Test Prep for Nursing Exam about Obstetric Nursing (36-40)

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36. Several female patients want to have Papanicolaou examination. Who among these patients should the nurse advise not to have the examination? The patient who states

a) the first day of my menstruation came this morning and I am bleeding profusely
b) I am 21 years old, and have not had any sex at all
c) I had the test 3 months ago and it was positive
d) I have herpes simplex virus (HSV) and had sex 2 weeks ago

37. A mother who has just delivered a term baby, wants to delay breastfeeding for 3 days. What is the best interpretation of this mother's behavior?

a) she has knowledge deficit regarding breastfeeding
b) she doesn't want to breastfeed her child
c) she doesn't want to have bonding with her child
d) she doesn't want to accept her responsibility of caring for her child

38. A primigravid client at 8 weeks gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, she has noticed flu-like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a physician because the nurse suspects which of the following sexually transmitted diseases.

a) gonorrhea
b) chlamydia trachomatis
c) syphilis
d) herpes genitalis

39. A middle-aged woman has just returned from the recovery room after a right mastectomy. A top priority in planning her care is to minimize the pain she is experiencing.

a) risk for ineffective airway clearance
b) alteration in comfort
c) potential for injury
d) alteration in nutrition

40. A patient who is on her 39 weeks gestation comes to the hospital accopmpanied by her husband. She tells the nurse she thinks she is in labor. Which of the following questions should the nurse ask to help confirm if the patient is in true labor?

a) do your contractions feel like severe menstrual cramps?
b) do you feel pressure in your legs
c) do you feel as if you can breathe easier?
d) does your pain increase in intensity when you are moving around?



ANSWERS AND RATIONALE

36) B
- papanicolaou examination is done in all sexually active women at any age. If the woman is not sexually active, baseline examination is at age 40.

37) A
- the mother needs to know that breastfeeding is best started as soon as possible to stimulate milk production and to promote bonding between the mother and the child.

38) D
- herpes genitalis is characterized by clusters of vesicles in the vaginal area. Trachomatis infection is often asymptomatic in women, but symptoms may include yellowish discharge and dysuria. Some women have no symptoms of gonorrhea. Others may experience vaginal itching and a thick purulent vaginal discharge. Syphilis is characterized by painless chanchroid.

39) B
- comfort is being free from pain. Alteration in comfort indicates presence of pain.

40) D
- in true labor, pain is intensified by walking. In false labor, pain is relieved by walking.


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Online Nursing Practice Test about Gastrointestinal Diseases (31-35)

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31. Which of the following interventions does the nurse expect to give to a client after gastrointestinal series?

a) analgesic
b) laxative
c) antiemetic
d) sedative

32. The client has been diagnosed to have acute pancreatitis. Which of the following is not a component of nursing care for the client?

a) administer morphine sulfate for pain
b) administer calcium supplement as ordered
c) administer digestive enzymes with each meal and snack
d) administer IV therapy as ordered

33. The client has been diagnosed to have VRE (Vancomycin-resistant enterocolitis). Which of the following is appropriate nursing action when caring for the client?

a) wear mask when entering the client's room
b) wear gloves when caring for the client
c) wear mask and gloves when performing procedures to the client
d) wear gown and mask when caring for the client

34. A patient was diagnosed to have Laennec's cirrhosis. Which of the following symptoms should be assessed first?

a) inability to write
b) jaundice
c) increased BUN
d) ascites

35. A nurse assists a physician in performing a liver biopsy. After the procedure, which of the following positions should the nurse place the patient?

a) prone position
b) supine position
c) right side-lying position with a pillow under the puncture site
d) left side-lying position with a pillow under the puncture site



ANSWERS AND RATIONALE

31) B
- BaSO4 which is used as the contrast medium in gastrointestinal series, causes constipation. Therefore, laxative will be administered after the procedure as ordered.

32) A
- morphine SO4 is contraindicated in a client with acute pancreatitis because it causes spasm of the sphincter of Oddi and the pancreas. Demerol is the drug of choice to relieve pain in acute pancreatitis.

33) B
- VRE is characterized by diarrhea. Contact precaution should be implemented, which includes use of gloves and gown when caring for the patient.

34) A
- inability to write indicates presence of asterixis (flapping tremors) this may signal impending hepatic encephalopathy. This is an assessment priority in a client with liver cirrhosis.

