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NCLEX Boot Camp Quiz 1

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52 slides

Sally Stroud

Nurses should monitor potassium levels, educate on digoxin risks, vitamin K for newborns, pacemaker issues, hypokalemia from diuretics, dietary choices post-surgery, and thrombocytopenia safety.

Slides (52)

1 - Freestyle
2 - Pick Answer 1. A nurse is caring for an 8-year-old child who has sickle cell anemia and is recovering from a vaso-occlusive crisis. Which of the following precautions should the nurse include in the discharge teaching?

1. Drink eight glasses of fluid dail
2. Avoid playground activities at school.
3. Assume postural drainage positions every 6 hr.
4. Maintain an updated haemophilus influenza type B immunization
3 - Leaderboard Rationale: Hydration decreases the viscosity of the blood. A decreased viscosity helps lower the risk for sickling as a result of venous stasis.
4 - Pick Answer 2. A nurse is collecting data from a client prior to administering nifedipine. For which of the following findings should the nurse contact the provider?

1. Peripheral edema of the ankles
2. Heart rate of 66/min
3. Increased alkaline phosphatase level
4. BP of 148/94 mm Hg
5 - Leaderboard Rationale: :Peripheral edema can occur due to the vasodilation principles of nifedipine. The nurse should monitor for edema of the feet and ankles and notify the provider if this occurs
6 - Pick Answer 3. A nurse caring for a client who has a new prescription for atenolol. For which of the following adverse effects should the nurse monitor the client?

1. Bradycardia
2. Hypokalemia
3. Anemia
4. Neutropenia
7 - Leaderboard Atenolol, a beta adrenergic blocker, is used to treat hypertension and stable angina pectoris. This medication slows the pulse rate due to blockage of cardiac beta 1 receptors. The nurse should monitor for bradycardia in clients who are prescribed atenolol and other beta adrenergic blockers.
8 - Pick Answer 4. A nurse is collecting data from a client prior to the administration of digoxin. Which of the following findings should the nurse report to the provider?

1. BP of 132/82 mm Hg
2. Potassium level of 3.0 mEq/L
3. Digoxin level of 1.2 ng/mL
4. Heart rate of 66/min
9 - Leaderboard Rationale: The nurse should report a potassium level of 3.0 mEq/L to the provider. This finding is an indication of hypokalemia, which can lead to cardiac dysrhythmias, the most serious adverse effect of digoxin.
10 - Pick Answer 5. A nurse is reviewing the morning laboratory results of electrolytes for four clients who are receiving digoxin. Which of the following clients should the nurse identify as being at risk for developing digoxin toxicity?

1. A client taking furosemide for chronic hypertension
2. A client taking aluminum hydroxide for gastric upse
3. A client taking chlorpropamide for type 2 diabetes mellitus
4. A client taking a potassium supplement twice a day
11 - Leaderboard Loop diuretics, such as furosemide, might cause hypokalemia, which greatly increases the risk of digoxin toxicity.
12 - Pick Answer 6. A nurse is reinforcing teaching for a client who has a new prescription for sublingual nitroglycerin. Which of the following instructions should the nurse include?

1. "You may take up to five nitroglycerin sublingual tablets at 3 min intervals if chest pain occurs."
2. "If you experience a headache after taking nitroglycerin, stop taking the medication and notify your provider immediately."
3. "You should keep an emergency supply of nitroglycerin tablets in a plastic container with other medications for each day."
4. "If your mouth is dry, take a sip of water before putting the tablet under your tongue.”
13 - Leaderboard Nitroglycerin tablets require moisture to dissolve completely. The client should be taught to take a sip of water before putting the tablet under the tongue if the mouth is very dry.
14 - Pick Answer 6. A nurse is reinforcing teaching with a new mother about the purpose of administering vitamin K to her newborn following delivery. The nurse should explain that the purpose of administering vitamin K is to prevent which of the following complications?

1. Vitamin K does not prevent infection.
2. Potassium deficiency
3. Bleeding
4. Hyperbilirubinemia
15 - Leaderboard A newborn is unable to manufacture vitamin K, which is necessary for blood clotting, without intestinal flora. Vitamin K also promotes production of clotting factors II, VII, IX, and X in the liver. Vitamin K is usually produced by day 8; therefore, it is routinely given to newborns to prevent bleed
16 - Pick Answer 7. A nurse is assisting with the plan of care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan of care?

