NCLEX Preparation Course - Critical Thinking Exercises I (Questions 21-30)

Here are the Answers to NCLEX Preparation Course - Critical thinking I (21-30) -->

21. The client states, "I don't want to talk to anybody." The appropriate response by the nurse would be:

a) if you talk to me, you will feel better
b) okay the. I will leave you now, but once you feel like talking, you can call me anytime
c) you seem upset. Would you like to talk how you feel?
d) why don't you want to talk to me? I'm your nurse

22. The elderly client has varying stages of decubitus ulcer in the different parts of her body. Which of the following diet is best recommended for the client?

a) steamed chicken with pudding
b) peanut butter sandwich and skim milk
c) macaroni with cheese and orange slices
d) roasted beef with mashed potatoes

23. The nurse is assigned to take good care of 4 clients. Who among the following clients should the nurse assess first?

a) the client with WBC level of 11,000/cu.mm
b) the client with hemoglobin level of 10g/dL
c) the client with cholesterol level of 280 mg/dL
d) the client with oxygen concentration of 90%

24.
Who among these clients is prone to hepatitis C?

a) the client undergoing hemodialysis
b) the client who has diabetes mellitus
c) the client who has hypertension
d) the client who has cushing's disease

25.Which of the following should the nurse assess in a client receiving steroid?

a) hyponatremia
b) hyperkalemia
c) hyperglycemia
d) weight loss

26.
A client does not respond when called by name. The next nursing action would be:

a) open the airway by head-tilt, chin-lift maneuver
b) provide rescue breathing
c) start external chest compression
d) tap the client by the shoulder

27. In the medical area, one RN, one LVN, and one CNA are on duty. Which patient is appropriate for the CNA to care?

a) a patient, who is dyspneic, admitted for asthma one hour ago
b) a patient with cast on the right arm, who complains of numbness and pain in the area
c) a 2-day post-appendectomy patient who needs assistance for ambulation
d) a patient with decubitus ulcer who needs dressing changes

28. A resident who is newly admitted to a nursing home seems slightly confused. Which of these measures is likely to assist in the client's initial adjustment?

a) encourage family or friends to bring in familiar objects
b) provide the resident with few choices in making decisions regarding care
c) keep stimuli in the environment to a minimum
d) remind the staff not to answer the same questions repeatedly

29. A hospitalized client had surgery and is in pain. She is drinking herbal tea brought in from home. She refuses the prescribed pain medication because she says in her culture she learned to drink herbal tea and to avoid all medications. Which of these actions by the nurse is best?

a) explain that herbal tea is not effective and may be harmful
b) insist she take the pain medication along with the tea
c) offer to position her more comfortably so she can drink the tea
d) tell her the physician wants her to take the pain medication

30. A client frequently refuses to follow the physician's orders and tries to dominate every situation. In planning for his care, which of these actions would be best initially?

a) allow him to make some decisions to promote a sense of control
b) be a good listener to help meet his need for affection
c) encourage family and friends to visit to satisfy his need for intimacy
d) provide information and explanations to help him feel worthwhile


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NCLEX Practice Exam/Test - Critical Thinking Exercises I (Anwers 11-20)

Here are the Questions to NCLEX Critical thinking 11-20 -->

11) B
- dehydration may occur during phototherapy. Diarrhea may also occur as bilirubin is excreted. There's no need to patch the eyes because bulbs are not used in fiberoptic phototherapy blanket.

12) C
- the nurse has reporting responsibilities. Communicable diseases should be reported to local authorities, to protect welfare of the public. Other reporting responsibilities of health care workers are abuse, assault/homicide, vehicular accident, gunshot/stab wounds. Suicide is not a reporting responsibility, because the client's privacy and right to confidentiality should be protected.

13) C
- black cohosh is estrogen enhancer. It is used to treat PMS. St. john's wort is antidepressant; Gingko is antioxidant and improves CNS, circulation; Ginger relieves nausea and vomiting and it relieves swelling in arthritis.

14) A
- Mexican-American use handshaking for greeting. This shows respect to the client.

15) B
- the client with problem in the airways should be attended to first. ABC is a priority.

16) B
- the most accurate area to assess for jaundice in a child is the mucous membrane - mouth, bud palate, conjuctiva. The other area where to check for jaundice is the nailbed. The nailbed of the child is not discolored yet by polish and nicotine.

17) B
- negative-airflow room is used for clients with airborne infection to prevent spread of microorganisms to the environment.

18) C
- the gloves should be removed first to prevent contamination of other parts of the body e.g. face, neck (needs intervention - means that the action is to be corrected).