35) C
- right side-lying position is intended to apply pressure at the puncture site, and thereby preventing bleeding after liver biopsy.


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Online Nursing Practice Test about Pharmacology (6-10)

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6. The client has hepatic encephalopathy. She is receiving lactulose. What is the expected outcome of the medication?

a) increased level of awareness
b) increased albumin levels
c) increased number of stools
d) increased serum protein levels

7. The nurse is preparing to administer Terbutaline (Brethine) to a multigravid client in preterm labor. Before administering this drug intravenously, the nurse should assess which of the following?

a) hematocrit level
b) weight gain
c) urinary output
d) heart rate

8. The physician orders Betamethasone (Celestone) for a 34-year old multigravid client at 32 weeks gestation who is experiencing preterm labor. The nurse explains that this drug is given for which of the following reasons?

a) to enhance fetal lung maturity
b) to counter the effects of tocolytic therapy
c) to treat chorioamnionitis
d) to decrease neonatal production of surfactant

9. Which of the following comments indicates that a client understands the nurse's teaching about Sertraline (Zoloft)?

a) this medicine will probably cause me to gain weight
b) this medicine can cause delayed ejaculations
c) dry mouth is a permanent side effect of Zoloft
d) I can take my medicine with St. John's wort

10. When the nurse begins to give the patient a prescribed medication, the patient says, "You are poisoning me with the pills you are giving me." Which of these responses by the nurse is most appropriate?

a) tell me why you think I am doing that to you
b) this isn't the first dose I've given you
c) I'll get a fresh package of pills so you can see me open the sealed package
d) are the other nurses giving you these pills?



ANSWERS AND RATIONALE

6) A
- lactulose inhibits ammonia formation and relieves hepatic encephalopathy

7) D
- terbutaline, a beta-adrenergic agonist may cause tachycardia.

8) A
- betamethasone enhances fetal lung maturity. Thereby, increasing chance of fetal survival if preterm delivery is inevitable.

9) B
- Zoloft, an antidepressant can cause decreased libido and sexual dysfunction. It can also cause loss of appetite and weight loss.

10) C
- if a client believes that he is being poisoned, allow him to see that the medications are opened in his presence.


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NCLEX Secrets - Neurology Board Review (46-50)

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NCLEX Secrets - Neurology Board Review

46. Which of the following assessment findings indicated increased intracranial pressure? Select all that apply

a) headache
b) tachycardia
c) slow respiration
d) narrowing of pulse pressure
e) slow, bounding pulse
f) hyperthermia

47. Which of the following nursing measures should be included when caring for a client with Parkinson's disease?

a) put color on rails in going upstairs
b) provide high toilet seat
c) provide soft mattress
d) apply restraints to reduce tremors

48. Michael suddenly went into seizures. To protect a child from injury the nurse should:

a) retrain the child's arm and legs
b) place a tongue blade in the child's mouth
c) place a pillow under the child's head
d) provide a waterproof pad for the bed

49. The first nursing priority when providing nursing care for Michael is to:

a) administer antibiotic as ordered as soon as possible
b) keep the room quiet and dim
c) explain all the procedures to the patients
d) begin low-flow oxygen per mask

50. Which room should the nurse assign to Ashley?

a) room 201 with Joey, age 2 who underwent surgery for repair of hernia
b) room 206 with Rica, age one who had pneumonia
c) room 210 with Jack age 2 who has cerebral palsy
d) room 214 with no roommate




NCLEX Secrets - Neurology Board Review:
ANSWERS AND RATIONALE

46) A, C, E, F
- increased ICP is characterized by headache, nausea and vomiting, diplopia, increased systolic BP, slow respiration, slow bounding pulse, widening of pulse pressure, hyperthermia/hypothermia, altered LOC, papilledema, lateralizing sign.

47) B
- the client with Parkinson's disease experiences stiffness/rigidity due to inadequate dopamine production. Dopamine is a neurotransmitter that promotes muscle relaxation. High toilet seat facilitates the client's ability to sit during elimination.

48) C
- the child should never be restrained during a seizure because such action by the nurse can cause fracture of the bones. Tongue blade must not be inserted when the child is already having a seizure because of the risk of injury. Placing waterproof pad at this time is no longer advisable. It is correct to slip pillow under the head to protect the head of the child from banging on any hard object.

