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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Online Nursing Practice Test about Pharmacology (11-15)

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11. A patient who is known to be a narcotic abuser is involved in an automobile accident and has extensive surgery. In planning for analgesia post-surgery, the nurse should be aware that this patient is likely to:

a) tolerate pain than a patient who is not a drug abuser
b) require greater doses of medication before pain is relieved
c) refuse medication to prove addiction is not a problem
d) tolerate oral medication better than intravenous doses

12. When a patient is taking an antianxiety drug, such as Alprazolam (Xanax), the nurse should instruct the patient to:

a) avoid alcoholic beverages
b) increase potassium intake
c) discontinue use of drugs like tylenol
d) check for signs of edema

13. A client is to receive morphine sulfate 10mg IM. The morphine for injection is available in 8 mg per 1 ml. How many ml should the client receive?

14. A newborn baby boy was given Aquamephyton. The mother asks the purpose of the medication. Which of the following is most appropriate explanation to the mother?

a) this is given to prevent infectious diseases in the future
b) this is given to prevent blood clot formation
c) this is given to enhance immune system function
d) this is given to prevent bleeding

15. The patient is admitted for treatment of Garamycin IV drip. After 24 hours of receiving the medication, which of the following laboratory results are to be checked? Select all that apply

a) BUN
b) creatinine
c) peak and through
d) glucose
e) protein
f) hemoglobin
g) CBC



ANSWERS AND RATIONALE

11) B
- narcotic tolerance requires greater doses of the medication to obtain the desired therapeutic effect.

12) A
- alcohol is a CNS depressant. It enhances sedative effect of benzodiazepines like Alprazolam. Therefore, the patient should avoid alcoholic beverages when he is taking benzodiazepines.

13) 1.25 ml

D/S x dilution = quantity of drug

10 mg/8 mg x 1ml = 1.25 ml

14) D
- aquamephyton is a vitamin K preparation. It promotes synthesis of prothrombin and other clotting factors. Therefore, it will prevent bleeding.

15) A, B, C, E, F, G
- garamaycin is ototoxic, nephrotoxic, may cause agranulocytosis, thrombocytopenia, anemia, proteinura, and photosensitivity. Peak and through levels are determined to serve as basis for determining and adjusting dosage of the medication.


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Test Prep for Nursing Exam about Pediatric Nursing (41-45)

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41. Which of the following physical assessment findings is considered normal?

a) a 6-month old who is drooling
b) a 2-year old with pinkish color of the eyes
c) an 18-month old with no teeth
d) a 3-year old with dimpling in the spine

42. A pediatric nurse has received report from the previous shift. Which of the following patients should the nurse attend to first?

a) a 4-month old baby girl with ventricular septal defect (VSD) with heart murmurs
b) a 3-year old baby girl with Tetralogy of Fallot (TOF) with blue lips when crying
c) a 12-month old baby boy with coarctation of aorta (COA) who has weakness on the right extremity
d) a 10-month old baby boy with patent ductus arteriosus with positive babinski

43. A nurse is assigned in the pediatric unit. Which of the following patients should be assessed first by the nurse?

a) a 6-month old baby boy who vomited three times an hour ago
b) a 1-year old baby boy who cries when his mother leaves
c) a 2-month old baby girl with PR=122
d) a 9-month old baby boy who mobilizes through his abdomen

44. A 6-year old boy was diagnosed to have hemophilia. Which statement when made by the parents indicates correct understanding of the disease?

a) the child inherits the disease from the father
b) the child inherits the disease from the mother
c) the other sons and daughters are at risk to have the disease
d) the boy might not have any children in the future

45. A mother asks where to safely place her 5-year old child in the car. The appropriate response by the nurse is:

a) in the middle of the back seat, rear-facing, using a booster chair
b) in the middle of the back seat, front-facing, using a booster chair
c) in the front seat of the car, ensuring the presence of an airbag
d) in the front seat of the car, using a booster chair



ANSWERS AND RATIONALE

41) A
- it is normal for a 6-month old child to still experience drooling. The sclera is white; pinkish color of the eyes indicates inflammation. Eruption of teeth starts at 5-7 months. An 18-month old child should have 12 teeth (age in months - 6 = number of teeth).
Dimpling in the spine indicates spina bifida occulta.

42) C
- weakness on an extremity needs to be investigated immediately because this indicates that a complication is occurring.

43) A
- an infant's fluid electrolyte balance can easily be upset, which may pose severe problems. Eighty percent of an infant's weight is fluid; most of the fluid is found in the ECF compartment which can be lost easily.

44) B
- hemophilia is X-linked disorder, which is inherited from the mother. Only the sons will have the disease, daughters are carriers of the traits.

45) B
- the recommended place of a child who is over 2 years of age or over 20 lbs. in weight, when riding a car is middle of the back seat, front-facing. Booster chair is to be used until the child is 6 years of age or below 60 lbs in weight.

