperature
Choice C - the temporal lobe is responsible for hearing and taste
Choice D - the occipital lobe is responsible for vision and hearing.

43) A
- Alzheimer's disease is characterized by memory loss. Frequent orientation of the client is necessary.

44) A
- frontal lobe is responsible for thought processes, logical operations, and reasoning.
Choice B evaluates function of the occipital lobe.
Choice C evaluates function of the temporal lobe.
Choice D evaluates function of the parietal lobe.

45) B
- the client with increased intracranial pressure should be positioned with the neck in neutral position. This prevents compression of jugular veins and will prevent cerebral venous congestion.


Go to the next page ---> NCLEX Secrets - Neurology Board Review (46-50)  

Or Go back to NCLEX Secrets - Neurology Board Review (1-5) to start the test from the beginning.


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Test Prep for Nursing Exam about Obstetric Nursing (31-35)

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SAVE

31. Which of the following findings should the nurse report to the physician when observed in a 6-month old infant?

a) absent moro reflex
b) positive kernig's sign
c) positive babinski's sign
d) absent tonic neck reflex

32. A pregnant client is admitted in the emergency room, with cervix fully dilated. Which of the following is the priority action by the RN to facilitate proper bearing down?

a) put the client in sitting position with shoulders supported
b) put the client in lithotomy position
c) put the client in right side-lying position
d) put the client in semi-sitting position and use elbows for support

33. The client is 3 days postpartum, and she bottle-feeds her newborn. She complains of hardness and swelling of hr breasts. Which of the following is the most essential intervention?

a) apply ice cap over the breasts
b) massage the breasts
c) use breast pump to express the milk
d) apply warm compress over the breasts

34. A woman is in active labor. In what position does the nurse properly place the client?

a) semi-fowler's position
b) side-lying position
c) trendelenburg position
supine position

35. The client has been diagnosed to have placenta previa. Which of the following should be included in the nursing care plan of the client? Select all that apply

a) promote bed rest with bathroom privileges
b) ask for prescription of internal fetal heart rate (FHR) monitoring
c) perform vaginal examination every 8 hours
d) place the client in the left lateral position
e) administer blood transfusion as prescribed
f) administer Rh globulin as prescribed if the mother is Rh negative
g) prepare for premature delivery or cesarean section



ANSWERS AND RATIONALE

31) B
- positive kernig's sign is a manifestation of meningeal irritation. This should be reported to the physician. Moro reflex and tonic neck reflex disappear at 3 to 4 months of age. Babinski's sign disappears at 1-year of age.

32) B
- lithotomy position facilitates bearing down in a woman whose cervix is fully dilated.

33) A
- ice cap is used to relieve swelling of the breasts when the mother will not breastfeed. Cold application inhibits milk production. Massaging the breasts, using breast pump, and applying warm compress stimulate milk production.

34) B
- side-lying position relieves compression of the inferior vena cava.

35) D, E, F, G
- these are appropriate nursing interventions for a client with placenta previa. Placenta previa is low implantation of placenta. The client should be on complete bed rest; invasive procedures like vaginal examination and internal FHR monitoring should be avoided



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NCLEX Preparation Course - Critical Thinking Exercises VI (Questions 1-10)

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Here are the Answers to NCLEX Preparation Course - Critical Thinking VI (1-10) -->

1. Which of the following is inappropriate nursing action when caring for a client with multiple myeloma?

a) give calcium supplement
b) increase client's fluid intake
c) prevent falls
d) protect the client from infection

2. A client has an AV-fistula on the right arm. The RN would intervene if the CNA performs which of the following?

a) listens for bruits
b) palpates for thrill
c) takes the BP on the right arm
d) takes the BP on the left arm

3. Which of the following conditions is Hawthorn indicated?

a) insomnia
b) hypertension
c) urinary tract infection
d) diarrhea

4. Eschinacea is used to treat which of the following conditions?

a) urinary tract infections
b) sunburns
c) migraine headache
d) arthritis

5. The client is for Caloric testing. The test primarily involves which of the following:

a) introducing hot water into the ear
b) introducing warm water into the ear
c) introducing cold water into the ear
d) introducing tap water into the ear

6. The client was pronounced dead by the physician. When the RN performs post-mortem care to the client, which of the following is appropriate nursing action?

a) place the client's arms across his chest
b) place the client's arms over his abdomen
c) place the client's arms on the side and wrap the client
d) remove the client's gown and change linen to cover the body

7. The client is 66 years old, and is having diarrhea and vomiting. How would you evaluate dehydration on the patient?

a) assess for poor skin turgor
b) check for dry mucous membrane
c) note for dark, concentrated urine
d) monitor vital signs

8. The client has been diagnosed to have thrombocytopenia. The R.N. will administer heparin subcutaneously to the client. Which of the following is appropriate nursing action?

a) aspirate before injecting the medication
b) massage the site of injection after introduction of the medication
c) inspect the site for hematoma
d) use syringe with needle gauge 22

9. The client who went on a mountain climbing was bitten by a rattle snake. While waiting for the emergency rescue team, what is the most appropriate immediate action for the client?

a) suck the area bitten by the rattle snake
b) apply tourniquet above the bitten area
c) cover the area with clean clothing
d) elevate the area above the level of the heart

10. The client is diagnosed to have systemic lupus erythematosus. Which of the following assessment should be given highest priority by the nurse?

a) butterfly rash over the cheek and nose
b) elevated BP
c) tachycardia
d) pericardial friction rub


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