1. Restrict visitors.
2. Monitor level of consciousness every 4 hr.
3. Use a nasal cannula to administer oxygen at 2 L/min.
4. Keep dedicated equipment in the client's room.
17 - Leaderboard Clients with thrombocytopenia have a decreased platelet count, which puts them at risk for bleeding. An early indication of bleeding is a change in the level of consciousness and tachycardia. Therefore, the nurse should monitor the client's vital signs and level of consciousness every 4 hr.
18 - Pick Answer 8. A nurse is collecting data from an infant who has coarctation of the aorta. Which of the following manifestations should the nurse expect?

1. Machine-like murmur
2. Decreased blood pressure in the legs
3. Pulmonary edema
4. Severe cyanosis
19 - Leaderboard Coarctation of the aorta is a narrowing at or near the ductus arteriosus, which results in an increased pressure proximal to the defect with a decreased pressure distal to the obstruction. Therefore, an increased blood pressure in the arms and a decreased blood pressure in the legs is a clinical m
20 - Pick Answer 9. A nurse is collecting data from an infant who has a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?

1. Weak pulses
2. Chronic hypoxemia
3. Machine-like murmur
4. Cyanosis with crying
21 - Leaderboard A patent ductus arteriosus is the failure of the opening connecting the aorta and pulmonary artery to close after birth causing a left-to-right shunt. A machine-like murmur is a clinical manifestation found in infants who have a large patent ductus arteriosus.
22 - Pick Answer 10. A nurse is reinforcing teaching for a client who has rheumatoid arthritis and a new prescription for aspirin 650 mg orally every 6 hr. The nurse should instruct the client to monitor for which of the following adverse effects of aspirin therapy?

1. Constipation
2. Bleeding
3. Blurred vision
4. Insomnia
23 - Leaderboard Aspirin can cause bleeding, tinnitus, gastric ulceration, nausea, and heartburn. Aspirin inhibits platelet aggregation and prolongs bleeding time. The client should be instructed to report blood in the stool, urine, or in emesis, and should also report unusual bruising or bleeding gums.
24 - Pick Answer 10. A nurse is reinforcing teaching with an older adult client who has had a newly inserted permanent pacemaker. Which of the following manifestations should the nurse include in the teaching as a pacemaker malfunction that the client should report to the provider?

1. Increased urine output
2. Fatigue
3. Sneezing
4. Rapid pulse
25 - Leaderboard Pacemaker malfunction causes bradycardia and a drop in cardiac output. This can cause hypoxia, with classic manifestations of weakness, fatigue, and dizziness.
26 - Pick Answer 11. A nurse is reinforcing teaching with a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client’s understanding of these dietary instructions?

1. Liver
2. Beans
3. Eggs
4. Milk
27 - Leaderboard Beans do not contain animal products. Therefore, they do not contain cholesterol. Beans are a good source of protein for a client who follows a low-cholesterol diet.
28 - Pick Answer 12. A nurse is caring for an older adult client who has left-sided heart failure. Which of the following findings should the nurse expect?

1. Frothy sputum
2. Dependent edema
3. Jugular distention
4. Nocturnal polyuria
29 - Leaderboard Left-sided heart failure reduces cardiac output and raises pulmonary venous pressure. Manifestations include hacking cough, frothy sputum, wheezing, fatigue, and weakness.
30 - Pick Answer 13. A nurse is reinforcing teaching with a client who has increased cholesterol levels and a new prescription for colestipol granules 15 gm PO twice daily. The nurse should identify that which of the following statements by the client indicates an understanding of colestipol administration?

1. "I can mix the granules with applesauce and take the mixture with a spoon."
2. "I should check my blood sugar before meals while taking colestipol.
3. "I will take the granules along with my other medications in the morning and evening."
31 - Leaderboard Colestipol granules can be mixed with a liquid, such as water, carbonated beverages, or soup. The granules can also be mixed with crushed fruit or a fruit sauce, such as applesauce, before swallowing them. This decreases the risk for irritation to the esophagus.
32 - Pick Answer 14. A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mm3. Which of the following interventions should the nurse include in the plan of care?

