NCLEX Review

The mother of a child with juvenile idiopathic arthritis calls the nurse because the child is experiencing a painful exacerbation of the disease. The mother asks the nurse if the child should perform range-of-motion (ROM) exercises at this time. The nurse would make which response to the mother?

"Have the child perform simple isometric exercises during this time."

The nurse has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

"I should routinely use polyunsaturated oils in my diet."

The nurse will be caring for several older adults who will be undergoing general anesthesia. Which older adult will require the closest monitoring for a prolonged effect of anesthesia?

An older adult with increased amount of fatty tissue

A client is admitted with a diagnosis of pheochromocytoma. The nurse would monitor which parameter to detect the most common sign of pheochromocytoma?

Blood pressure elevation

A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving if which breath sounds are noted?

Crackles in the lung bases

The nurse has a prescription to give 30 mL of an antacid through a nasogastric (NG) tube connected to wall suction. The nurse would do which best action to perform this procedure correctly?

Clamp the NG tube for 30 minutes following administration of the medication.

Which laboratory result would verify the diagnosis of bacterial meningitis?

Cloudy cerebrospinal fluid with high protein and low glucose levels

The nurse has provided instructions regarding specific leg exercises for the client immobilized in right skeletal lower leg traction. The nurse determines that the client needs further teaching if the nurse observes the client doing which activity?

Performing active range of motion (ROM) to the right ankle and knee

A client is admitted to the hospital with possible rheumatic endocarditis. The nurse would check for a history of which type of infection?

Streptococcal infection

A client with Parkinson's disease is beginning treatment with carbidopa/levodopa. Which statement made by the client indicates the need for further teaching?

"I should take my medication after a full meal."

Which information would the nurse include when reinforcing client teaching regarding ostomy care? Select all that apply.

1) Empty pouch when 1⁄3 to 1⁄2 full. 2)The stoma should be moist and pink to red. 3)The skin barrier should be within 1⁄16 to 1⁄8 inch of the stoma. 4)Change the appliance about every 3 days, or sooner, if it is leaking effluent.

The nurse is caring for a mother and her infant who was born 12 hours ago. Which statements made by the mother would prompt the nurse to have the baby evaluated for early heart failure? Select all that apply.

1)"I'm chilly, but my baby's forehead is sweaty." 2)"I can feel my baby's heart rate when he's sleeping; it seems much faster than it did yesterday." 3)"My baby latches on to my nipple well and has a strong suck, but seems to get weak very quickly, then stops too soon."

The nurse is reinforcing the teaching to parents of a diabetic child about the signs/symptoms of hypoglycemia. Which signs/symptoms would the nurse include when reinforcing the teaching? Select all that apply.

1)Sweating 2)Dizziness 3)Trembling

A hospitalized client with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applications followed by the application of an occlusive dressing. The nurse monitors the client for which systemic effect that can occur as a result of this treatment?

Adrenal suppression

The nurse is caring for the nullipara woman in labor. The nurse understands that the primary health care provider must be contacted if which condition becomes apparent?

Decreased periods of uterine relaxation between contractions

The nurse is reviewing the record of a client admitted to the hospital for treatment of bladder cancer. Which risk factor related to this type of cancer would the nurse likely note in the client's record?

Drinks coffee and smokes cigarettes

A visitor brings a suicidal client a brightly packaged gift. The nurse accompanies the visitor to the client's room and takes which action?

Has the client open the gift with the nurse present

A client with cancer develops white, dough-like patches on the mucous membranes of the oral cavity. Which action would the nurse take when noting this?

Report these symptoms, which are consistent with candidiasis.

The nurse would plan to fill which chamber of the chest drainage unit to prevent atmospheric air from reentering the pleural space? Refer to figure.

Water-Seal Chamber

A client who has developed paralysis of the lower extremities is admitted to the hospital. The client shares information with the nurse regarding a severe emotional trauma that occurred 6 weeks ago. The nurse develops a plan of care, knowing which action is the priority?

The administration of a vasoconstrictor

The nurse reviews a client's serum sodium level and notes that the level is 150 mEq/L (150 mmol/L). The primary health care provider prescribes dietary instructions for the client based on the sodium level. Which food items would the nurse instruct the client to avoid? Select all that apply.

1)Bacon 2)Salami 3)Processed oat cereals

The licensed practical nurse is assisting in the admittance of a client who has been involuntarily committed to the behavioral health unit. Which actions by the client before hospitalization led to the commitment? Select all that apply.

1)Client threatened to commit suicide. 2)Client threatened to kidnap his spouse.

The nurse is admitting a client with a possible diagnosis of chronic bronchitis. The nurse collects data from the client and notes that which signs/symptoms support this diagnosis? Select all that apply.

1)Early onset cough 2)Purulent mucous production 3)Mild episodes of dyspnea

A delivery room nurse collects data on a mother who just delivered a healthy newborn infant. The nurse checks the uterus to determine if the placenta has detached. Which findings indicate to the nurse that placental detachment has occurred? Select all that apply.

1)Lengthening of the umbilical cord 2)Sudden gush of dark blood from the vagina 3)Appearance of fetal membranes at the introitus