49) A
- the priority is to treat the patient with antibiotics at the soonest time possible because the longer the disease goes on without treatment, the greater the risk of seizures and of permanent neurologic damage, such as hearing loss, brain damage, blindness, loss of speech, learning disabilities and behavior problems. Non-neurologic complications may include kidney and adrenal gland failure. Bacterial infections of the central nervous system progress quickly. Within hours of the onset of symptoms, the disease can lead to shock and death.

50) D
- Bacterial meningitis is a highly contagious. Therefore the patient must be placed in a private room to prevent transmitting it to other patients. Nurses who will be in contact with patients with meningitis should wear mask, the mask should be discarded right away when it gets moist or wet. The different types of bacterial meningitis are:
  • Pneumococcus - this bacterium is the most common cause of meningitis in adults and children. It most often occurs when the bacterium Streptococcus pneumoniae (pneumococcus), the same bacterium that causes pneumonia and ear infections, enters the bloodstream and migrates to the brain and spinal cord. Mode of transmission is the same as pneumonia: droplet, direct contact and through respiratory discharges.
  • Meningococcus - this bacterium is another common cause of meningitis in children under age 5, in teens and in young adults. Meningococcal meningitis commonly occurs when bloodstream. It's highly contagious and may cause localized epidemics in college dormitories, boarding schools and on military bases. Five strains of the Neisseria meningitidis bacterium cause meningococcal meningitis. Mode of transmission is by direct contact and respiratory droplets. This type of meningitis is communicable until the meningococci are no longer present from nose and mouth. Prophylactic treatment is Rifampicin taken for 4 days at a dose of 20 mg/kg/day.
  • Haemophilus - the Haemophilus influenzae (H. influenzae) bacterium is the leading cause of bacterial meningitis in children under age 5. The use of the Hib vaccine prevents this type of meningitis. When it occurs, it tends to follow an upper respiratory infection, ear infection (otitis media) or sinusitis. Mode of transmission is by droplet infection and discharges from nose and throat during the infectious period. This type of meningitis is no longer communicable 48 hours after starting antibiotic therapy.

Go to the next page ---> NCLEX Secrets - Neurology Board Review (51-55)  

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    NCLEX Review about Cardiac Nursing (31-35)

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    NCLEX Review about Cardiac Nursing

    31. Left-sided congestive heart failure is most often associated with which of the following manifestations?

    a) dyspnea
    b) distended neck vein
    c) hepatomegaly
    d) pedal edema

    32. A client with chest pain is admitted to the emergency department. He states that his chest pain was not relieved after taking 3 nitroglycerine tablets at home. Which of the following is the best initial nursing action?

    a) administer the prescribed analgesic
    b) give nitroglycerine sublingually
    c) monitor blood pressure
    d) monitor ECG

    33. After cardiac catheterization, which of the following findings should the nurse report to the physician?

    a) pain on the groin when changing positions
    b) the client denies tingling sensation in the extremity
    c) the client verbalizes that she experienced flushing sensation during the procedure
    d) the toenail blanches on compression and pinkish color returns after 1 to 3 seconds

    34. After cardiac catheterization that involves femoral artery, which of the following actions by the RN needs intervention by the charge nurse?

    a) the RN monitors the client's vital signs
    b) the RN applies small ice pack over the puncture site
    c) the RN elevates the head of the bed to sitting position as requested by the client
    d) the RN immobilizes the affected extremity in extension

    35. An elderly client who had suffered a severe heart attack says to the nurse, "I have a living will and my children do not agree with what I have decided. I hope you nurses and doctors will abide by my wishes." Which of these responses by the nurse is best?

    a) your wishes are the most important
    b) do you expect your children to be here when you have to make decisions?
    c) you and your children should really decide together
    d) it's always best to reconsider your decisions






    NCLEX Review about Cardiac Nursing:
    ANSWERS AND RATIONALE

    31) A
    - left-sided congestive heart failure is characterized by signs and symptoms due to: a. pulmonary edema ("left" - "lung"), b. cellular hypoxia, c. RAAS activation --> hypertension and hypokalemia.
    Choices B, C, D are signs and symptoms of right-sided CHF.

    32) A
    - relief of chest pain is a priority in myocardial infarction. Pain increases cardiac workload and may lead to shock. Morphine sulfate is the drug of choice.

