NCLEX Review on Delegation and Prioritization Questions (1-5)

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 1. A nurse from medical-surgical unit is asked to work on the orthopedic unit. The medical-surgical nurse has no orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse?a) a client with a cast for a fractured femur and who has numbness and discoloration of the toes
b) a client with balanced skeletal traction and who needs assistance with morning care
c) a client who had an above-the-knee amputation yesterday and has a temperature of 101.4F
d) a client who had a total hip replacement 2 days ago and needs blood glucose monitoring


2. The nurse plans care for a client undergoing a colposcopy. Which of the following actions should the nurse take first?

a) discuss the client's fear regarding potential cervical cancer
b) assist with silver nitrate application to the cervix to control bleeding
c) provide instructions regarding douching and sexual relations
d) administer pain medication

3. A nurse is caring for four clients and is preparing to do her initial rounds. Which client should the nurse assess first?

a) a client with diabetes being discharged today
b) a client with tracheostomy and copious secretions
c) a client scheduled for physical therapy this morning
d) a client with a pressure ulcer that needs dressing change

4. A nurse enters a room and finds a client lying on the floor. Which action should the nurse perform first?

a) call for help to get the client back in bed
b) establish whether the client is responsive
c) assist the client back to bed
d) ask the client what happened


5. A nurse preceptor is working with a new nurse and notes that the new nurse is reluctant to delegate tasks to members of the care team. The nurse preceptor recognizes that this reluctance most likely is due to:

a) role modeling behaviors of the preceptor
b) the philosophy of the new nurse's school of nursing
c) the orientation provided to the new nurse
d) lack of trust in the team members




NCLEX Review on Delegation and Prioritization Questions:
ANSWERS AND RATIONALE

1) D
- a nurse from medical-surgical unit floated to the orthopedic unit should be given clients with stable condition, and those whose care are similar to her training and experience. A client who is 2-day postop is more likely to be on stable condition. And the medical-surgical unit nurse is competent in monitoring blood glucose.

2) B
- the priority nursing action when caring for a client who will undergo colposcopy is to assist in controlling potential bleeding by applying silver nitrate to the cervix.

3) B
- a patient with problem of the airway should be given highest priority. ABC is a priority.

4) B
- assessing for responsiveness is the first nursing action when performing CPR.

5) D
- lack of trust is the most common reason for reluctance in delegating tasks among members of the team.



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Online Nursing Practice Test about Pharmacology (66-70)

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66. The patient is receiving heparin. What should the nurse keep readily available?

a) aquamephyton
b) coumadin
c) ASA
d) protamine sulfate

67. Which of the following drugs more likely will be prescribed for a client with Zollinger-Ellison syndrome?

a) tapazole
b) propylthiouracil
c) omeprazole
d) hydrochlorothiazide

68. The client's serum albumin level is 2 mg/dL. Which of the following drugs does the nurse anticipate to be ordered by the physician?

a) hetastarch
b) ciprofloxacin
c) lisinopril (zestril)
d) furosemide (lasix)

69. Which of the following indicates effectiveness of levodopa in a client with Parkinson's disease?

a) relief of tremors and rigidity
b) improved emotional state
c) improve of memory
d) return of sensation

70. The client is receiving Retrovir. Which of the following are potential side effects of the drugs? Select all that apply

a) tingling sensation
b) elevated BUN, serum creatinine
c) hyperglycemia
d) elevated liver enzymes
e) hypertension



ANSWERS AND RATIONALE

66) D
- protamine sulfate is the antidote of heparin, if bleeding occurs.

67) C
- Zollinger-Ellison syndrome is characterized by multiple areas of ulcers in the gastrointestinal tract. Omeprazole reduces gastric acid production and help relieve signs and symptoms experienced by the patient.

68) A
- the normal serum albumin level is 3.5 to 5 mg/dl. If the level is low, the client needs plasma expander like hetastarch.

69) A
- levodopa relieves tremors and rigidity in clients with Parkinson's disease.

70) A, B, D
- these are potential side effects of Retrovir, an antiviral medication.


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Online Nursing Practice Test about Pharmacology (61-65)

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61. The nurse will administer drugs to several patients. Which of the following drugs should she administer first?

a) hydralazine for a client with PIH
b) antibiotic for ruptured abscess
c) insulin for a client with high blood glucose
d) diuretic for the client with congestive heart failure

62. When administering Synthroid (Levothyroxine), which of the following considerations should be observed by the nurse?

a) assess pulse rate prior to administration
b) administer the medication on full stomach
c) advise client to increase fluid intake
d) monitor intake and output

63. Which of the following is an important nursing consideration when administering Garamycin?

a) monitor blood pressure
b) monitor intake and output
c) monitor body temperature
d) monitor pulse rate

64. When a client is on Chlorothiazide therapy, which of the following should be included in the health teachings to the client?

a) include fruits and green leafy vegetables in the diet
b) include milk and cheese in the diet
c) include meat in the diet
d) include beans and rice in the diet

65. The nurse will administer an IV fluid of 1,000 mls for 10 hours. The IV set has a drop factor of 10 gtts/ml. How many gtts/min should the nurse regulate the IV fluid.



