NCLEX-RN Quiz Part 11 (601-675)

NO.601 A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the effectiveness of the instruction about diet and weight control?

A.            She is compliant with her diet as previously taught.

B.            She needs further instruction and reinforcement.

C.            She needs to increase her caloric intake.

D.            She needs to be placed on a restrictive diet immediately.

NO.602 A 47-year-old client comes to the emergency department complaining of moderate flank, abdominal, and testicular pain with nausea of 4 hours’ duration. After physical examination and obtaining the client’s history, the physician suspects urethral obstruction by calculi. The nurse realizes that the physician will order which one of the following diagnostic studies to best confirm the diagnosis?

A.            Cystoscopy

B.            Kidneys, ureter, bladder, x-ray of abdomen

C.            Intravenous pyelogram with excretory urogram

D.            Ureterolithotomy  

NO.603 A child has a nursing diagnosis of fluid volume excess related to compromised regulatory mechanisms. Which of the following nursing interventions is the most accurate measure to include in his care?

A.            Weigh the child twice daily on the same scale.

B.            Monitor intake and output.

C.            Check urine specific gravity of each voiding.

D.            Observe for edema.

NO.604 A client is being discharged from the hospital today. The discharge teaching for care of her colostomy included which of the following basic principles for protecting the skin around her stoma:

A.            Taping a pouch that is leaking

B.            Cutting the skin barrier 112 inches larger than the stoma

C.            Changing the pouch only when leakage occurs

D.            Using a skin sealant under pouch adhesives

NO.605 A 22-year-old client who is being seen in the clinic for a possible asthma attack stops wheezing suddenly as the nurse is doing a lung assessment. Which one of the following nursing interventions is most important?

A.            Place the client in a supine position.

B.            Draw a blood sample for arterial blood gases.

C.            Start O2 at 4 L/min.

 D.           Establish a patent airway.

NO.606 The physician orders fluoxetine (Prozac) for a depressed client. Which of the following should the nurse remember about fluoxetine?

A.            Because fluoxetine is a tricyclic antidepressant, it may precipitate a hypertensive crisis.

B.            The therapeutic effect of the drug occurs 2-4 weeks after treatment is begun.

C.            Foods such as aged cheese, yogurt, soy sauce, and bananas should not be eaten with this drug.

D.            Fluoxetine may be administered safely in combination with monoamine oxidase (MAO) inhibitors.

NO.607 The following medications were noted on review of the client’s home medication profile. Which of the medications would most likely potentiate or elevate serum digoxin levels?

A.            KCl

B.            Thyroid agents

C.            Quinidine

D.            Theophylline

NO.608 In discussing the plan of care for a child with chronic nephrosis with the mother, the nurse identifies that the purpose of weighing the child is to:

A.            Measure adequacy of nutritional management

B.            Check the accuracy of the fluid intake record

C.            Impress the child with the importance of eating well

D.            Determine changes in the amount of edema

NO.609 The nurse and prenatal client discuss the effects of cigarette smoking on pregnancy. It would be correct for the nurse to explain that with cigarette smoking there is increased risk that the baby will have:

A.            Nicotine withdrawal

B.            A birth defect

C.            Anemia

D.            A low birth weight

NO.610 The primary reason for sending a burn client home with a pressure garment, such as a Jobst garment, is that the garment:

A.            Decreases hypertrophic scar formation

B.            Assists with ambulation

C.            Covers burn scars and decreases the psychological impact during recovery

D.            Increases venous return and cardiac output by normalizing fluid status

NO.611 A child sustains a supracondylar fracture of the femur. When assessing for vascular injury, the nurse should be alert for the signs of ischemia, which include:

A.            Bleeding, bruising, and hemorrhage

B.            Increase in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase

C.            Pain, pallor, pulselessness, paresthesia, and paralysis

D.            Generalized swelling, pain, and diminished functional use with muscle rigidity and crepitus

NO.612 A 47-year-old client has been admitted to the general surgery unit for bowel obstruction. The doctor has ordered that an NG tube be inserted to aid in bowel de-compression. When preparing to insert a NG tube, the nurse measures from the:

