NCLEX EXAM Correct and Verified Answers Graded A

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NCLEX EXAM Correct and Verified Answers Graded A

• The nurse is caring for a 12-year-old client who has a prescription for lorazepam 0.05

mg/kg, p.o., stat. The client weighs 103 lb (47 kg). The nurse has 2 mg/mL of solution available. How many milliliters should the nurse administer to the client? Record your answer using one decimal place.• Correct Answer: 0.05mg/kg X 47kg X (1ml/2mg) = 1.2 mL (Note: Text provided

formula: 0.05mg/kgXx/47X2mg/ml=)

• The nurse has reinforced teaching with a client who is receiving prescribed

alendronate. Which of the following statements by the client would indicate a correct understanding of the teaching?

• "I should take the medication with orange juice."
• "I can take the medication at any time of day."
• "I will avoid taking over-the-counter (OTC) vitamin D supplements."
• "I must sit upright for 30 minutes after taking the medication."

• Correct Answer: 4. "I must sit upright for 30 minutes after taking the medication."

• The nurse is reinforcing teaching with the parents of a child who is scheduled for

surgical repair of hypospadias. The nurse should reinforce that intended outcomes of

the procedure include:

• relief from pain
• relief from bladder obstruction
• the ability to void while standing
• the ability to achieve an erection

• Correct Answer: 3. the ability to void while standing

• The nurse is assisting to admit a client who has Streptococcal pharyngitis. Which of

the following actions should the nurse take?

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• Wear a surgical mask when checking the client's vital signs.
• Ensure the assigned room has monitored negative air pressure.
• Obtain particulate respirator masks for staff members to use when providing client

care.

• Request the dietary department provide disposable dishes and utensils for the

client's meals.• Correct Answer: 4. Request the dietary department provide disposable dishes and utensils for the client's meals.

• The nurse is talking with the spouse of a client with left-sided hemiplegia. The

spouse tells the nurse, "I scheduled this appointment because I noticed a sore had developed on my spouse's hip. I feel so guilty because I caused this to happen. I do not know what to do." Which of the following would be an appropriate initial response for the nurse to make?

• "Have you been offering your spouse fluids at regular time intervals?"
• "How often do you change your spouse's position?"
• "The type of care that you have undertaken is not easy."
• "We will make sure that you have help if this requires special dressings."

• Correct Answer: 3. "The type of care that you have undertaken is not easy."

• The nurse is caring for a client. Which of the following prescriptions should the

nurse clarify? Click the exhibit button for additional client information.

• 2 g sodium diet
• implement bed rest
• furosemide 20 mg, p.o., once daily
• enalapril 5 mg, p.o., twice daily

• Correct Answer: 3. furosemide 20 mg, p.o., once daily

• The nurse is caring for a client with dysthymic disorder. Which of the following

behaviors would the nurse expect to observe?

• grandiose actions
• reports of auditory hallucinations

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• expansive, pressured speech
• inability to experience joy or pleasure in life

• Correct Answer: 4. inability to experience joy or pleasure in life

• The nurse is caring for a 6-year-old client who is receiving prescribed skeletal

traction. Which of the following would be a priority for the nurse to monitor?

• the distance between the client's knees
• the pull of the traction on the client's pins
• the degree of flexion of the client's ankles
• the position of the client's cervical spine on the bed

• Correct Answer: 2. the pull of the traction on the client's pins

• The nurse has reinforced teaching with a client who is scheduled for

electroconvulsive therapy (ECT). Which of the following statements by the client would indicate a correct understanding of the teaching?

• "I will experience a tonic-clonic seizure for approximately 15 minutes during the ECT

procedure."

• "ECT is commonly used to treat depression when several antidepressants have not

been effective."

• "ECT is effective because it decreases the level of neurotransmitters in the central

nervous system."

• "Common side effects of ECT are diarrhea, a low-grade fever and short-term

memory loss." • Correct Answer: 2. "ECT is commonly used to treat depression when several antidepressants have not been effective."

• The nurse is contributing to the plan of care for a client with chronic obstructive

pulmonary disease (COPD). Which of the following interventions should the nurse suggest including in the client's plan of care?

• Place the client in low-Fowler's position for meals.
• Provide the client with a high-carbohydrate diet and high-carbohydrate snacks.
• Restrict the client's fluid intake to 500 mL daily.

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• Provide the client with small, frequent meals, and schedule a rest period before and

after meals.• Correct Answer: 2. Provide the client with a high-carbohydrate diet and high- carbohydrate snacks.

• The nurse has reinforced discharge teaching with the parent of a newborn. Which

of the following statements by the parent would require follow-up?

• "I will leave my baby's diaper off when possible if the diaper area starts to become

red."

• "I will secure my baby in a rear-facing infant seat in the front seat of the car since

there is an airbag there."

• "I should give my baby a pacifier at bedtime to reduce the risk for sudden infant

death syndrome (SIDS)."

• "I should squeeze the bulb syringe before inserting it into my baby's mouth when I

suction excess secretions." • Correct Answer: 3. "I should give my baby a pacifier at bedtime to reduce the risk for sudden infant death syndrome (SIDS)."

• The nurse is caring for a client with pediculosis. Which of the following infection

control precautions should the nurse implement?

• Place a thermometer in the client's room to be used with that client only.
• Wear a surgical mask when assisting the client to bathe.
• Keep the door to the client's room closed.
• Remove the gloves after leaving the client's room.

• Correct Answer: 1. Place a thermometer in the client's room to be used with that client only.

• The charge nurse in a long-term care facility has completed client care

assignments for unlicensed assistive personnel (UAP). Which of the following statements by the charge nurse would provide the best directions to a UAP regarding the assignment?

• "Record your assigned clients' vital signs before you take a mid-morning break."
• "Weigh your assigned clients before breakfast with the scale used 1 day ago."