ANSWERS AND RATIONALE

61) D
- the client with CHF experiences increased cardiac workload and dyspnea. Therefore, diuretic needs to be given first among the aforementioned medications. Priority: ABC.

62) A
- thyroid preparation like Synthroid may cause tachycardia. Therefore the nurse should check the client's pulse rate prior to administration of this drug.

63) B
- garamycin is nephrotoxic. Kidney function should be monitored like measuring fluid intake and output when administering this drug.

64) A
- chlorothiazide is a potassium-wasting diuretic. Potassium-rich foods like fruits and green leafy vegetables should be included in the diet to prevent hypokalemia.

65) 17 gtts/min

gtts/min = vol in cc x gtt factor/no. of hours x 60 mins

1,000 x 10/10 x 60 = 10,000/600

= 17 gtts/min


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Online Nursing Practice Test about Pharmacology (56-60)

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56. The client receives thyroid replacement therapy and notes inadequacy when which of the following findings occur?

a) prolonged QT interval
b) tachycardia
c) nervousness
d) hypothermia

57. A patient is undergoing testing to confirm diagnosis of myasthenia gravis. The nurse explains that the diagnosis is confirmed when muscle function improves after the patient receives an IV injection of a medication. What is this drug administered to the patient during the test?

58. The nurse is caring for a 10-year old client newly diagnosed with tonic-clonic seizure disorder. What instructions do you give the mother about phenytoin?

a) monitor the child for skin rash
b) maintain adequate amounts of fluids
c) the child will be frequently having blood works done
d) maintain good oral hygiene, brushing and flossing
e) report to the physician any problems with walking, coordination, slurred speech, and nausea

59. Which of the following drugs will be administered first in the patient with bronchial asthma?

a) corticosteroid
b) bronchodilator
c) antihistamine
d) mucolytic

60. Which of the following drugs is administered first, in a client with asthma?

a) robitussin DM
b) benadryl (diphenhydramine)
c) beclomethasone (vanceril)
d) theophylline (theo-dur)



ANSWERS AND RATIONALE

56) D
- hypothermia indicates that the client is still experiencing hypothyroidism. Therefore, the thyroid replacement therapy is inadequate.

57) Tensilon
- tensilon (edrophonium) is a short-acting cholinergic. Positive tensilon test is characterized by transitory improvement of the client's signs and symptoms. Then after a few minutes, these signs and symptoms recur.

58) A, B, C, E
- these are health instructions to be given during phenytoin therapy. Dilantin may cause skin rash, constipation, gingival hyperplasia (bleeding, tenderness, swelling of gums), bone marrow depression (pancytopenia), ataxia, nystagmus, double vision, drowsiness. Dental flossing should be avoided because bleeding may occur due to gum hyperplasia and blood dyscrasia.

59) B
- bronchodilator should be administered first in a patient with bronchial asthma so that the other medications can be inhaled into the bronchial tree more adequately.

60) D
- theophylline is a bronchodilator. It is the first drug to be administered in asthma to facilitate breathing and better absorption of the drugs.


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Test Prep for Nursing Exam about Pediatric Nursing (46-50)

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46. The physician called the nurse and told her to prepare to give "enemas until clear" to an 18-month old child before surgery for Hirschprung's disease. What would the nurse anticipate the physician to order?

a) saline (300 ml)
b) tap water (120 ml)
c) oil retention (250 ml)
d) fleet solution (200 ml)

47. When a doctor has consent form signed for a surgical procedure on a child, the nurse knows that:

a) the person giving the consent must be at least 18 years of age
b) only a parent or legal guardian can sign the consent
c) the risk and benefits of procedures are part of the consent
d) the consent is valid for 72 hours

48. In which of the following situations should the charge nurse in the pediatric unit intervene in the staff nurse's action?

a) the nurse is going to do throat culture to a child who is drooling with saliva and sore throat
b) the nurse feeds the child with gastroesophageal reflux in an upright position
c) the nurse places the child with meningocele in prone position
d) the nurse gives popsicle to a child who had undergone tonsillectomy

49. A child is 8 months old. Which of the following assessment should the nurse find?

a) dancing reflex
b) palmar grasp reflex
c) dorsiflexion of the big toe when the sole of the foot is stroked from the heel upward
d) fencing reflex

50. A nurse receives a child with a cleft palate on the pediatric unit. Which action is best for the nurse to take?

a) to ask the nursing assistant to obtain necessary feeding equipment for the client while the nurse completes the admission assessment.
b) to ask the nursing assistant to take the child's vital signs while the nurse calls the physician
c) to ask the LPN/LVN to talk to the parents while the nurse administers a tube feeding to the child in the next room
d) to ask the parents to leave the room while the nurse completes the admission assessment



ANSWERS AND RATIONALE

46. A
- saline solution is isotonic and will prevent fluid-electrolyte losses.

47) B
- if the client is a child, the parent or legal guardian will sign the consent for procedures.

48) A
- a child who is having drooling with saliva and sore throat is experiencing epiglottitis. Stimulation of the throat like doing throat culture should be avoided to prevent airway spasm and obstruction.