1. Use contact precautions.
2. Administer a stool softener.
3. Administer ibuprofen prior to assisting with ADLs.
4. Measure rectal temperature every 4 hr.
33 - Leaderboard This client’s platelet count is below the expected reference range and the client is at risk for bleeding. The nurse should administer a stool softener to prevent constipation, since constipation can lead to rectal bleeding.
34 - Pick Answer 15. A nurse is collecting data from a client who has a prosthetic aortic valve and takes warfarin daily at bedtime. Which of the following data is the priority finding for the nurse to report to the provider?

1. The client sprinkles flaxseeds on breakfast food every day.
2. The client consistently eats fish for dinner twice weekly.
3. The client keeps a small supply of vitamin K tablets on hand for emergency use
4. The client uses garlic as a daily dietary supplement.
35 - Leaderboard The nurse should be aware that the use of garlic as a dietary supplement might potentiate the action of warfarin and may cause bleeding. Therefore, use of garlic is the finding to report to the provider. The nurse should apply the safety and risk reduction priority-setting framework.
36 - Pick Answer The nurse is reviewing orders for a newly admitted client. Which activity would be most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?

1. Infuse 500 ml normal saline (NS) over 3 hours for dehydration.
2. Collect routine vital signs after the nurse has completed the initial assessment.
3. Obtain a portable chest X-ray to rule out pneumonia.
4. Titrate oxygen per nasal cannula for oxygen (O2) saturation less than 90%.
37 - Leaderboard The UAP is qualified to obtain routine vital signs on clients after the RN has obtained an initial set on admission. Only the nurse can administer medications including NS and O2. A trained radiology technician is required to obtain a portable chest X-ray.
38 - Pick Answer A client has just been diagnosed with pneumonia. What is the nurse’s priority action?

1. Maintain airway clearance.
2. Reverse fluid volume excess.
3. Provide information about how to avoid a recurrence.
4. Incrementally increase activity tolerance.
39 - Leaderboard Pneumonia refers to inflammation of the lungs and can produce copious amounts of tracheobronchial secretions. These secretions interfere with airway patency and gas exchange. Airway clearance is a priority. The client may experience decreased fluid volume, not an excess, due to increased temperature
40 - Pick Answer A client with pneumonia has developed dyspnea, has a respiratory rate of 32 breaths/min, and is having difficulty expelling secretions. The nurse auscultates the lung fields and hears bronchial sounds in the lower left lobe. Which action should the nurse take first?

1. Administer antibiotics
2. Encourage bed rest
3. Apply oxygen
4. Assess nutritional intake
41 - Leaderboard The client is having difficulty breathing, and is probably becoming hypoxic. As an emergency measure, the nurse should provide oxygen without waiting for a health care provider’s order. Antibiotics may be warranted, but would require a provider’s order. This client should be maintained on bed rest
42 - Pick Answer A 25-year-old male client has just had a plaster cast applied to their right forearm following the reduction of a closed radius fracture due to an inline skating accident. What is the priority nursing assessment for this client?

1. Whether the client is having any pain
2. Sensation and movement of the fingers
3. Whether the client is having any pain
4. Whether the cast needs petaling
43 - Leaderboard Neurovascular checks are most important because they are used to determine if any impairment exists after cast application. Checking to see if the cast is completely dry isn’t the nurse’s highest priority. Petaling to smooth the cast’s edge is done when the cast is completely dry.
44 - Pick Answer The nurse is assigned to care for four clients. Which client should the nurse see first?

1. a client with an avoidant personality disorder who refuses to go to groups on the unit
2. a client with borderline personality disorder who continues to talk about wanting to self-harm by cutting
3. a divorced client with a dependent personality disorder who is seeking care from another client
4. a client with paranoid personality disorder who refuses to attend the community morning meeting
45 - Leaderboard The nurse has to address the physical safety of the borderline personality disorder client first. The behaviors of the other three clients with personality disorders affect the milieu of the unit and can be addressed later.
46 - Pick Answer A client with gestational hypertension is experiencing abdominal pain and vaginal bleeding. Which assessment should the nurse perform first

1. urinary output
2. strength of contractions
3. fetal heart tones
4. serum electrolytes
47 - Leaderboard Since the findings suggest that the client is experiencing abruptio placentae, fetal heart tones should be assessed immediately to determine fetal well-being. The other interventions should also be implemented after the fetus is assessed.
48 - Pick Answer A four-year-old child is diagnosed as having acute lymphocytic leukemia. The white blood cell (WBC) count, especially the neutrophil count, is low. What is the most important intervention the nurse should teach the parents?