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NCLEX Secrets - Neurology Board Review (51-55)

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NCLEX Secrets - Neurology Board Review

51. A 75-year old woman is admitted to a nursing home with a diagnosis of primary dementia of the Alzheimer's type. In the nursing home, which of these behaviors of the client is of greatest danger to her?

a) she wanders into other patient's room
b) she climbs over the side rails of her bed
c) she eats the food off other resident's plates
d) she refuses to change her clothes

52. An elderly client is diagnosed with Alzheimer's disease. When planning care, the nurse should include which of these vital considerations?

a) allowing him to plan his own day
b) encouraging outside diversional activities
c) limiting his caloric intake
d) providing a calm, predictable environment

53. While in the dining room having lunch, a nursing home client with Alzheimer's disease suddenly begins shouting and banging on the table. Which action should be taken by the nurse first?

a) speak in a firm voice asking the client to stop the behavior
b) put the client in the corner of the dining room by himself
c) take the client back to his room to finish lunch
d) remove the lunch tray until the client can control himself

54. A patient with hepatic encephalopathy is given instructions regarding his diet. Which of the following foods should the patient avoid?

a) proteins
b) calcium
c) fats
d) carbohydrates

55. A male client, 89 years old who has a mild Alzheimer's disease was admitted 2 days ago. Which of the following signs and symptoms are expected in the client?

a) poor attention span
b) poor personal hygiene
c) unable to remember misplaced objects
d) irritable
e) intention tremors
f) shuffling gait





NCLEX Secrets - Neurology Board Review:
ANSWERS AND RATIONALE

51) B
- falls is one of the greatest dangers among confused client.

52) D
- a simple, structured environment should be provided to the client with Alzheimer's disease to help him cope up with his/her memory loss.

53) C
- remove the client from the environment that may have triggered agitation. But continue provide care, like allowing him to finish his meal.

54) A
- the natural end-product of protein is ammonia. Increased ammonia production causes hepatic encephalopathy.

55) A, B, C, D
- the main problem with Alzheimer's disease is memory loss. Intention tremors and shuffling gait are manifestations of Parkinson's disease.


Go to the next page ---> NCLEX Secrets - Neurology Board Review (56-60)  

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


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NCLEX Review Questions on Cancer (26-30)

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NCLEX Review Questions on Cancer

26. A 40-year old woman is admitted to the hospital for a radiation implant therapy to treat recently diagnosed cervical cancer. The most important consideration when planning care is her

a) level of anxiety
b) loss of income due to inability to work
c) support system
d) energy level to perform ADL's

27. When the nurse is discussing risk factors for cervical cancer, which of these women would be at greatest risk?

a) a 25-year old woman with family history of cancer and using birth control pills
b) a 50-year old woman who has several exposures to radiation and has chronic anemia
c) a 19-year old woman who initiated sexual intercourse early with multiple partners
d) a 60-year old woman who had smoked cigarettes for 5 years and used diaphragm for birth control

28. Which of the following nursing diagnoses would rank as the most important in the planning of care for a client in two weeks after the chemotherapy has begun?

a) potential for infection
b) activity intolerance
c) impaired skin integrity
d) self-esteem disturbance

29. During the administration of a chemotherapeutic drug, the nurse observes that there is a lack of blood return from the intravenous catheter. The priority action by the nurse would be to

a) stop the administration of the drug immediately
b) reposition the client's arm and continue with the administration of the drug
c) apply a tourniquet to the patient's affected arm and notify the doctor
d) continue to administer the drug and assess for edema at the IV site

30. A patient who is receiving chemotherapy develops stomatitis. Which of the following actions would be priority for the nurse to incorporate into the plan of care?

a) rinse the patient's mouth with full strength hydrogen peroxide every 4 hours
b) use a soft toothbrush after each meal
c) provide hot tea with honey to soothe the patient's painful oral mucosa
d) use dental floss only





NCLEX Review Questions on Cancer:
ANSWERS AND RATIONALE

26) A
- anxiety is the usual response to a change in life situation like undergoing treatment for cancer.

27) C
- early sexual intercourse and having multiple sexual partners pose highest risk to cervical cancer.

28) A
- chemotherapy causes immunosuppression. Therefore, the patient is at risk to develop infection.

29) A
- chemotherapeutic agents are irritating to tissues. Lack of blood return from the IV catheter indicates that it is out of vein. Therefore, administration of the drug should be stopped immediately.

30) B
- use soft toothbrush in a client with stomatitis to prevent further trauma and pain to the oral mucosa. Half-strength hydrogen peroxide is recommended to relieve stomatitis not full strength. Hot beverages will further cause irritation. Honey may support proliferation of microorganisms in the oral mucosa. Flossing may also cause trauma to the mouth and gums of the patient with stomatitis.