49) C
- positive babinski reflex is normal up to one year of age. Other infantile reflexes will normally disappear by age 3 to 4 months.

50) A
- obtaining equipment is a task of the CNA. Performing nursing process including assessment is a task of RN.


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Online Nursing Practice Test about Pharmacology (51-55)

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51. A medication is ordered to be given, 1250 mg. BID. Available stock is 10 gram in 50 ml. How many ml. will be given per dose?

52. The client with schizophrenia has been prescribed with Thorazine (Chlorpromazine) 25 mg QID. He experiences protrusion and rolling of tongue, involuntary movements of the body and extremities, sucking and smacking movements of the lips. These signs and symptoms indicate which of the following adverse reactions to the drug?

a) pseudoparkinsonism
b) akathisia
c) acute dystonia
d) tardive dyskinesia

53. You will administer an IV solution of D5LR 3L for fluid replacement on a patient with mild dehydration for 24 hours. What is the infusion rate in drops per minute? Answer in whole numbers

54. The patient with supraventricular tachycardia has been treated with digoxin. What should be considered when giving the medication? Select all that apply

a) monitor digoxin blood levels
b) check and count apical pulse for a whole minute
c) recognize symptoms of hypokalemia
d) withhold medication when client complains of visual disturbances and refer to opthalmologist
e) place digoxin under the tongue
f) give digoxin bolus dose as ordered

55. The client is prescribed with Lisinopril (Zestril) for treatment of hypertension. She asks you about the possible side effects of the medication. Which of the following are possible side effects of the drug? Select all that apply

a) dizziness
b) headache
c) constipation
d) hyperglycemia
e) hypotension
f) impotence



ANSWERS AND RATIONALE

51) 6.25 ml

D/S x dilution = quantity of the drug

10 g = 10g x 1,000 mg/gm = 10,000 mg

1,250 mg/10,000 mg x 50 = 6.25 ml


52) D
- these signs and symptoms characterize tardive dyskinesia.
Pseudoparkinsonism is characterized by rigidity
Akathisia is motor restlessness
Acute dystonia is characterized by muscle spasms and contractions

53) 31 gtts/min

gtts/min = vol. in cc x gtt factor/no. of hours x 60 min

= 3,000 x 15/24 hrs x 60 min
= 450,000/1,440
= 31 gtts/min

54) A, B, C, F
- these are nursing considerations when administering digoxin. The therapeutic serum level of digoxin is 0.5 to 2.0 mg/ml. Above this level results to digoxin toxicity.
Digoxin decreases heart rate and increases force of cardiac contractility. Hypokalemia increases risk of digitalis toxicity.
Visual disturbances indicate digitalis toxicity. Hold the medication and notify physician.
Digoxin is not given sublingually. Bolus dose of digoxin is administered as ordered to produce rapid effect of the drug.

55) A, B, E
- these are possible side effects of Lisinopril, an angiotensin-converting enzyme inhibitor.


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NCLEX Review about Cardiac Nursing (36-40)

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NCLEX Review about Cardiac Nursing

36. The following are manifestations of left-sided congestive heart failure. Select all that apply

a) hypertension
b) dependent edema
c) hypokalemia
d) paroxysmal nocturnal dyspnea
e) non-productive cough
f) pink-tinged, frothy sputum
g) ascites

37. Which of the following health teachings should be included when caring for a client with angina pectoris?

a) limit cigarette smoking
b) do not go out during cold weather
c) take sublingual nitroglycerine every 5 minutes until chest pain subsides
d) keep nitroglycerine in a clear plastic container

38. A client has dual chamber pacemaker, which of the following is true about the pacemaker?

a) it provides atrial firing
b) it provides ventricular firing
c) it provides both atrial and ventricular firing
d) it provides alternate atrial and ventricular firing

39. Which of the following is a characteristic manifestation of the patient with cardiac tamponade?

a) increased pulse rate
b) rapid respiration
c) increased body temperature
d) distended neck vein

40. Which of the following findings in a client who had undergone cardiac catheterization needs immediate follow-up?

a) bleeding on dressing
b) capillary refill of more than 3 seconds
c) feeling of warmth and thirst
d) drowsiness





NCLEX Review about Cardiac Nursing:
ANSWERS AND RATIONALE

36) A, C, D, E, F
- these are signs and symptoms of left-sided CHF. Signs and symptoms of left-sided CHF are due to pulmonary edema, cellular hypoxia and activation of renin-angiotensin- aldosterone system (RAAS).

37) B
- precipitating events to chest pain in angina pectoris include exposure to cold, exertion, eating a large meal, and strong emotions.

38) C
- a dual chamber pacemaker provides both atrial and ventricular firing.

39) D
- cardiac tamponade, an accumulation of blood in the pericardial sac is characterized by Beck's triad signs and symptoms which are as follows: distended neck vein, muffled heart sounds and diminished or absent pulse.

40) B
- capillary refill of more than 3 seconds indicates circulatory impairment, and needs immediate follow-up. Normal capillary refill time is 1 to 2 seconds.