A.            Lower lip to the shoulder to the upper sternum

B.            Tip of the nose to the lower lip to the umbilicus

C.            End of the tube to the first measurement line on the tube

D.            Tip of the nose to the ear lobe to the xiphoid process or midepigastric area

NO.613 Provide the 1-minute Apgar score for an infant born with the following findings: Heart rate: Above 100 Respiratory effort: Slow, irregular Muscle tone: Some flexion of extremities Reflex irritability: Vigorous cry Color: Body pink, blue extremities

A.            7

B.            10

C.            8

D.            9

NO.614 Newborns are routinely screened for phenylketonuria. The nursery nurse ensures that this screening test is performed:

A.            Immediately after birth, because the most accurate result is obtained at this time

B.            After 2-3 days of milk ingestion

C.            At 2-3 days of age regardless of amount of milk feedings

D.            At 1 month, because the biochemical buildup of phenylalanine takes 1 month to detect

NO.615 A client is admitted to the psychiatric unit after lavage and stabilization in the emergency room for an overdose of antidepressants. This is her third attempt in 2 years. The highest priority intervention at this time is to:

A.            Assess level of consciousness

B.            Assess suicide potential

C.            Observe for sedation and hypotension

D.            Orient to her room and unit rules

NO.616 Which stage of labor lasts from delivery of the baby to delivery of the placenta?

A.            Second

B.            Third

C.            Fourth

D.            Fifth

NO.617 A client develops an intestinal obstruction postoperatively. A nasogastric tube is attached to low, intermittent suction with orders to “Irrigate NG tube with sterile saline q1h and prn.” The rationale for using sterile saline, as opposed to using sterile water to irrigate the NG tube is:

A.            Water will deplete electrolytes resulting in metabolic acidosis.

B.            Saline will reduce the risk of severe, colicky abdominal pain during NG irrigation.

C.            Water is not isotonic and will increase restlessness and insomnia in the immediate postoperative period.

D.            Saline will increase peristalsis in the bowel.

NO.618 A client is admitted to the labor room. She is dilated 4 cm. She is placed on electric fetal monitoring. Which of the following observations necessitates notifying the physician?

A.            Contractions every 2 minutes, lasting 100 seconds

B.            Fetal heart decelerations during a contraction

C.            Beat-to-beat variability between contractions

D.            Fetal heart decelerations at the beginning of contractions

NO.619 In evaluating the effectiveness of magnesium sulfate (MgSO4), which of the following might indicate that the client was developing MgSO4 toxicity?

A.            A 31 patellar tendon reflex

B.            Respirations of 12 breaths/min

C.            Urine output of 40 mL/hr

D.            A 21 proteinuria value

NO.620 An infant weighing 15 lb has just been treated for severe diarrhea in the hospital. Discharge instructions by the nurse will include maintenance fluid requirements for the pediatric client. Which of the following values best indicates the nurse’s understanding of normal fluid requirements for this infant?

A.            240 mL/day

B.            680 mL/day

C.            330 mL/day

D.            960 mL/day

NO.621 Discharge teaching was effective if the parents of a child with atopic dermatitis could state the importance of:

A.            Showering 3-4 times a day

B.            Maintaining a high-humidified environment

C.            Wrapping hands in soft cotton gloves

D.            Furry, soft stuffed animals for play

NO.622 A young boy tells the nurse, “I don’t like my Dad to kiss or hug my Mom. I love my Mom and want to marry her.” The nurse recognizes this stage of growth and development as:

A.            Electra complex

B.            Oedipus complex

C.            Superego

D.            Ego

NO.623 A client was admitted to the hospital after falling in her home. At the time of admission, her blood alcohol level was 0.27 mg%. Her family indicates that she has been drinking a fifth of vodka a day for the past 9 months. She had her last drink 30 minutes prior to admission. Alcohol withdrawal symptoms would most likely be exhibited by her:

A.            Two to 4 hours after the last drink

B.            Six to 8 hours after the last drink

C.            Immediately on admission

D.            Twenty-four hours after the last drink

NO.624 The nurse is caring for a client who has diabetes insipidus. The nurse would describe this client’s urine

output pattern as:

A.            Anuria

B.            Oliguria

C.            Dysuria

D.            Polyuria

NO.625 The most important goal in the care plan for a child who was hospitalized with an accidental overdose would be to:

A.            Determine child’s activity pattern

B.            Reduce mother’s sense of guilt

 C.           Instruct parents in use of ipecac

D.            Teach parents appropriate safety precautions

NO.626 The serial sevens test is often used to determine delirium and dementia. This test aids in assessing which of the following?

