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Details: Category: NCLEX CAT; Last Updated: December 06 2023

Details: Category: NCLEX CAT; Last Updated: May 01 2023

1. A nurse is caring for a client with a below-the-knee amputation. What should the nurse encourage the client to do to prepare the residual limb for a prosthesis?

Abduct the residual limb when ambulating.
Dangle the residual limb off the bed frequently.
Soak the residual limb in warm water twice a day.
Press the end of the residual limb against a pillow periodically.

2. An IV infusion of magnesium sulfate is prescribed for a client with severe preeclampsia. The dose is twice the usual adult dose. When a nurse questions the dosage, the health care provider insists that it is the desired dose and directs the nurse to administer the medication. How should the nurse respond to this directive?

Administer the dose and monitor the client.
Withhold the dose and notify the nurse manager.
Administer the dose and document it on the client’s record.
Withhold the dose and notify the director of the obstetric department.

3. A client with severe preeclampsia is hospitalized. What should a nurse do first to ensure her physical safety?

Decrease environmental stimuli.
Place her on seizure precautions.
Administer the prescribed sedatives.
Strictly monitor her intake and output.

4. A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client?

Determine the client’s emotional state.
Give prescribed drugs to promote bronchiolar dilation.
Provide education about the impact of a family history.
Encourage the client to use an incentive spirometer routinely.

5. A nurse is assessing a newborn. What finding indicates the need for follow-up care?

Babinski reflex is positive.
Head circumference is 33 cm.
Hips are abducted at 30 degrees.
Umbilical cord has three vessels.

Details: Category: NCLEX CAT; Last Updated: December 06 2023

1. A client who is at 26 weeks’ gestation arrives at the clinic for her scheduled examination. Her blood pressure is 150/86. She tells the nurse that she has gained 5 pounds in the last 2 weeks. What is the priority nursing action?

Test the client’s urine for albumin.
Take the client’s body temperature.
Prepare the client for a vaginal examination.
Schedule the client for an appointment in a week.

2. A new mother refuses to look at her newborn who has a severe birth defect. What is the nurse’s most therapeutic approach?

Request that the family try to distract her.
Clarify why she should stop blaming herself for the baby’s handicap.
Reinforce the explanation of the handicap and allow time for her to discuss her fears.
Wait until she has sufficiently recovered from the stress of birth and then bring the baby to her again.

3. An African-American woman is diagnosed with primary hypertension. She asks, “Is hypertension a disease of African- American people?” What is the nurse’s best response?

“The prevalence of hypertension is about equal for women of all races.”
“The higher-risk population is composed of African- American men and women.”
“The highest-risk population consists of older Caucasian- American men and women.”
“The prevalence of hypertension is greater for African- American women than for African-American men.”

4. An infant born with hydrocephalus is to be discharged after insertion of a ventriculoperitoneal shunt. Which common complication of this type of surgery should the nurse explain to the parents to prepare them for their child’s discharge?

Violent involuntary muscle contractions
Eyes with sclerae visible above the irises
Excessive fluid accumulation in the abdomen
Fever accompanied by decreased responsiveness

5. Parents are considering a bone marrow transplant for their child who has recurrent leukemia. The parents ask the nurse for clarification about the procedure. What is the best response by the nurse?

“It is rarely performed in children.”
“The immune system must be destroyed before a transplant can take place.”
“The hematopoietic stem cells are surgically implanted in the bone marrow.”
“It is a simple procedure with little preparation needed, and the stem cells are infused as in a blood transfusion.”

2. A client is admitted to the emergency department with a contaminated wound. The client is a poor historian, and the nurse realizes that it is impossible to determine whether the client is immunized against tetanus. Which medication does the nurse expect the health care provider to prescribe because it will produce passive immunity for several weeks with minimal danger of an allergic reaction?

Tetanus toxoid
Equine tetanus antitoxin
Human tetanus antitoxin
Diphtheria, tetanus, pertussis vaccine

3. A nurse is caring for a client on bed rest. How can the nurse system is important for the nurse to consider? help prevent a pulmonary embolus?

Limit the clients fluid intake
Teach the client how to exercise the legs
Encourage use of the incentive spirometer
Maintain the knee gatch position at an angle

4. A nurse is caring for a client with ascites. What does the nurse consider to be the cause of the ascites?

Portal hypotension
Kidney malfunction
Diminished plasma protein level
Decreased production of potassium

5. After abdominal surgery a client reports pain. What action should the nurse take first?

Reposition the client.
Obtain the client’s vital signs.
Administer the prescribed analgesic.
Determine the characteristics of the pain.

2. A nurse is caring for a client with a spinal cord injury during the immediate postinjury period. What is the primary focus of nursing care during this immediate phase?

Inhibiting urinary tract infections
Preventing contractures and atrophy
Avoiding flexion or hyperextension of the spine
Preparing the client for vocational rehabilitation

3. A client asks for and receives instruction regarding birth control methods. She elects to use a diaphragm with a spermicide. What disadvantage of using a diaphragm should be explained to the client?

It fails half the time when used alone.
It is physically uncomfortable when in place.
Thrombus formation and pulmonary emboli may occur.
Some women find insertion and removal to be objectionable.

4. A nurse is caring for a client in labor. What client response indicates that the transition phase of labor probably has begun?

Assumes the lithotomy position
Perspires and has a flushed face
Indicates back and perineal pain
Exhibits decreases in frequency of contractions

5. A male client receiving hemodialysis undergoes surgery to create an arteriovenous fistula. Before discharge, the nurse discusses care at home with the client and his wife. Which statement by the client’s wife indicates that further teaching is required?

“I must touch the shunt several times a day to feel for the bruit.”
“I have to take his blood pressure every day in the arm with the fistula.”
“He will have to be very careful at night not to lie on the arm with the fistula.”
“We really should check the fistula every day for signs of redness and swelling.”

2. In the immediate postoperative period after a gastrectomy, the client’s nasogastric tube is draining a light-red liquid. For how long should the nurse expect this type of drainage?

1 to 2 hours
3 to 4 hours
10 to 12 hours
24 to 48 hours

3. A nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which diet should the nurse teach the client to maintain because it will help minimize clinical manifestations of dumping syndrome?

Low-residue, bland diet
Small, frequent feeding schedule
Fluid intake less than half a quart
Low-protein, high-carbohydrate diet

4. An external monitor is placed on the abdomen of a client admitted in active labor. The nurse identifies that during each contraction, the fetal heart rate decelerates as the contraction peaks. What should the nurse do next?

Help the client to a knee-chest position to avoid cord compression.
Notify the health care provider because of possible head compression.
Monitor the fetal heart rate until it returns to baseline when the contraction ends.
Place the client in a semi-Fowler position to prevent compression of the vena cava.

5. A client who has had thoracic surgery is admitted to the postanesthesia care unit (PACU). What should the nurse do after the chest tube is attached to a disposable plastic waterseal drainage system?

Ensure the security of the connections from the client to the drainage unit.
Empty the drainage container and measure and record the amount once a day.
Verify that there is vigorous bubbling in the wet suction control compartment.
Check that the fluid level in the water seal compartment increases with expiration.

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