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Online Nursing Practice Test about Pharmacology (46-50)

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46. The client is taking Sudafed. Which herbal drug should not be taken by the client?

a) valerian
b) feverfew
c) black cohosh
d) billberry

47. The client is taking neupogen. Which of the following is the desired effect of the drug?

a) increased in plasma
b) increased in platelet
c) increase in RBC'S
d) increase in WBC

48. The client is on Coumadin therapy. The prothrombin time (PT) is 32 secs. Which of the following is the most appropriate action by the nurse?

a) withhold the drug
b) continue giving the drug
c) report the result to the physician
d) increase the dose

49. A woman in preterm labor will receive Betamethasone. What is the purpose of this medication?

a) to delay the delivery of the fetus
b) to promote fetal lung maturity
c) to relax the uterus
d) to shorten second stage of labor

50. Which of the following signs and symptoms indicates early digitalis toxicity?

a) the client complains of dryness of mouth
b) the client complains of watery stools
c) the client complains of blurring of visions
d) the client complains of numbness of fingers and toes




ANSWERS AND RATIONALE

46) A
- valerian is a sedative-hypnotic. It may cause drowsiness when taken in conjunction with decongestant like sudafed.

47) D
- neupogen is administered to increase WBC levels. Epogen is administered to increase RBC

48) B
- therapeutic effect of coumadin is: Normal value of PT (control) x 1.5-2 (11-16 secs x 2 = 22-32 secs). Therefore continue giving Coumadin, because PT of 32 secs is within the therapeutic range.

49) B
- betamethasone promotes fetal lung maturity. It is indicated if preterm labor is inevitable. This will give chance for the fetus to survive.

50) B
- diarrhea is an early manifestation of digitalis toxicity. Other manifestations of digitalis toxicity are as follows: nausea and vomiting, anorexia, bradycardia, dysrhythmias, visual disturbances and antiandronergic effects among males (gynecomastia, decreased libido, and impotence). Blurring of vision is a late manifestation of digitalis toxicity.


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Online Nursing Practice Test about Pharmacology (41-45)

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41. The client is receiving Spironolactone (Aldactone). Which of the following diets is recommended for the client?

a) high-potassium diet
b) high-protein diet
c) low-potassium diet
d) low protein diet

42. The client is receiving Gentamycin sulfate (Garamycin). Which of the following are side effects of the drug? Select all that apply.

a) photosensitivity
b) elevated BUN
c) elevated serum creatinine
d) hearing loss
e) increased urine output
f) nausea and vomiting

43. The client is receiving amphogel (AL-OH). Which of the following are side effects of the drug? Select all that apply.

a) constipation
b) hypophosphatemia
c) hyperkalemia
d) hypercalcemia
e) diarrhea
f) hypermagnesemia

44. The client is receiving Pepcid (Famotidine). Which of the following should be included when giving health teachings to the client?

a) take the medication with meals
b) avoid taking aspirin
c) take the medication with milk
d) take the medication before meals

45. The client is in digitalis therapy. What question should the nurse ask to know if the client is experiencing digitalis toxicity?

a) do you feel dizzy?
b) do you experience lack of appetite to eat?
c) do you have constipation?
d) do you experience tightening of your ring?



ANSWERS AND RATIONALE

41) C
- spironolactone is a potassium-sparing diueretic. It may cause hyperkalemia so; the diet of the client should be low-potassium diet.

42) A, B, C, D, F
- gentamycin causes photosensitivity, nephrotoxicity, and ototoxicity. It also causes G.I. manifestations.

43) A, B, D
- amphogel is a phosphate binder. It causes constipation. As it binds with phosphate, phosphate is excreted via the GI tract. As phosphates goes down, levels of calcium will elevate: hypophosphatemia -> hypercalcemia.

44) B
- pepcid is indicated in peptic ulcer disease. Aspirin causes gastric irritation; therefore it should not be taken by the client.

45) B
- anorexia is an early sign of digitalis toxicity. Other signs and symptoms of digitalis toxicity are as follows: bradycardia, nausea and vomiting, dysrhythmias, blurred vision, green/yellow vision, halos/rainbows around lights, antiandrogenic effects like gynecomastia, decreased libido, and impotence.


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Online Nursing Practice Test about Pharmacology (36-40)

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36. The client is on coumadin therapy. Which of the following is inappropriate action by the nurse?

a) monitor prothrombin time
b) observe for signs and symptoms of bleeding
c) provide vitamin K-rich foods
d) have aquamephyton readily available

37. The physician order is acetaminophen (tylenol) gr xv, P.O., PRN. Available stock is tylenol 325 mg. tablet. How many tablets should be given?

38. The physician ordered gentamycin (garamycin) 50 mg IM. Available stock is gentamycin 80mg/2ml in a vial. How many ml. should be administered to client?

39. Which of the following indicates effectiveness of lactulose in a client with hepatic encephalopathy?

a) dehydration is resolved
b) level of consciousness (LOC) has improved
c) 4 watery stools in 24 hours
d) jaundice is diminished

40. Which of the following is not a side effect of dilaudid?

a) respiratory depression
b) urinary retention
c) hypertension
d) constipation



ANSWERS AND RATIONALE

31) C
- vitamin K antagonizes effect of coumadin. Therefore, the client should avoid vitamin K rich foods.