A.            Abstract thinking

B.            Ability to focus and concentrate thoughts

C.            Judgment

D.            Memory

NO.627 A client had a renal transplant 3 months ago. He has suddenly developed graft tenderness, an increased white blood cell count, and malaise. The client is experiencing which type of rejection?

A.            Acute

B.            Chronic

C.            Hyperacute

D.            Hyperchronic

NO.628 On assessment, the nurse learns that a chronic paranoid schizophrenic has been taking “the blue pill” (haloperidol) in the morning and evening, and “the white pill” (benztropine) right beforebedtime. The nurse might suggest to the client that she try:

A.            Doubling the daily dose of benztropine

B.            Decreasing the haloperidol dosage for a few days

C.            Taking the benztropine in the morning

D.            Taking her medication with food or milk

NO.629 An 18-year-old girl is admitted to the hospital with a depressed skull fracture as a result of a car accident. If the nurse were to observe a rising pulse rate and lowering blood pressure, the nurse would suspect that the client:

A.            Has a sudden and severe increase in intracranial pressure

B.            Has sustained an internal injury in addition to the head injury

C.            Is beginning to experience a dangerously high level of anxiety

D.            Is having intracranial bleeding

NO.630 A 6-year-old child returned to the surgical floor 20 hours ago after an appendectomy for a gangrenous appendix. His mother tells the nurse that he is becoming more restless and is anxious. Assessment findings indicate that the child has atelectasis. Appropriate nursing actions would include:

A.            Allowing the child to remain in the position of comfort, preferably semi-or high-Fowler position

B.            Administering analgesics as ordered

C.            Having the child turn, cough, and deep breathe every 1-2 hours

D.            Remaining with the child and keeping as calm and quiet as possible

NO.631 On an assessment of a client’s mouth, the nurse notices white patches on the buccal mucosa. The nurse tries to obtain a sample for a culture, but the lesion cannot be rubbed off. The nurse would suspect that this lesion is:

A.            Xerosteromia

B.            Candidiasis

C.            Leukoplakia

D.            Stomatitis

NO.632 A female client is anticipating a visit with her parents over the Thanksgiving holidays. She has recently begun experiencing periods of extreme shortness of breath, which her physician has labeled as panic attacks. Which of the following statements by the nurse would enhance therapeutic communication?

A.            “Why do you feel this way?”

B.            “Tell me about your dislike for your parents.”

C.            “Don’t worry, everything will be all right on your visit with your parents.”

D.            “Perhaps you and I can discover what produces your anxiety.”

NO.633 A client is diagnosed with Mycobacterium tuberculosis. He is placed in respiratory isolation, intubated, and receives mechanical ventilation. When performing suctioning, the nurse should:

A.            Suction for a maximum of 20 seconds

B.            Hyperoxygenate before and after suctioning

C.            Suction for a maximum of 30 seconds

D.            Maintain clean technique during suctioning

 NO.634 A client confides to the nurse that he tasted poison in his evening meal. This would be an example of what type of hallucination?

A.            Auditory

B.            Gustatory

C.            Olfactory

D.            Visceral

NO.635 A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the gravida and para system to record the client’s obstetrical history, the nurse should record:

A.            Gravida 3 para 1

B.            Gravida 3 para 2

C.            Gravida 2 para 1

D.            Gravida 2 para 2

NO.636 A client presents to the emergency room with cyanosis, coughing, tachypnea, and tachycardia. She has a history of asthma. Arterial blood gas values are pH 7.28, PaO2 54, PaCO2 60, and HCO3 24. The nursing assessment of arterial blood gases indicate the presence of:

A.            Respiratory alkalosis

B.            Respiratory acidosis

 C.           Metabolic alkalosis

D.            Metabolic acidosis

NO.637 Assessment of severe depression in a client reveals feelings of hopelessness, worthlessness; inability to feel pleasure; sleep, psychomotor, and nutritional alterations; delusional thinking; negative view of self; and feelings of abandonment. These clinical features of the client’s depression alert the nurse to prioritize problems and care by addressing which of the following problems first:

A.            Nutritional status

B.            Impaired thinking

C.            Possible harm to self

D.            Rest and activity impairment

NO.638 The physician of an alcoholic client places him on a low-protein, high-carbohydrate diet. When choosing his menu, the client’s best choice from the items below would be:

A.            Liver and onions, macaroni and cheese, tea with sugar

B.            Baked chicken, baked potato with bacon bits, milk

C.            Waffles with butter and honey, orange juice

D.            Cheese omelette with ham and mushrooms, milk

NO.639 The nurse would need to monitor the serum glucose levels of a client receiving which of the following medications, owing to its effects on glycogenolysis and insulin release?