1. Protect your child from falls because of their increased risk of bleeding
2. Treat constipation, which frequently accompanies a decrease in WBC
3. Protect your child from infections because their resistance to infection is decreased
4. Provide rest periods because the oxygen-carrying capacity of your child’s blood is diminished
49 - Leaderboard One of the complications of both acute lymphocytic leukemia and its treatment is a decreased WBC count, especially a decreased absolute neutrophil count. Because neutrophils are the body’s first line of defense against infection, the child must be protected from infection. Bleeding is a risk factor.
50 - Pick Answer A client with pneumonia has developed dyspnea, has a respiratory rate of 32 breaths/min, and is having difficulty expelling secretions. The nurse auscultates the lung fields and hears bronchial sounds in the lower left lobe. Which action should the nurse take first?

1. Administer antibiotics
2. Encourage bed rest
3. Apply oxygen
4. Assess nutritional intake
51 - Leaderboard The client is having difficulty breathing, and is probably becoming hypoxic. As an emergency measure, the nurse should provide oxygen without waiting for a health care provider’s order. Antibiotics may be warranted, but would require a provider’s order. This client should be maintained on bed rest i
52 - Leaderboard

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NCLEX Boot Camp Quiz 1

Slides (52)

1 - Freestyle

2 - Pick Answer 1. A nurse is caring for an 8-year-old child who has sickle cell anemia and is recovering from a vaso-occlusive crisis. Which of the following precautions should the nurse include in the discharge teaching?

3 - Leaderboard Rationale: Hydration decreases the viscosity of the blood. A decreased viscosity helps lower the risk for sickling as a result of venous stasis.

4 - Pick Answer 2. A nurse is collecting data from a client prior to administering nifedipine. For which of the following findings should the nurse contact the provider?

5 - Leaderboard Rationale: :Peripheral edema can occur due to the vasodilation principles of nifedipine. The nurse should monitor for edema of the feet and ankles and notify the provider if this occurs

6 - Pick Answer 3. A nurse caring for a client who has a new prescription for atenolol. For which of the following adverse effects should the nurse monitor the client?

8 - Pick Answer 4. A nurse is collecting data from a client prior to the administration of digoxin. Which of the following findings should the nurse report to the provider?

9 - Leaderboard Rationale: The nurse should report a potassium level of 3.0 mEq/L to the provider. This finding is an indication of hypokalemia, which can lead to cardiac dysrhythmias, the most serious adverse effect of digoxin.

10 - Pick Answer 5. A nurse is reviewing the morning laboratory results of electrolytes for four clients who are receiving digoxin. Which of the following clients should the nurse identify as being at risk for developing digoxin toxicity?

11 - Leaderboard Loop diuretics, such as furosemide, might cause hypokalemia, which greatly increases the risk of digoxin toxicity.

12 - Pick Answer 6. A nurse is reinforcing teaching for a client who has a new prescription for sublingual nitroglycerin. Which of the following instructions should the nurse include?

13 - Leaderboard Nitroglycerin tablets require moisture to dissolve completely. The client should be taught to take a sip of water before putting the tablet under the tongue if the mouth is very dry.

14 - Pick Answer 6. A nurse is reinforcing teaching with a new mother about the purpose of administering vitamin K to her newborn following delivery. The nurse should explain that the purpose of administering vitamin K is to prevent which of the following complications?

16 - Pick Answer 7. A nurse is assisting with the plan of care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan of care?

18 - Pick Answer 8. A nurse is collecting data from an infant who has coarctation of the aorta. Which of the following manifestations should the nurse expect?

20 - Pick Answer 9. A nurse is collecting data from an infant who has a large patent ductus arteriosus. Which of the following is clinical manifestations should the nurse expect?