32) 3 tablets

gr 1 = 60 mg gr 15 x 60 mg/gr = 900 mg

D/S = Q of drug
900mg/325mg = 3 tablets


33) 1.25 ml

D/S = Q of drug
50mg/80mg x 2 ml = 1.25 ml

34) B
- lactulose acidifies the colon and prevents formation of alkaline ammonia. Therefore, it manages hepatic encephalopathy is resolved, there will be improvement of LOC.

35) C
- dilaudid is a narcotic analgesic. It causes hypotension not hypertension.


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NCLEX Review about Digestive Problems 41-45

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NCLEX Review about Digestive Problems

41. The client with liver cirrhosis has developed esophageal varices. Which of the following should the nurse advise the client to avoid? Select all that apply

a) coughing
b) straining at stool
c) yawning
d) bending and stooping
e) swallowing
f) heavy lifting
g) spicy foods

42. The client had undergone Billroth II surgery. Which of the following health teachings should be taken to the client before discharge? Select all that apply

a) take dry, high protein foods
b) limit concentrated carbohydrates
c) lie down in left side-lying position after meals
d) take fluids with meals
e) take small, frequent meals
f) start meal with hot foods and beverages

43. The nurse is taking care of a patient with a positive clostridium difficile culture result. The charge nurse will intervene if she observes the nurse to be

a) wearing gloves in handling secretions
b) washing hands before and after entering the room and giving care to the patient
c) instructing the patient to wash hands with antimicrobial soap
d) wearing gown, gloves, mask, and cap while giving care to the patient

44. After gastrojejunostomy, which of the following instructions should be included in the health teachings of the patient?

a) limit carbohydrates in your diet
b) increase fluid intake
c) avoid lying down after eating
d) limit proteins in your diet

45. Arrange in sequence the following actions when cleaning an abdominal incision.

a) prepare supplies
b) apply sterile gloves
c) do hand washing apply clean gloves
d) remove soiled dressings
e) clean from the top to the bottom of the abdominal incision
g) apply sterile dressings




NCLEX REVIEW ABOUT DIGESTIVE PROBLEMS:
ANSWERS AND RATIONALE

41) A, B, D, F, G
- these factors should be avoided by the client with liver cirrhosis to prevent rupture of esophageal varices.

42) A, B, C, E
- these are preventive measures for dumping syndrome. To prevent dumping syndrome, avoid factors that cause rapid emptying of gastric content.

43) D
- clostridium difficile is characterized by severe diarrhea. It requires contact precaution which involves use of gloves and gown only. There is no need to wear mask and cap.

44) A
- after gastric surgery, dumping syndrome should be prevented. Dumping syndrome is caused by rapid emptying of gastric content into the jejunum. The hypertonic gastric content emptied into the jejunum causes shifting of plasma from the intestinal capillaries. This reduces the circulating volume and may lead to shock. Carbohydrates should be limited in the diet because these foods empty the stomach rapidly.

45) C, D, A, B, E, F
- this is the correct sequence of actions when cleaning an abdominal incision. Practice asepsis and infection control measures.



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Online Nursing Practice Test about Pharmacology (31-35)

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31. 60-year old man is receiving Tagamet/IV. After 30 minutes of infusion, he complains of headache and dizziness. Which of the following actions should the nurse take first?

a) stop infusion
b) call the physician
c) take vital signs
d) elevate the head of bed

32. The client is receiving Gentamycin sulfate (garamycin), an amoniglycoside. Which of the following laboratory tests should the nurse monitor?

a) BUN, serum creatinine
b) SGOT, SGPT
c) serum glucose levels
d) complete blood count

33. Which of the following statements by the client indicates effectiveness of benzodiazepines?

a) my appetite to eat has greatly improved
b) I am less confused than before
c) I can remember things better now
d) I am now sleeping more than I used to

34. Which of the following assessment indicates the need for Dilantin (phenytoin) administration after dialysis?

a) headache, nausea, vomiting
b) hypertension, headache, restlessness
c) nausea, vomiting, restlessness
d) dizziness, headache, restlessness

35. The client is on Mestinon therapy. Which of the following signs and symptoms when experienced by the client need to be reported to the physician? Select all that apply

a) weakness
b) diarrhea
c) reduced tremors
d) increased muscle strength
e) nausea and vomiting
f) abdominal cramps
g) headache, dizziness



ANSWERS AND RATIONALE

31) A
- these are sins of adverse reaction to the medication. Therefore the nurse should stop the infusion.

32) A
- gentamycin is an aminoglycoside. The most common side effect of gentamycin is nephrotoxicity. BUN and serum creatinine are indicators of renal function.

33) D
- benzodiazepines (e.g. diazepam, alprozalam, and lorazepam) are sedative hypnotics, so they can promote sleep.

34) C
- twitching indicates seizure. Therefore dilantin, an anticonvulsant is indicated.