19) A
- bleeding is a potential complication of suctioning. If the platelet count is low, extreme caution should be practiced when performing this procedure.

20) A
- the client perceives that he is no longer in control of his situation. This indicates powerlessness.


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Online Nursing Practice Test about Respiratory Diseases (14-20)









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14. A 14-year old male is to be admitted to the unit due to high fever related to influenza. With whom among the following clients should he be placed together in the room?

a) the 12-year old male client who had undergone appendectomy
b) the 12-year old female client with flu
c) the 12-year old boy with flu
d) the 12-year old boy with leukemia

15. Why is influenza vaccine given to adults annually?

a) immunity last only for a year
b) some organisms are resistant to the vaccine
c) this is the routine procedure
d) adults have low resistance to flu virus

16. Which of the following nursing interventions should be implemented for a client with influenza?

a) instructing family members not to visit the client until the fever declines
b) instructing family members or visitors to wear surgical mask before entering the client's room
c) instructing family members that there are no special precautions needed when caring for the client
d) instructing family members to wear gown and gloves before entering the client's room

17. Which of the following should concern the nurse most, when caring for a client who will undergo bronchoscopy?

a) the client had a glass of orange juice an hour ago
b) the client has yellowish sputum
c) the client complains of thirst and dryness of mouth
d) the client says, he had removed his dentures

18. The client had undergone decortication of the right lung. The nurse needs to intervene when the unlicensed nursing assistant does which of the following?

a) instructs the client to lie on the operated side
b) instructs the client to lie on the unoperated side
c) keeps the client on supine with head of the bed elevated
d) ensures that chest tube with water-seal drainage functions properly

19. Which of the following findings should concern the nurse that the oxygen saturation monitor is not working?

a) there is no sensor light on the probe
b) oxygen saturation (Sa O2) is 92%
c) pulse rate= 58/min; Sa is 97%
d) mucous membrane in the mouth appears pinkish

20. The client had left chest injury. The nurse can feel air going in and out of injured site during breathing. Which of the following should the nurse do initially?

a) apply petrolatum jelly dressing at the site
b) turn the client to right side
c) give oxygen therapy at 2 L/min
d) transport the client to the nearest medical facility



ANSWERS AND RATIONALE

14) C
cohorts (client with the same diagnosis) can be roomed-in as long as one does not have infection which is different from the other. Age group is another consideration as well as gender of clients.

15) A
- annual influenza vaccine is required to maintain adequate protection.

16) B
- influenza requires droplet precaution. Healthcare workers and family members should wear surgical mask when entering client's room to ensure prevention of contamination.

17) A
- the client should be on NPO 6-8 hours before bronchoscopy if the client had taken anything by mouth, aspiration and airway obstruction may occur.

18) A
- the nurse should intervene when the nursing assistant instructs the client to lie on the operated side. This may inhibit expansion of the affected lung. Options B, C, and D are correct nursing interventions.

19) A
- if the O2 saturation monitor is not working, there will be no sensor light on the probe.

20) A
- cover the injured site of the chest with occlusive dressing like petrolatum jelly dressing to prevent pneumothorax and atelectasis.


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NCLEX Secrets - Neurology Board Review (6-10)

NCLEX Secrets - Neurology Board Review

6. The client is diagnosed to have hypertension. He is on maintenance dose with captopril (capoten). Which of the following manifestations indicate side effects of the medication?

a) diarrhea, hypoglycemia
b) hyperkalemia, insomnia
c) bruising, bleeding
d) headache, dizziness

7. To provide exercise for a client who had cerebral vascular accident (CVA) with hemiplegia, what should the nurse include in the nursing care plan?

a) provide gentle, smooth range of motion exercises, 5 times for each joint
b) ensure that the arms are always above the shoulders
c) provide passive flexion-extension exercises only on the stronger extremities
d) massage the legs vigorously to improve muscle tone

8. When the nurse observes that the patient has extension and internal rotation of the arms and wrists and extension, plantar flexion and internal rotation of the feet, she records the patient's posturing as (supply the answer) . . .

9. Bell's palsy is a disorder of which cranial nerve?

a) trigeminal (V)
b) acoustic (VIII)
c) facial (VII)
d) vagus (X)

10. A client diagnosed to have Guillain-Barre Syndrome. The client has the following blood gas results: pH is 7.35 and the paCO2 IS 50 mmHg. What acid-base imbalance is the client experiencing?

a) respiratory acidosis
b) respiratory alkalosis
c) metabolic acidosis
d) metabolic alkalosis




NCLEX Secrets - Neurology Board Review:
ANSWERS AND RATIONALE

6) D
- hypotension causes headache and dizziness. Angioedema (swelling of face and hands) may also occur as side effect of capoten.