Go to the next page ---> NCLEX Review Questions on Cancer (31-35) 

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

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      36. Which of the following growth and development changes is not expected in an adolescent?

      a) growth of body hair
      b) voice changes
      c) loss of subcutaneous tissues
      d) increased activity of sweat glands and sebaceous glands

      37. A young mother brings her 6-month old daughter to the ER about midnight. The infant is not crying, but has bruises on her arms and legs. The baby is not able to sit even when held in an upright position. The mother says the baby fell out of her crib. The mother is quite non-committal about events leading up to the baby's fall. In order to complete the assessment, which of the following actions by the nurse is a priority?

      a) ask the mother to call her husband to the hospital
      b) determine whether the infant has any serious physical problems
      c) sit down and chat with the mother in order to reassure her
      d) order a blood level for alcohol on both parents

      38. A medical-surgical nurse is to work in a pediatric unit for 8 hours. Which of these patients should be assigned to her?

      a) a school-aged child with bronchial asthma and teenager who had an appendectomy 4 hours ago
      b) a 2-month old infant with cleft palate and a 3-year old with inguinal hernia
      c) a 4-year old male with nephrotic syndrome and a week old infant who just had a pylorotomy
      d) a 10-year old female with Down's syndrome admitted for pneumonia and a 3-year old with Tetralogy of Fallot who is scheduled for surgery the next day

      39. A mother calls the clinic and says her 6-year old son swallowed some toilet bowl cleaner. The nurse should tell the mother to do which of the following first?

      a) bring the child to the hospital
      b) give the child syrup of ipecac
      c) wrap a blanket around the child
      d) try to get the child to drink milk

      40. A new order is written for eardrops on a 3-year old child. Which nursing action has the lowest priority in preparation for this procedure?

      a) anticipate the need for assistance to restrain the child
      b) check the child's name bracelet before administration of the medication
      c) explain the purpose of the medication to the child
      d) check which ear is to receive the drops prior to instillation



      ANSWERS AND RATIONALE

      36) C
      - there is usually accumulation of subcutaneous tissues among adolescents

      37) B
      - when there is incongruence between the severity of injury and explanation of how the injury occurred, consider abuse. Serious physical problems support presence of abuse. Suspicion of abuse should be reported to the local authority.

      38) A
      - older children with medical-surgical conditions like asthma are more appropriate to be taken good care of by the medical-surgical nurse. This is similar to her training and experience.

      39) D
      - to neutralize the corrosive effect of the toilet bowl cleaner, try to get the child to drink milk. Do not induce vomiting when the ingested substance is corrosive. Therefore, do not give syrup of ipecac, an emetic.

      40) C
      - a 3-year old child is still unable to comprehend the purpose of the medication. Explanation should be given to the parents.

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      Online Nursing Practice Test about Respiratory Diseases (41-45)

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      41. High pressure alarm still alarms after suctioning the client. What should the nurse do next?

      a) disconnect the client from mechanical ventilation and do manual resuscitation
      b) call the respiratory therapist
      c) call another nurse to be with the client while the nurse calls for the physician
      d) turn off the alarm

      42. Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?

      a) pneumococcal pneumonia
      b) legionaire's pneumonia
      c) viral pneumonia
      d) mycoplasma pneumonia

      43. A client is admitted to an acute care facility with a tentative diagnosis of PCP (pneumocystis carinii pneumonia). She had lost 25 lbs. over the past 2 months and complains of anorexia. At this point, the highest priority goal is that the patient will

      a) increase nutrient intake
      b) have no further weight loss
      c) be free from infection
      d) maintain cardiopulmonary functioning

      44. A patient underwent a pneumonectomy and developed tension pneumothorax. Which of the following is an early indication of tension pneumothorax

      a) frothy, blood-tinged sputum
      b) trachea shifts toward unaffected side of the chest
      c) development of subcutaneous emphysema
      d) open, sucking chest wound

      45. The nurse is caring for a client on mechanical ventilator. The low-pressure alarm of the ventilator turns on. The most important nursing action is:

      a) prepare to suction the client
      b) check air leak from endotracheal tube
      c) check if the tube is kinked
      d) turn off the alarm



      ANSWERS AND RATIONALE

      41) A
      - oxygenation and ventilation are the priority among clients on mechanical ventilation

      42) B
      - legionaire's pneumonia is the highest in incidence during summer. Whereas, pneumococcal pneumonia is most common during winter.

      43) D
      - cardiopulmonary functioning is a priority in the patient with pneumocystis carinii pneumonia.

      44) B
      - mediastinal shift indicates pneumothorax. This causes airway obstruction.

      45) B
      - when the low-pressure alarm turns on, this indicates disconnection of tubings. So, appropriate nursing action is to check for air leak. When the high pressure alarm turns on, this indicates obstruction. It may be due to accumulation of mucous secretions, kinks along the tubing, or the client is biting the endotracheal tube.



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