35) A, B, D, E, F
- these are signs and symptoms of cholinergic crisis and should be reported. Mestinon is a cholinergic medication, indicated in clients with myasthenia gravis. It is used to relieve muscle weakness.


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Online Nursing Practice Test about Pharmacology (26-30)

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26. Which of the following signs and symptoms indicates toxicity of gentamycin sulfate (garamycin)?

a) nausea and vomiting
b) hypotension
c) numbness of fingers and toes
d) ringing in the ears

27. The client has history of allergy to sulfonamides and penicillin. Which of the following drugs may safely be given to the client?

a) ampicillin
b) cloxacillin
c) ciprofloxacin
d) co-trimoxazole

28. The client is receiving Floricef. Which of the following types of diet should the nurse advise the client to have?

a) low sodium, high potassium, high protein
b) low sodium, low potassium, low protein
c) high sodium, high potassium, high protein
d) high sodium, high potassium, low protein

29. The client is receiving Questran. Which of the following should be included in the client teaching?

a) limit fluid intake
b) take fat-soluble vitamins
c) include potassium-rich foods in the diet
d) provide low-fiber diet

30. Which of the following health teachings should be included by the nurse for a client on prolonged Dilantin treatment?

a) wear long-sleeved clothing
b) use soft-bristled toothbrush
c) notify physician if urine becomes reddish brown
d) take the medication one hour before meals


ANSWERS AND RATIONALE

26) D
- gentamycin sulfate is an aminoglycoside. Common side effects are ototoxicity, nephrotoxicity and hepatotoxicity. Ringing in the ears indicates ototoxicity.

27) C
- ciprofloxacin is a quinolone. It can safely be given if a client has allergy to sulfonamides and penicillin. Ampicillin and cloxacillin are penicillins. Co-trimoxazole is a sulfonamide. If a client has allergy to penicillin, more likely he also, has allergy to cephalosphorin.

28) A
- floricef is a steroid. It causes retention of sodium ion, excretion of potassium ion and protein breakdown. The diet should be low sodium, high in potassium, high protein.

29) B
- questran is antihyperlipidemic. It may inhibit absorption of fat-soluble vitamins, or may enhance excretion of fat-soluble vitamins. Therefore, the client needs to take fat-soluble vitamins.

30) B
- dilantin may cause gum hyperplasia. Prevention of this adverse effect includes good oral care, massaging the gums, and using soft-bristled toothbrush.


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Online Nursing Practice Test about Pharmacology (21-25)

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21. Which of the following assessment findings indicate that propylthiouracil (PTU) is effective in the treatment of grave's disease?

a) the exopthalmos is decreased
b) the weight decreased
c) the edema decreased
d) the pulse rate decreased

22. What medication does the nurse expect to be prescribed for a client with adrenal insufficiency?

a) epinephrine
b) hydrocortisone
c) cyclophosphamide
d) amphogel

23. A patient is on coumadin therapy. Which statement when made by the client will concern the nurse?

a) I will refrain from taking aspirin for my headache
b) I'm glad I'll be able to eat lettuce, spinach and other green vegetables
c) I will use soft-bristled toothbrush
d) I will drink 8-10 glasses of water everyday

24. Which of the following complaints when made by the client who is receiving penicillin should concern the nurse most?

a) erythema in the lips and eyelids
b) difficulty in swallowing
c) itchiness of the skin
d) dryness of the mouth

25. What assessment parameter will the nurse check prior to giving potassium supplement per slow IV infusion drip?

a) blood pressure
b) complete blood count
c) liver enzymes
d) urine output



ANSWERS AND RATIONALE

21) D
- PTU is antithyroid. It will relieve the signs and symptoms of hyperthyroidism. Pulse will be decreased and the client will also gain weight. Exopthalmos is irreversible. There is no edema in hyperthyroidism.

22) B
- adrenal insufficiency (addison's disease) requires steroid therapy (hormonal replacement therapy), like hydrocortisone.

23) B
- green leafy vegetables are rich in Vit. K which is antagonizes coumadin, and anticoagulant.

24) B
- spasm of smooth muscles, like difficulty in swallowing indicates severe allergic reaction to penicillin.

25) D
- when a client will receive KCl/slow IV drip, urine output must be adequate to prevent renal damage. "No PEE, No K."


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NCLEX Secrets - Neurology Board Review (56-60)

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NCLEX Secrets - Neurology Board Review

56. Which of the following is a sign of neuroleptic malignant syndrome?

a) Temperature of 39.9 C
b) muscle weakness
c) red-purplish blotchy areas in the skin
d) weight gain

57. A nurse is caring for a client diagnosed to have head injury. Which of the following situations needs intervention by the nurse?

a) the padded side rails are up
b) the bed is adjusted to low level
c) the client's spouse turns on the TV one hour in the afternoon and 2 hours in the evening
d) the head of bed is elevated at 30 degree angle

58. Which of the following should be included when giving health teachings to a client with left hemianopsia?

a) tell her to fully turn her head from side to side
b) tell her to fully turn her head on her right side only
c) tell her not to turn her head from side to side
d) tell her to look forward most of the time

59. The client is diagnosed to have amyotrophic lateral sclerosis. Which of the following signs and symptoms should concern the nurse most?

a) tremors
b) difficulty in swallowing
c) ptosis of the eyelid
d) muscle atrophy

60. A client with closed head injury manifests increased urine output. What should the nurse do next?

a) measure urine specific gravity
b) start an IV fluid
c) monitor blood glucose levels
d) administer mannitol drip




NCLEX Secrets - Neurology Board Review:
ANSWERS AND RATIONALE

56) A
- fever is a characteristic manifestation of neuroleptic malignant syndrome

57) C
- in a client with head injury, increased ICP occurs. External stimuli should be reduced to prevent seizures.

