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EXAM CRAM NCLEX-PN PRACTICE QUESTIONS WITH 100% CORRECT ANSWERS
"A 24 year-old female client is scheduled for surgery in the morning. Which of the following is the primary responsibility of the nurse? A. taking the vital signs B. obtaining the permit C. explaining the procedure
D. Checking the lab work - CORRECT ANSWER A. taking the vital signs
why? the primary responisblity of the nurse is to take the vital signs before any surgery. answers B,C and D are the responsibility of the doctor." "The nurse is working in the emergency room when a client arrives with severe burns of the left arm, hands, face, and neck. which action should receive priority? A. starting an IV? B. Applying oxygen C.Obtaining blood gas
D. Medicating the client foe pain - CORRECT ANSWER B. Applying oxygen
why? the client with burns to the neck needs airway assessments and supplemental oxygen, so applying oxygen is priority. the next action should be to start an IV and medicate for pain." "The nurse is making initial rounds on a client with a C5 fracture and crutchfield thongs. Which equipment should be kept at the bedside? A. A pair of forceps B. A torque wrench C. A pair or wire cutters
D. A screwdriver - CORRECT ANSWER B. A torque wrench
why? A tourque wrench is kept at the bedside to tighten and loosen the screws of crutchfield tongs. This wrench controls the amount of pressure that is placed on the screws."
"An infant weighs 7 pounds at birth. The excpectd weight by 1 year should be: A. 10 pounds B.12 pounds C. 18 pounds
D. 21 pounds - CORRECT ANSWER D. 21 pounds
why? A birth weight of 7 pounds would indicate 21 pounds in 1 year or triple the his birth weight." "A client is admitted with a Ewing's sacroma. which symptoms would be expected due to this tumor's location? A. Hemiplegia B. Aphasia C. Nausea
D. Bone Pain - CORRECT ANSWER D. Bone Pain
why? Sacroma is a type of bone cancer, therefor, bone pain would be expected" "The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which labatory value might be a indicate a serious side effect of this drug? A. Uric acid of 5mg/dL B. Hematoccrit of 33% C. WBC 2,000 per cubic millimeter
D. Platelets 150,000 per cubic millimeter - CORRECT ANSWER C. WBC 2,000 per cubic
millimeter why? Tegratol can suppress the bone marrow and decrease the white blood cells count; thus, a lab value of WBC 2,000 per cubic millimeter indicates side effects of the drug." "The nurse is assisting a client with diverticulosis to select appropiate foods. Which food should be avoided?
After birth, meconium stool, loss of extracellular fluid, and initiation of breastfeeding cause the infant to lose body mass. There is no evidence to indicate dehydration, hypoglycemia, or allergy to the infant formula" "The nurse if caring for a client with laryngeal cancer. Which finding ascertained in the health history would not be common for this diagnosis? A. Foul breath B. Dysphagia C. Diarrhea
D. Chronic hiccups - CORRECT ANSWER C. Diarrhea
why? Diarrhea is not common in clients with mouth and throat cancer" "Six hours after birth, the infant is found to have an areas of swelling over the right parietal area that does not cross the suture line. The nurse should chart this finding as: A. A cephalohematoma B. Molding C. Subdural hematoma
D. Caput succedaneum - CORRECT ANSWER A. A cephalohematoma
why? The swelling over the right parietal area is a cephalohematoma, an area of bleeding outside the cranium. This type of hematoma does not cross the suture line because it's outside the cranium but beneath the periosteum." "A client in the cardiac step-down unit requires suctioning for excess mucous secretions. The nurse should be most careful to monitor the client for which dysrhythmia during this procedure? A. Bradycardia B. Tachycardia C. Premature ventricular beats
D. Heart block - CORRECT ANSWER A. Bradycardia
why? Suctioning can cause a vagal response and bradycardia." "A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session? A. "You will be sitting for the examination procedure." B. "Portions of the procedure will cause pain or discomfort." C. "You will be given some medication to anesthetize the area."
D. "you will not be able to drink fluids for 24 hours before the study." - CORRECT ANSWER B.
"Portions of the procedure will cause pain or discomfort." why? Portions of the exam are painful especially when the sample is being withdrawn so this should be included in the session with the client." "A client arrives in the emergency room with a possible fractured femur. The nurse should anticipate an order for: A. Trendelenburg position B. Ice to the entire extremity C. Bucks traction
D. An abduction pillow - CORRECT ANSWER C. Bucks traction
why? The client with a fractured femur will be placed in Bucks traction to realign the leg and decrease spasms and pain." "A client with caner is to undergo an intravenous pyelogram. The nurse should: A. Force fluids 24 hours before the procedure. B. Ask the client to void immediately before the study. C. Hold medication that affects the central nervous system for 12 hours pre- and post-test.