21 - Leaderboard A patent ductus arteriosus is the failure of the opening connecting the aorta and pulmonary artery to close after birth causing a left-to-right shunt. A machine-like murmur is a clinical manifestation found in infants who have a large patent ductus arteriosus.

22 - Pick Answer 10. A nurse is reinforcing teaching for a client who has rheumatoid arthritis and a new prescription for aspirin 650 mg orally every 6 hr. The nurse should instruct the client to monitor for which of the following adverse effects of aspirin therapy?

24 - Pick Answer 10. A nurse is reinforcing teaching with an older adult client who has had a newly inserted permanent pacemaker. Which of the following manifestations should the nurse include in the teaching as a pacemaker malfunction that the client should report to the provider?

25 - Leaderboard Pacemaker malfunction causes bradycardia and a drop in cardiac output. This can cause hypoxia, with classic manifestations of weakness, fatigue, and dizziness.

26 - Pick Answer 11. A nurse is reinforcing teaching with a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client’s understanding of these dietary instructions?

27 - Leaderboard Beans do not contain animal products. Therefore, they do not contain cholesterol. Beans are a good source of protein for a client who follows a low-cholesterol diet.

28 - Pick Answer 12. A nurse is caring for an older adult client who has left-sided heart failure. Which of the following findings should the nurse expect?

29 - Leaderboard Left-sided heart failure reduces cardiac output and raises pulmonary venous pressure. Manifestations include hacking cough, frothy sputum, wheezing, fatigue, and weakness.

31 - Leaderboard Colestipol granules can be mixed with a liquid, such as water, carbonated beverages, or soup. The granules can also be mixed with crushed fruit or a fruit sauce, such as applesauce, before swallowing them. This decreases the risk for irritation to the esophagus.

32 - Pick Answer 14. A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mm3. Which of the following interventions should the nurse include in the plan of care?

33 - Leaderboard This client’s platelet count is below the expected reference range and the client is at risk for bleeding. The nurse should administer a stool softener to prevent constipation, since constipation can lead to rectal bleeding.

34 - Pick Answer 15. A nurse is collecting data from a client who has a prosthetic aortic valve and takes warfarin daily at bedtime. Which of the following data is the priority finding for the nurse to report to the provider?

36 - Pick Answer The nurse is reviewing orders for a newly admitted client. Which activity would be most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?

37 - Leaderboard The UAP is qualified to obtain routine vital signs on clients after the RN has obtained an initial set on admission. Only the nurse can administer medications including NS and O2. A trained radiology technician is required to obtain a portable chest X-ray.

38 - Pick Answer A client has just been diagnosed with pneumonia. What is the nurse’s priority action?

40 - Pick Answer A client with pneumonia has developed dyspnea, has a respiratory rate of 32 breaths/min, and is having difficulty expelling secretions. The nurse auscultates the lung fields and hears bronchial sounds in the lower left lobe. Which action should the nurse take first?

42 - Pick Answer A 25-year-old male client has just had a plaster cast applied to their right forearm following the reduction of a closed radius fracture due to an inline skating accident. What is the priority nursing assessment for this client?

44 - Pick Answer The nurse is assigned to care for four clients. Which client should the nurse see first?

45 - Leaderboard The nurse has to address the physical safety of the borderline personality disorder client first. The behaviors of the other three clients with personality disorders affect the milieu of the unit and can be addressed later.

46 - Pick Answer A client with gestational hypertension is experiencing abdominal pain and vaginal bleeding. Which assessment should the nurse perform first

47 - Leaderboard Since the findings suggest that the client is experiencing abruptio placentae, fetal heart tones should be assessed immediately to determine fetal well-being. The other interventions should also be implemented after the fetus is assessed.

48 - Pick Answer A four-year-old child is diagnosed as having acute lymphocytic leukemia. The white blood cell (WBC) count, especially the neutrophil count, is low. What is the most important intervention the nurse should teach the parents?

50 - Pick Answer A client with pneumonia has developed dyspnea, has a respiratory rate of 32 breaths/min, and is having difficulty expelling secretions. The nurse auscultates the lung fields and hears bronchial sounds in the lower left lobe. Which action should the nurse take first?

52 - Leaderboard