7) A
- gentle, smooth ROM exercises promote well-being of the client; prevent stiffness of joints, and contractures. Exercises should be done in a manner that prevents increase in ICP.

8) Decerebration
- is abnormal extension. It indicates brainstem function impairment.

9) C
- Bell's palsy is paralysis of the facial nerve (CN VII). It is characterized by asymmetry of the face with ptosis of the eyelid on the affected eye.

10) A
- high paCO2 level in the blood causes respiratory acidosis. In Guillain-Barre Syndrome, there is weakness/paralysis of respiratory muscles. This causes carbon dioxide retention.


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NCLEX Peds Questions (1-5)

Let us try to answer nclex peds questions . . .

1. A mother of a 1-month old infant expresses concern because one of the infant's eye appears to be crossed. The most appropriate and supportive response by the nurse is which of the following?
a) this is normal in the young infant but should not be present after about age 4 months
b) this condition is probably permanent
c) the infant will probably need surgery
d) it needs observation because this thing may happen to the other eye

2. The nurse is taking good care of a one-day old newborn. Which of the following assessment findings does the nurse expect?

a) temp-37.7C, apical rate-100 bpm, RR-45, BP-65/41 mmHg
b) temp-37.4C, apical rate-120 bpm, RR-28, BP-65/41 mmHg
c) temp-36.7C, apical rate-130 bpm, RR-irregular, BP-65/41 mmHg
d) temp-36.5C, apical rate-140 bpm, RR-regular, BP-95/58 mmHg

3. Who among the following pediatric client should be assessed first by the nurse?

a) the child with 2 episodes of soft stools during the shift
b) the child who had cough for the past three days, with clear nasal discharge and is irritable
c) the child with 2 episodes of inconsolable crying while the knees are drawn over the abdomen and plays between the episodes
d) the child with skin rashes on his face and trunk

4. The nurse is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn?

a) uneven head shape
b) respirations are irregular, abdominal, 30-60 bpm
c) (+) moro reflex
d) heart rate is 80 bpm

5. The nurse is caring for several infants who are 2-day old. Who among these infants should be given highest priority by the nurse?

a) a bottlefed infant who takes 1-ounce of milk every 3 to 5 hours
b) a breastfed infant who lost 0.5 ounce of his weight
c) a bottlefed infant who takes 2 to 3 ounces of milk every 2 to 4 hours
d) a breastfed infant who feeds every 2 to 4 hours






NCLEX PEDS QUESTIONS
ANSWERS AND RATIONALE

1) A
- strabismus is normal in an infant and it normally resolves before age 4 months

2) C
- the body temperature of the newborn is slightly lower than 37C, apical rate is 120-160 bpm, respiration are irregular (30-60 per min)

3) C
- this indicates appendicitis. The pattern of abdominal pain in appendicitis is as follows: pain occurs for 2 to 3 hours, pain is relieved in 2 to 3 hours, the n pain recurs and persists. During the time that pain subsides, it is when rupture of appendicitis may occur unnoticed.

4) D
- normal heart rate of the newborn is 120 to 160 bpm. Choices A, B, and C are normal assessment findings (uneven head shape is molding).

5) A
- the client experiences poor feeding (1 ounce = 30 ml) which indicates specific problems. The infant normally looses weight during the first week of life and he/she usually gains weight on the second week.


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NCLEX Peds Questions (6-10)

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Test Prep for Nursing Exam about Obstetric Nursing (6-10)





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6. The client is in active phase of labor. The physician has administered epidural anesthesia. Which of the following nursing actions should be given highest priority by the nurse?

a) ensuring patent IV access line
b) checking for rupture of membrane
c) monitoring duration of each contraction
d) providing food and fluids

7. The client is on her twelfth-week of pregnancy. She had been diagnosed to have ruptured ectopic pregnancy. Which of the following signs and symptoms are characteristic of the condition?

a) profuse bright red vaginal bleeding
b) spotting, abdominal pain that radiates to the shoulder
c) elevated hemoglobin and hematocrit level
d) leukopenia, decreased body temperature

8.You are assessing a 32-week pregnant woman. Which of the following is a biophysical nursing diagnosis?

a) body image disturbance
b) knowledge deficit
c) ambivalence
d) alteration in nutrition

9. A nurse provides instructions to a malnourished client regarding iron supplementation during pregnancy. Which statement when made by the client would indicate an understanding of the instructions?

a) the iron is best taken on empty stomach
b) meat does not provide iron and should be avoided
c) iron supplements will give me diarrhea
d) my body has all iron it needs and I don't need to take supplement

10. Which of the following meals is best for pregnant woman?

a) turkey with green salad
b) angel food cake
c) hamburger with coffee
d) french fries with soda drink



ANSWERS AND RATIONALE

6) A
- epidural anesthesia causes hypotension. A patent IV line should be established for administration of ephedrine if hypotension occurs.