 A.           Norepinephrine (Levophed)

B.            Dobutamine (Dobutrex)

C.            Propranolol (Inderal)

D.            Epinephrine (Adrenalin)

NO.640 A male client is being treated in the burn unit for thirddegree burns on his head, neck, and upper chest received in the last 24 hours. The nurse is evaluating the effectiveness of fluid resuscitation. Which of the following indicates effective fluid balance?

A.            His weight increases from 165 to 175 lb.

B.            His urine output is equal to his total fluid intake.

C.            His urine output has been>35 mL/hr for the past 12 hours.

D.            His blood pressure is 94/62.

NO.641 A client delivered her first-born son 4 hours ago. She asks the nurse what the white cheeselike substance is under the baby’s arms. The nurse should respond:

A.            “This is a normal skin variation in newborns. It will go away in a few days.”

B.            “Let me have a closer look at it. The baby may have an infection.”

C.            “This material, called vernix, covered the baby before it was born. It will disappear in a few days.”

D.            “Babies sometimes have sebaceous glands that get plugged at birth. This substance is an example of that condition.”

NO.642 A 13-year-old hemophiliac is hospitalized for hemarthrosis of his right knee. To relieve the pain, the nurse should:

A.            Place on bed rest; elevate and splint the right knee

B.            Apply moist heat to the right knee

C.            Administer aspirin for pain

D.            Encourage active range of motion to right knee

NO.643 Because a client is taking an MAO inhibitor, it is necessary to discuss the need for adherence to a low-tyramine diet. Which of the following are foods that she should avoid?

A.            Pickled, aged, smoked, and fermented foods

B.            Fresh vegetables

C.            Broiled fresh fish and fowl

D.            Fresh fruit such as apples and oranges

NO.644 One of the medications that is prescribed for a male client is furosemide (Lasix) 80 mg bid. To reduce his risk of falls, the nurse would teach him to take this medication:

A.            On arising and no later than 6 PM

B.            At evenly spaced intervals, such as 8 AM and 8 PM

C.            With at least one glass of water per pill

D.            With breakfast and at bedtime

NO.645 A client was admitted with rib fractures and a pneumothorax, which were sustained as a result of a motor vehicle accident. A chest tube was placed on the left side to reinflate his lung, and he was transferred to a client unit. Twenty-four hours after admission he continues to have bloody sputum, develops increasing hypoxemia, and his chest x-ray shows patchy infiltrates. The nurse analyzes these symptoms as being consistent with:

A.            Pneumonia

B.            Pulmonary contusions

C.            Pulmonary edema

D.            Tension pneumothorax

NO.646 A 24-year-old woman who is gravida 1 reports, “I can’t take iron pills because they make me sick.” She continues, “My bowels aren’t moving either.” In counseling her based on these complaints, the nurse’s most appropriate response would be, “It would be beneficial for you to eat . . .

A.            prunes.”

B.            green leafy vegetables.”

C.            red meat.”

D.            eggs.”

NO.647 During the active phase of rheumatic fever, the nurse teaches parents of a child with acute rheumatic fever to assist in minimizing joint pain and promoting healing by:

 A.           Putting all joints through full range-of-motion twice daily

B.            Massaging the joints briskly with lotion or liniment after bath

C.            Immobilizing the joints in functional position using splints, rolls, and pillows

D.            Applying warm water bottle or heating pads over involved joints

NO.648 A client is placed on lithium therapy for her manicdepressive illness. When monitoring the client, the nurse assesses the laboratory blood values. Toxicity may occur with lithium therapy when the blood level is above:

A.            1.0 mEq/L

B.            2.2 mEq/L

C.            0.03 mEq/L

D