D. Cover the client's reproductive organs with an x-ray shield. - CORRECT ANSWER B. Ask the
client to void immediately before the study.
C. A history of minimal physical activity
D. A history of the client's food intake - CORRECT ANSWER A. A history of radiation treatment
in the neck region why? Previous radiation to the neck might have damaged parathyroid glands, which are located on the thyroid gland and interfered with calcium and phosphorus regulation." "A client is admitted to the acute care unit. Initial laboratory values reveal serum sodium of 170 meq/L. What behavioral changes would be common for this client? A. Anger B. Mania C. Depression
D. Pyschosis - CORRECT ANSWER B. Mania
why? The client with serum sodium of 170 meq/L has hypernatrimia and might exhibit manic behvior." "A client visits the clinic after the death of a parent. Which statement made by the client's sister signifies abnormal grieving? A. "My sister still has episodes of crying and it's been 3 months since daddy died." B. "Sally seems to have forgotten the bad things that daddy did in his lifetime." C. "She really had a hard time after daddy's funeral. She said that she had a sense of longing."
D. "Sally has not been sad at all by daddy's death. She acts like nothing has happened." -
CORRECT ANSWER D. "Sally has not been sad at all by daddy's death. She acts like nothing has
happened at all." why? Abnormal grieving is exhibited by a lack of feeling sad; if the client's sister appears not to grieve, it might be abnormal grieving. This family member might be suppressing feelings of grief." "The nurse recognizes that which of the following would be most appropriate to wear when providing direct care to a client with a cough?
A. Mask B. Gown C. Gloves
D. Shoe covers - CORRECT ANSWER A. Mask
why? If the nurse is exposed to the client with a cough, the best item to wear is a mask. If the answer had included a mask, gloves, and a gown, all would be appropriate." "A client with pancreatitis has been transferred to the intensive care unit. Which order would the nurse anticipate? A. Blood pressure every 15 minutes B. Insertion of a levine tube C. Cardiac monitoring
D. Dressing changes 2x per day - CORRECT ANSWER B. Insertion of a levine tube
why? The client with pancreatitis frequently has nausea and vomiting. Lavage is often used to decompress the stomach and rest the bowel, so the insertion of a levine tube should be anticipated." "The client is admitted to the unit after a cholescystectomy. Montgomery straps are utilized with this client. The nurse is aware that Montgomery straps are utilized on this client because: A. The client is at risk for evisceration B. The client will require frequent dressing changes C. The straps provide support for drains that are inserted into the incision
D. No sutures or clips are used to secure the incision. - CORRECT ANSWER B. The client will
require frequent dressing changes why? Montgomery straps are used to secure dressing that require frequent dressing changes because the client with a cholescystectomy usually has a large amount of drainage on the dressing. Montgomery straps are also used for clients who are allergic to several types of tape."
"The nurse is assigned to care from infant with physiologic jaundice. Which action by the nurse would facilitate elimination of the bilirubin? A. Increase the infant's fluid intake B. Maintain the infant's body temp at 98.6 F C. Minimize tactile stimulation
D. Decrease caloric intake - CORRECT ANSWER A. Increase the infant's fluid intake
why? Bilirubin is excreted through the kidneys, thus the need for increased fluids. Maintaining the body temp is important but will not assist in eliminating bilirubin." "The graduate licensed practical nurse is assigned to care for the client on ventilator support, pending organ donation. Which goal should receive priority? A.Maintain the client's systolic blood pressure at 70 mm/Hg or greater B. Maintain the client's urinary output greater than 300 cc/hr C. Maintain the client's body temp of greater than 33 F rectal
D. Maintain the client's hematocrit less than 30% - CORRECT ANSWER A. Maintain the client's
systolic blood pressure at 70 mm/Hg or greater why? When the cadaver client is being prepared to donate and organ, the systolic blood pressure should be maintained at 70 mm/Hg or greater to ensure a blood supply to the donor organ." "The nurse is preparing the client for a mammogram. To prepare the client for a mammogram, the nurse should tell the client: A. Restrict her fat intake for one week before the test B. To omit creams, powders, or deodorants before the exam C. The mammography replaces the need for self breast exams
D. That mammography requires higher does of radiation than an x-ray. - CORRECT ANSWER B.
To omit creams, powders, or deodorants before the exam. why?