58) A
- scanning technique will help the client with hemianopsia to see the entire visual field.

59) B
- difficulty in swallowing may cause aspiration. This in turn may cause airway obstruction.

60) A
- closed head injury causes increased intracranial pressure. This causes compression of the posterior pituitary gland that leads to hyposecretion of antidiuretic hormone (ADH). Diabetes insipidus occurs. Diabetes insipidus is characterized by polyuria and low urine specific gravity.


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Intrapartum NCLEX Questions 41-45

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Let us try to answer Intrapartum NCLEX Questions . . .
41. The client had been diagnosed to have PIH (pregnancy-induced hypertension). Which of the following should be included in her care? Select all that apply

a) administer magnesium sulfate IV drip as ordered
b) check urine for presence of protein
c) have calcium gluconate readily available
d) monitor for elevated liver enzymes
e) observe for elevated platelet counts
f) encourage ambulation

42. A clinic nurse is teaching a pregnant client about the warning signs in pregnancy. Which of the following, if identified as a warning sign by the client would indicate that she understands the teaching?

a) purplish discoloration of the vulva
b) visual disturbances
c) irregular, painless contractions
d) urinary frequency

43. The breastfeeding mother of infant with lactose intolerance asks a nurse about dietary measures. The nurse tells the mother to avoid

a) hard cheeses
b) green leafy vegetables
c) dried beans
d) egg yolk

44. A newborn has a temperature of 35.8 C, pulse rate of 126/min, respiratory rate of 65/min. What action should the nurse take first?

a) dry the newborn and wrap him with blanket
b) put the newborn in a radiant warmer
c) check the newborn's blood sugar level
d) perform phototherapy to the newborn

45. The nurse on a night shift finds a multiparous patient 8 hours postpartum drenched in perspiration. The temperature is 99F, pulse is 66 bpm, and BP is 120/80 mmHg. Which of the following nursing diagnosis would be appropriate?

a) risk for infection related to birth trauma
b) ineffective thermoregulation related to hormonal changes
c) ineffective tissue perfusion
d) excess fluid volume related to normal postpartal diuresis




Intrapartum NCLEX Questions
ANSWERS AND RATIONALE

41) A, B, C, D
- these are appropriate nursing care for a client with PIH. PIH may lead to HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count). Magnesium sulfate is given to the patient to prevent seizures. Calcium gluconate is administered if magnesium toxicity occurs. The client with PIH should be on complete bedrest to prevent further elevation of blood pressure and to prevent seizures.

42) B
- visual disturbances may indicate presence of pregnancy-induced hypertension (PIH). Choices 1, 3, and 4 are normal assessment findings in pregnancy

43) A
- lactose intolerance is characterized by inability to digest and absorb milk and milk products like cheese.

44) A
- drying the newborn and wrapping him with blanket will prevent further heat loss by evaporation.

45) B
- during postpartum period, hormonal changes cause alterations in body temperature. There may be slight dehydration and diuresis.


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Online Nursing Practice Test about Pharmacology (16-20)

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16. The client with liver cirrhosis has an ammonia level of 80 mcg/dl. Which of the following medications does the nurse anticipate to be ordered for the client?

a) dulcolax
b) metamucil
c) lactulose
d) senokot

17. Which of the following indicates effectiveness of Spirolactone, in the client with liver cirrhosis?

a) increase in weight
b) decrease in abdominal girth
c) increase in serum potassium level
d) decrease in jaundice

18. Which of the following is a contraindication to influenza vaccine?

a) chronic illness
b) allergy to eggs
c) diabetes mellitus
d) chronic obstructive pulmonary disease

19. Sulfasalazine (Azulfidine) is prescribed for a client with a diagnosis of ulcerative colitis. A nurse instructs the client about the medication. Which statement when made by the client indicates that he understands the teaching about the medication?

a) I should avoid exposure to sunlight
b) this medication will cause constipation
c) this medication should be taken with meals
d) this medication should be taken as prescribed

20. Which of the following assessment data when made by the nurse indicates effectiveness of lithium?

a) the client paces along the hallway during the night
b) the client refuses to eat in the dining room
c) the client is able to attend the conference on time
d) the client washes his hands less frequently



ANSWERS AND RATIONALE

16) C
- lactulose blocks ammonia formation. The normal serum ammonia level is 35-65 mcg/dL.

17) B
- spirolactone is a diuretic. It increases urine output, and reduces ascites in clients with liver cirrhosis. Therefore, decrease in abdominal girth indicates resolution of ascites.