7) B
- the bleeding occurs in the abdominal cavity, not within the uterus. Therefore, spotting and not profuse bleeding may occur. When a client is bleeding, the hemoglobin and hematocrit levels will be low. Leukocytosis occurs in response to activation of protective mechanisms of the body.

8) D
- biophysical/physiologic nursing diagnosis is D. Choices A, B, and C are psychosocial nursing diagnosis.

9) A
- ferrous fumurate and ferrous gluconate are the most commonly used iron supplement. They are best absorbed on empty stomach.

10) A
- a pregnant woman should eat a well-balanced diet like turkey with green salad. Angel food cake is a carbohydrate; hamburger is a high in cholesterol and coffee is an "empty calorie"; French fries is high in fats and soda is an "empty calorie."


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NCLEX Preparation Course - Critical Thinking Exercises I (Questions 11-20)

Here are the Answers to NCLEX Preparation Course - Critical thinking I (11-20) -->

11. A fiberoptic phototherapy blanket is used to manage hyperbilirubinemia in a 2-day old infant. Which of the following interventions should the nurse include in the nursing care plan for the child?

a) cover the child's eye with eye patch
b) check the number of wet diapers and stools of the child
c) keep the child in one position during the treatment
d) cover the entire body with two layers of clothing during the treatment

12. The nurse attended a conference on care of clients with Communicable diseases. Which of the following statements when made by the nurse indicates that she has learned from the conference?

a) all communicable diseases are contagious
b) I should always wear mask, gloves, gown when caring for clients with communicable diseases
c) I should report communicable diseases to local health authorities
d) I should implement strict isolation technique for all clients with communicable diseases

13. Which of the following herbal medicines may be used to treat premenstrual syndrome (PMS)?

a) st. john's wort
b) gingko
c) black cohosh
d) ginger

14. A home care nurse is assigned to visit a Mexican-American client to perform an admission assessment. On initial meeting with the client, the nurse should plan to:

a) greet the client with handshake
b) avoid touching the client
c) avoid any affirmative nod during the conversations with the client
d) smile and use humor throughout the entire admission assessment

15. The nurse has received report from the previous shift. On making her rounds, which patient should the nurse assess first?

a) a 2-day post-TURP patient who has not voided for 6 hours since the 3-way foley catheter was removed
b) a patient with myasthenia gravis whose secretions is increasing and is feeling weak
c) a 1-day post-appendectomy patient with temperature of 37.8 C
d) a patient with Parkinson's disease who is experiencing rigidity and non-intentional tremors

16. Which anatomical area will provide the best data regarding presence of jaundice in a child with hepatitis?

a) the skin in the abdominal area
b) the nailbeds
c) the skin in sacral area
d) the membranes in the ear canal

17. A nurse attends the unit conference on the care of the clients with airborne infections. Which of the following statements indicates that the nurse understands the care of these clients.

a) the nurse suggests that the client wear surgical masks all the times
b) the nurse suggests that these clients be confined in negative-airflow room
c) the nurse suggests that these client should not be transported to any department in the hospital
d) the nurse suggests that all caregivers of these clients must wear gloves at all times

18. A registered nurse (RN) supervises a licensed vocational nurse (LVN) when caring for client with communicable diseases. Which of the following actions by the LVN needs intervention by the RN?

a) the LVN washes her hands before and after removing the gloves
b) the LVN avoids touching with bare hands anything that is wet coming from a body surface
c) the LVN removes the mask, then the gown, then the gloves, and then the cap and shoe cover after caring with the client with extensive body burns
d) the LVN discards uncapped needles and syringes into a puncture-proof, leak-proof container

19.Which of the following laboratory test results should be checked by the nurse prior to endotracheal suctioning?

a) platelet count
b) serum potassium
c) blood urea nitrogen (BUN)
d) blood uric acid (BUA)

20. Which of the following is the priority nursing diagnosis for the client who does not want to comply with therapeutic regimen and states, "I will not recover anymore, anyway. So why should I bother?"

a) powerlessness
b) knowledge deficit
c) self-care deficit
d) disturbed thought process


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