The client having the mammogram should be instructed to omit deodorants or powders beforehand because powders and deodorants can be interpreted as abnormal." "Which of the following roommates would be best for the client with gastric resection? A. A client with Chron's disease B. A client with pneuomia C. A client with gastritis
D. A client with phlebitis - CORRECT ANSWER D. A client with phlebitis
why? The most suitable roommate for the client with gastric resection is the client with phlebitis because phlebitis is an inflammation of the blood vessel and is not infectious." "The LPN is observing a graduate nurse as she assess the central venous pressure. Which observation indicates that the graduate needs further teaching? A. The graduate places the client in a supine position to read the manometer B. The graduate turns the stopcock to the off position from the IV fluid to the client C. The graduate instructs the client to perform the Valsalva manuever during the CVP reading
D. The graduate notes the level at the top of the meniscus - CORRECT ANSWER C. The
Graduate instructs the client to perform the Valsalva manuever during the CVP reading. why? The client should breathe normally during a central venous pressure monitor reading." "The nurse employed in the ER is responsible for triage for 4 clients injured in a motor vehicle accident. Which of the following clients should receive priority in care? A. A 10 year old with lacerations to the face B. A 15 year old with sternal bruising C. A 34 year old with fractured femur
D. A 50 year old with dislocation of the elbow - CORRECT ANSWER B. A 15 year old with sternal
bruising
When the client is receiving TPN, the blood glucose level should be drawn. TPN is a solution that contains large amounts of glucose." "The client with a myocardial farction comes to the nurse's station stating that he is ready to go come because there is nothing wrong with him. Which defense mechanism is the client using? A. Rationalization B. Denial C. Projection
D. Conversion reaction - CORRECT ANSWER B. Denial
why? The client who says he has nothing wrong is in denial about his myocardial infarction." "The licensed practical nurse assigned to the post-partal unit is preparing to administer Rhogam to a post-patrum client. Which of the women is not a candidate for the RhoGam? A. A gravida IV para 3 that is Rh negative with a Rh postivie baby B. A gravida I para I that is Rh negative with a Rh positive baby C. A gravida II para 0 that is Rh negative attempted after a still birth delivery
D. A gravida IV para II that is Rh negative with a Rh negative baby - CORRECT ANSWER D. A
gravida IV para II that is Rh negative with a Rh negative baby why? The mother in answer D is the only one who does not require a RhoGam injection." "The first exercise that should be performed by a client with a mastectomy is: A. Walking the hand up the wall B. Sweeping the floor C. Combing her hair
D. Squeezing a ball - CORRECT ANSWER D. Squeezing a ball
why? The first exercise that should be done by the client with a mastectomy is squeezing the ball"
"This client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept during the test? A. Atropine sulfate B. Furosemide C. Prostigmin
D.Promethazine - CORRECT ANSWER A. Atropine sulfate
why? Atropine sulfate is the antidote for Tensilon and is given to treat cholenergic crises" "To ensure safety while administering a Nitroglycerin patch, the nurse should: A. Wear gloves B. Shave the area where the patch should be applied C. Wash the area thoroughly with soap and rinse with hot water
D. Apply the patch to the buttocks - CORRECT ANSWER A. Wear gloves
why? To protect herself, the nurse should wear gloves when applying a nitroglycerin patch or cream." "A 25 year old male is brought to the ER with a piece of metal in his eye. Which action by the nurse is correct? A. Use a magnet to remove the object B. Rinse the eye thoroughly with saline C. Cover both eyes with paper cups
D. Patch the affected eye only - CORRECT ANSWER C. Cover both eyes with paper cups
why? Covering both eyes prevents consensual movement of the affected eye." "The physician has order sodium warfrin ( Coumadin) for the client with thrombophlebitis. The order should be entered to administer the medication at: A. 0900
C. Sitz bath
D. Ice bath - CORRECT ANSWER C. Sitz bath
why? A sitz bath will help with swelling and improve healing" "Which of the following post-op diets are most appropriate for a client who has had a hemorroidectomy? A. High fiber B. Low-residue C. Bland
D. Clear liquids - CORRECT ANSWER D. Clear liquids
why? After surgery, the client will be placed o n a clear-liquid diet and progressed to a regular diet. stool softeners will be included in the plan of care, to avoid constipation." "The nurse is caring for a client with cerebral plasy. The nurse should provide frequent rest periods because: A: Grimacing and withering movements decrease with relaxation and rest. B. Hypoactive deep tendon reflexes become more active with rest C. Stretch reflexes become more increases with rest