18) B
- allergy to eggs is contraindication to influenza vaccine.

19) A
- sulfonamides cause photosensitivity. The client should avoid exposure to sunlight

20) C
- lithium is antimanic. Improved attention span and concentration ability indicate that the manic behavior is resolving. These indicate effectiveness of lithium.



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NCLEX Review about Gastrointestinal Disorder 36-40

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NCLEX Review about Gastrointestinal Disorder

36. The client had been diagnosed to have acute pancreatitis. Which of the following signs and symptoms most likely are experienced by the client? Select all that apply

a) pain in the left upper quadrant of the abdomen
b) bile-stained vomitus
c) elevated serum amylase
d) hypercalcemia
e) steatorrhea
f) hypoglycemia
g) weight loss

37. The child has been diagnosed to have Hirschprung's disease (Aganglionic megacolon) by rectal biopsy. Which of the following findings most likely is experienced by the child?

a) ribbon-like stool
b) currant jelly-like stool
c) olive-sized mass in the abdomen
d) sausage-like mass in the abdomen

38. The nurse assists the physician during paracentesis. In which position does the nurse place the client?

a) lying position
b) sitting position
c) prone position
d) side-lying position

39. The client had been diagnosed to have complete intestinal obstruction. Which of the following assessment findings will the nurse expect?

a) medium-pitched gurgling sounds
b) high-pitched tinkling bowel sounds
c) absence of bowel sounds
d) increased bowel sounds

40. Which of the following physician's orders for a client with acute pancreatitis should be questioned by the nurse?

a) zantac 300mg 1 tablet BID
b) morphine sulfate 5mg/IV every 6 hours
c) bland, low fat diet
d) meperidine hydrochloride 50mg/IV every 4 hours





NCLEX REVIEW ABOUT GASTROINTESTINAL DISORDER:
ANSWERS AND RATIONALE

36) A, B, C, E, G
- other signs and symptoms of acute pancreatitis are hypoglycalcemia and hyperglycemia

37) A
- hirschprung's disease is characterized by intestinal obstruction producing ribbon-like stool. Currant jelly stool and sausage-like mass are characteristics of intussusception. Olive-sized mass is a manifestation of pyloric stenosis.

38) B
- paracentesis is aspiration of fluid from the abdominal cavity. Sitting position allows fluid to settle at lower abdomen. This facilitates aspiration of fluids.

39) C
- absence of bowel sounds indicates complete intestinal obstruction. High-pitched tinkling sounds indicate partial intestinal obstruction.

40) B
- morphine sulfate is contraindicated in a client with acute pancreatitis because it causes spasm of sphincter of Oddi. The drug of choice to relieve pain in acute pancreatitis is Demerol (meperidine HCL).




Go to the next page ---> NCLEX Review about Gastrointestinal Disorder 41-45  

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NCLEX Secrets about Musculoskeletal Injuries (36-40)

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NCLEX Secrets about Musculoskeletal Injuries

36. A patient was admitted and diagnosed with fibromyalgia. Which of the following is true of the disease?

a) the disease is characterized by muscle weakness
b) the signs and symptoms are relieved by steroids
c) the disease is related to arthritis
d) the disease is characterized by tender points in the different parts of the body and headache

37. The client with cervical spinal cord injury is on halo-vest traction. Which of the following emergency equipment is most important to keep readily available at the bedside?

a) small wrench
b) suction apparatus
c) ambu bag
d) tracheostomy tray

38. The client had undergone total hip replacement. Which of the following crutch-walking gaits is most appropriate for the client?

a) four-point gait
b) two-point gait
c) swing-to gait
d) three-point gait

39. Which non-pharmacologic intervention should the nurse include in the care plan for a patient who has moderate rheumatoid arthritis?

a) massaging inflamed joints
b) avoiding range of motion
c) selecting clothing that have Velcro fasteners
d) using assistive devices at meal times

40. A client with Paget's disease develops osteoporosis due to

a) vitamin D deficiency
b) inadequate calcium in diet
c) bone resorption is rapid
d) lack of pressure on the bones




NCLEX Secrets about Musculoskeletal Injuries:
ANSWERS AND RATIONALE

36) D
- fibromyalgia is characterized by muscle pain and tender points in the different parts of the body and headache. Treatment of choice is non-steroidal anti-inflammatory drugs.

37) A
- the small wrench taped over the vest will be used for untightening the screws of the traction if CPR needs to be done to the client with halo-vest traction.

38) D
- three point gait is the most appropriate crutch gait for the client who had undergone total hip replacement. It is a non-weight bearing crutch gait.

39) C
- selecting clothing that have Velcro fasteners facilitates task of the client with rheumatoid arthritis. Joints of fingers of the client are the most commonly affected joint. This makes it difficult for the client to perform activities of daily living like dressing and grooming.

40) C
- paget's disease is characterized by very rapid bone resorption, followed by very rapid bone regeneration. However, the new bone tissues formed are weak. The client is prone to fracture.




Go to the next page ---> NCLEX Secrets about Musculoskeletal Injuries (41-45)  

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