    33) A
    - pain in the groin after cardiac catheterization may indicate hematoma at the site. This indicates bleeding at the site and compression of blood vessels by the hematoma may occur. his in turn, may cause circulatory impairment in the area.

    34) C
    - avoid acute hip flexion after cardiac catheterization involving the femoral artery to prevent circulatory impairment. HOB may be elevated only up to 30 deg for the first 6 to 8 hours

    35) A
    - the client's wishes are primary considerations in living will.



    Go to the next page ---> NCLEX Review about Cardiac Nursing (36-40)  

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    Online Nursing Practice Test about Pharmacology (1-5)

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    1. Which of the following laboratory results shows adverse effect of garamycin?

    a) elevated SGOT and SGPT
    b) decreased wbc count
    c) increased platelet count
    d) elevated BUN and serum creatinine

    2. The client is on heparin therapy. Which of the following health teaching is essential?

    a) use a safety razor to shave
    b) use a soft sponge toothbrush
    c) take ecotrin for pain
    d) use compression support stockings

    3. Which of the following medications would the nurse be prepared to administer to a client in liver failure?

    a) neomycin and lactulose
    b) phenytoin sodium
    c) diazepam
    d) phenobarbital

    4. What is the difference between epidural analgesia and analgesia given through intravenous route?

    a) epidural analgesia has longer effect in the body
    b) epidural analgesia has more sedative effect
    c) epidural analgesia is more effective in relieving pain
    d) epidural analgesia has fewer side effects

    5. A client is receiving Synthroid. Which of the following assessment data indicates that the client is experiencing a side effect of the drug?

    a) muscle weakness and fatigue
    b) headache and lethargy
    c) tachycardia and weight loss
    d) anorexia and obesity



    ANSWERS AND RATIONALE

    1) D
    - garamycin is an aminoglycoside. It is nephrotoxic and ototoxic. Nephrotoxicity is indicated by elevated BUN and serum creatinine.

    2) B
    - heparin is an anticoagulant. Avoid factors that may cause bleeding. Use soft bristled/soft sponge toothbrush to prevent gum bleeding. Ecotrin (ASA) may cause bleeding. Electric razor, and not safety razor is recommended to prevent trauma.

    3) A
    - neomycin and lactulose block ammonia formation. These are indicated to relieve hepatic encephalopathy. Neomycin reduces colonic bacteria which are responsible for ammonia formation. Lactulose acidifies the colon and inhibits formation of alkaline ammonia.

    4) A
    - epidural analgesia has longer effect on the body.

    5) C
    - synthroid is a thyroid preparation. This may cause hypersensitivity of the thyroid gland as manifested by tachycardia and weight loss.

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    NCLEX Preparation Course - Critical Thinking Exercises VI (Answers 11-20)

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    Here are the Questions to NCLEX Preparation Course - Critical Thinking VI (11-20) -->

    11) B
    - application of warm compress relieves joint pains in a client with sickle cell anemia. Warm compress also thins the blood. This prevent further accumulation of clumped RBC's in the joints. The management for sickle cell anemia HHOP - Hydration, Heat application, Oxygenation, Pain medication.


    12) D
    - the client with SLE experience joint pain. ROM exercises will help relieve the pain. Exposure to sunlight should be avoided by the client with SLE to prevent exacerbation of signs and symptoms.

    13) D, E, F, G
    - these are not included when giving information about hepatitis A.
    Choices A, B, C are to be included when giving health teachings to a client with hepatitis A.

    14) A, B, C, F
    - thse are appropriate interventions for a patient with Addison's disease which is hyposecretion of the adrenal cortex hormones. Low secretion of glucocorticoid: hypoglycemia, low resistance to infection; low secretion of mineralocorticoid ( aldosterone): loss of sodium and water, hypotension, retention of potassium.

    15) C
    - assess the client first, before implementation

    16) A
    - the post CVA client requires services of different members of the health team during rehabilitation.

    17) D
    - herbal medicines believed to relieve menstrual cramps are Black Cohosh, Evening Primrose and Dong quai.

    18) A
    - after herniorrhaphy, straining at stool should be avoided to prevent weakening of the repair. Increasing fluid intake prevents constipation.

    19) B
    - aspiration causes airway obstruction that may lead to death. Therefore, this should be given highest priority. (ABC is priority).

    20) A
    - the nurse should take the BP on the other arm. Hypocalcemia is manifested by bilateral carpopedal spasm.


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