D. Fine motor movements are improved - CORRECT ANSWER A. Grimacing and withering
movements decrease with relaxation and rest. why? Frequent rest periods help to relx tense muscles and preserve energy" "The nurse is making assignments for the day. Which client should be assigned to the nursing assistant? A. A client with Alzheimer's B. A client with pnuemonia C. A client with appendicitis
D. A client with thrombophebitis - CORRECT ANSWER A. A client with Alzheimer's
why? The client with Alzheimer's disease is the most stable of these clients and can be assigned to the nursing assistant, who can perform duties such as feeding and assisting the client with activities of daily living." "A home health nurse is making preparations for morning visits. Which of the following clients should the nurse visit first? A. A client with brain- attack (stroke) with tube feeding B. A client with congestive heart failure complaining of nighttime dyspnea C. A client with a thoracotomy 6 months ago
D. A client with Parkinson disease - CORRECT ANSWER B. The client with congestive heart
failure complaining of nighttime dyspnea why? The client with congestive heart failure who is complaining of nighttime dyspnea should be seen first because airway si number one in nursing care" "During the change of the shift, the ongoing nurse notes a discrepancy in the number of Perocept (oxycodone) listed in the number present in the narcotics drawer. The nurse's first action should be to: A. Notify the hospital pharmacist B. Notify the nursing supervisor C. Notify the board of nursing
D. Notify the director of nursing - CORRECT ANSWER B. Notify the nursing supervisor
why? The first action the nurse should take is to report the finding to the nurse supervisor and follow the chain of command."
The client with unilateral neglect will neglect one side of the body" "The nurse is providing discharge teaching for a client who is taking dissulfiram (Antabuse). The nurse should instruct the client to avoid eating: A. Peanuts, dates, raisins B. Figs, chocolate, eggplant C. Pickles, salad with vinaigrette dressing, and beef
D. Milk, cottage cheese, ice cream - CORRECT ANSWER C. Pickles, salad with vinaigrette
dressing, beef why? The client taking antabuse should not eat or drink anything containing alcohol or vinegar" "A client has been receiving cyanocobalamine (B12) injections for the past 6 weeks. Which lab finding indicates that the medication is having the desired effect? A. Neutrophil count of 60% B. Basophil count of 0.5% C. Monocyte count of 2%
D. Reticlocyte count of 1% - CORRECT ANSWER D. Reticlocyte count of 1 %
why? Cyanocolamine is a B12 medication that is used for pernicious anemia, and a reticulocyte count of 1% indicates that it is having the desired effect." "The nurse has just received a change of shift report. Which client should the nurse assess first? A. A client 2 hours post-lobectomy with 150 cc drainage B. A client 2 days post-gastrectomy with scant drainage C. A client with pnuemonia with a oral temp of 102 F
D. A client with a fractured hip in Bucks traction - CORRECT ANSWER A. A client 2 hours post-
lobectomy with 150 cc drainage why? The first client to be seen is the one who recently returned from surgery."
"Several clients are admitted to the ER following a three- car vehicle accident. Which clients can be assigned to share a room in the emergency department during the disaster? A. The schizophrenic client having visual and auditory hallucinations and the client with ulcerative collitis B. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm C. A child whose pupils are fixed and dilated and his parents, and the client with a frontal head injury D. The client who arrives with a large puncture wound to the abdomen and the client with chest
pain - CORRECT ANSWER B. The client who is 6 months pregnant with abdominal pain and the
client with facial lacerations and a broken arm why? Out of all these clients, it is best to hold the pregnant client and the client with a broken arm and facial lacerations in the same room." "The home health nurse is planning for the day's visits. Which client should be seen first? A. The 78 year old who had a gastrectomy 3 weeks ago with a PEG tube B. The 5 month old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension C. The 50 year old with MRSA being treated with Vancomycin via a PICC line D. The 30 year old with an exacerbation of multiple sclerosis being treated with cortisone via a
centrally placed venous catheter - CORRECT ANSWER D. The 30 year old with an exacerbation
of multiple sclerosis being treated with cortisone via a centrally placed venous catheter why? The priority client is the one with multiple sclerosis who is being treated with cortisone via the central line. This client is at highest risk for complications." "The nurse is found to be guilty of charting blood glucose results without actually performing the procedure. After talking to the nurse, the charge nurse should: A. Call the Board of Nursing B. File a formal reprimand C. Terminate the nurse
D. Charge the nurse with a tort - CORRECT ANSWER B. File a formal reprimand
