NCLEX PN TestBank (200 Questions with Answers and Explanations) NEW VERSION

1. The nurse is caring for a client scheduled for removal of a pituitary tumor using the

transsphenoidal approach. The nurse should be particularly alert for:

A. Nasal congestion

B. Abdominal tenderness

C. Muscle tetany

D. Oliguria

ANSWER A: Removal of the pituitary gland is usually done by a transsphenoidal approach, through the nose. Nasal congestion further interferes with the airway. ANSWERs B, C, andDarenot correct because they are not directly associated with the pituitary gland. 2. A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that theclient is experiencing which of the following?

A. Hypernatremia

B. Hypokalemia

C. Myelosuppression

D. Leukocytosis

ANSWER B: Hypokalemia is evident from the lab values listed. The other laboratory findingsarewithin normal limits, making ANSWERs A, C, and D

incorrect.

3. A 24-year-old female client is scheduled for surgery in the morning. Which of the

following is the primary responsibility of the nurse?

A. Taking the vital signs

B. Obtaining the permit

C. Explaining the procedure

D. Checking the lab work

ANSWER A: The primary responsibility of the nurse is to take the vital signs before anysurgery. The actions in ANSWERs B, C, and D are the responsibility of the doctor and, therefore, areincorrect for this question. 4. The nurse is working in the emergency room when a client arrives with severe burns of

the left arm, hands, face, and neck. Which action should receive priority?

A. Starting an IV

B. Applying oxygen

C. Obtaining blood gases

D. Medicating the client for pain

ANSWER B: The client with burns to the neck needs airway assessment and supplemental

oxygen, so applying oxygen is the priority. The next action should be to start an IVand medicatefor pain,making ANSWERs A and C incorrect. ANSWER D, obtaining blood gases, is orderedby the doctor. 5. The nurse is visiting a home health client with osteoporosis. The client has a newprescription for alendronate (Fosamax). Which instruction should be given to the client?

A. Rest in bed after taking the medication for at least 30 minutes

B. Avoid rapid movements after taking the medication

C. Take the medication with water only

D. Allow at least 1 hour between taking the medicine and taking other medications

ANSWER B: The client with burns to the neck needs airway assessment and supplemental

oxygen, so applying oxygen is the priority. The next action should be to start an IVand medicatefor pain,making ANSWERs A and C incorrect. ANSWER D, obtaining blood gases, is orderedby the doctor. 6. The nurse is making initial rounds on a client with a C5 fracture and crutchfield tongs. Which equipment should be kept at the bedside?

A. A pair of forceps

B. A torque wrench

C. A pair of wire cutters

D. A screwdriver

ANSWER B: A torque wrench is kept at the bedside to tighten and loosen the screws of

crutchfield tongs. This wrench controls the amount of pressure that is placed on the screws. Apair of forceps, wire cutters, and a screwdriver, in ANSWERs A, C, and D, would not be usedand, thus, areincorrect. 7. An infant weighs 7 pounds at birth. The expected weight by 1 year should

be:

A. 10 pounds

B. 12 pounds

C. 18 pounds

D. 21 pounds

ANSWER D: A birth weight of 7 pounds would indicate 21 pounds in 1 year, or triple his

birthweight. ANSWERs A, B, and C therefore are incorrect. 8. A client is admitted with a Ewing’s sarcoma. Which symptoms would be expectedduetothis tumor’s location?

A. Hemiplegia

B. Aphasia

C. Nausea

D. Bone pain

ANSWER D: Sarcoma is a type of bone cancer; therefore, bone pain would be expected. ANSWERsA, B, and C are not specific to this type of cancer and are incorrect. 9. The nurse is caring for a client with epilepsy who is being treated with carbamazepine(Tegretol). Which laboratory value might indicate a serious side effect of this drug?

A. Uric acid of 5mg/dL

B. Hematocrit of 33%

C. WBC 2,000 per cubic millimeter

D. Platelets 150,000 per cubic millimeter

ANSWER C: Tegretol can suppress the bone marrow and decrease the white blood cell count;

thus, a lab value of WBC 2,000 per cubic millimeter indicates side effects of the drug. ANSWERs A and D are within normal limits, and ANSWER B is a lower limit of normal;

therefore, ANSWERs A, B, andD are incorrect.

10. A 6-month-old client is admitted with possible intussuception. Which question duringthenursing history is least helpful in obtaining information regarding this diagnosis?

A. “Tell me about his pain.” B. “What does his vomit look like?” C. “Describe his usual diet.” D. “Have you noticed changes in his abdominal size?” ANSWER C: The least-helpful questions are those describing his usual diet. A, B, and Dareusefulin determining the extent of disease process and, thus, are incorrect. 11. The nurse is assisting a client with diverticulosis to select appropriate foods. Whichfoodshould be avoided?

A. Bran

B. Fresh peaches

C. Cucumber salad

D. Yeast rolls

ANSWER C: The client with diverticulitis should avoid foods with seeds. The foods in

ANSWERs A,B, and D are allowed; in fact, bran cereal and fruit will help prevent constipation. 12. A client has rectal cancer and is scheduled for an abdominal perineal resection. What

should be the priority nursing care during the post-op period?

A. Teaching how to irrigate the illeostomy

B. Stopping electrolyte loss in the incisional area

C. Encouraging a high-fiber diet

D. Facilitating perineal wound drainage

ANSWER D: The client with a perineal resection will have a perineal incision. Drains will beusedto facilitate wound drainage. This will help prevent infection of the surgical site. The client

willnot have an illeostomy, as in ANSWER A; he will have some electrolyte loss, but treatment

is not focused on preventing the loss, so ANSWER B is incorrect. A high-fiber diet, in

ANSWER C, is not ordered at this time

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