NCLEX-PN Practice Test
The LPN/LVN is gathering information from the mother of a six year old girl who is at the clinic for a well-child visit. The nurse asks if the mother has any special concerns regarding her daughter. The mother states that her daughter has recently been complaining of an itchy scalp and she would like to talk with the doctor about some dandruff treatment. What would be the MOST appropriate response?
Examine the child’s scalp and hair for evidence of small, white, sesame seed size flecks which cannot be brushed away or pulled off of the hair. This is the most appropriate response because you will not be able to provide accurate information to the physician if you do not examine the child’s scalp and hair for evidence of head lice (pediculosis). The child could just have an irritated scalp or dandruff. It is not appropriate to make an assumption or judgment about the patient due to the only symptom reported which is pruritus of the scalp.
A medical care team consists of three RN’s, and a LPN/LVN. Identify the MOST appropriate assignment for the LPN/LVN.
A multiparous C-section patient who is two days post-op should be stable and mobilizing fairly well. Since she is a repeat C-section and multiparous, she has experienced a C-section and most likely is quite comfortable breastfeeding her new infant. Out of all the patient choices, she is the most stable. The primiparous four hour post vaginal delivery patient is still in need of immediate postpartum teaching and will be at a higher risk for complications than some of the other more stable patients. Even though the multiparous C-section patient is stable enough to be discharged, she will require discharge teaching and instructions. The primiparous patient who would like to discuss tubal ligation should be assessed for signs of post-partum depression and she may require counseling and follow up by her treating physician.
A LPN/LVN has received an assignment of four patients on the Medical-Surgical floor. Which patient should she/he go to check on first?
The 70 year old woman who is only one day post-op from ankle surgery has probably been immobile due to her age and the surgery type and is at a greater risk of thrombophlebitis and the subsequent complication of pulmonary embolus. If she is complaining of shortness of breath, her vital signs should be obtained and the physician should be notified. This patient is the highest priority, though all have the potential to have some type of medical complication.
A nurse is planning to reinforce instructions regarding nutrition to a Muslim patient. The nurse should be aware that certain foods are prohibited by this religion. Identify the food which is prohibited.
People who are of the Muslim religion or Islamic faith prohibit pork in their diet. In some sects of Buddhism, Seventh-Day Adventism they are vegetarian. Jewish people adhere to the kosher laws if they are Orthodox believers. People who practice Hinduism are prohibited from eating beef and veal. Spicy foods are normally not a dietary restriction of a particular religion.
A nurse is checking the circulation in the right leg of an Asian American patient who had a total knee replacement two days ago. The patient does not smile, make eye contact and does not speak much. The nurse should:
Asian Americans value silence. Eye contact may be considered inappropriate or disrespectful. It is important for the nurse to be aware of these cultural differences so that he/she does not assume that this is unusual behavior. It would be inappropriate of the nurse to continue talking to the patient to try to “engage” them in conversation. The nurse should not assume that the patient is exhibiting signs of depression or physical instability due to the understanding of this as normal behavior within this culture.
A LPN/LVN is attempting to review and reinforce an African American patient’s Synthroid medication schedule. The patient nods her head up and down throughout the review of instructions. The nurse should understand that:
It is important for the nurse to understand that in the African American, head nodding does not necessarily mean agreement or acceptance or understanding of information presented. The other statements are untrue.
The LPN/LVN is gathering physical information about the status of an Asian American patient who is one day postpartum from normal vaginal delivery. The nurse must check her fundal height. She should be aware that:
Asian Americans are normally modest and private and prefer a formal personal space, except with family and close friends. The female Asian American may consider it inappropriate to be examined in front of her husband or children. The nurse should be aware of this need for privacy and modesty and do all she can to provide a private evaluation with limited exposure of the patient’s body. It is important to note that Asian Americans usually do not touch others during conversation and that touching is unacceptable with members of the opposite sex. The other statements are incorrect.
A LPN/LVN is caring for a 41 year old Hispanic American female, who has been diagnosed with Type II Diabetes. The patient states, “I know I am sick because I have been too busy to help at my church like I should”. The nurse should be aware that:
Hispanic Americans may view illness as a punishment from God for their sins. Her statement reveals that she believes that she may have become ill with diabetes due to her lack of involvement and help at church and thus she believes God is punishing her with diabetes. In this case, it would be helpful for the nurse to report the patient’s statement to the RN, in order to develop an appropriate teaching plan regarding the cause of diabetes and its treatment. The other statements are not necessarily true of Hispanic Americans.
A LPN/LVN has been asked to float to another floor in the hospital that she has never worked on before. Identify the statement which is incorrect.
Floating is a risky legal practice used by some hospitals to help with understaffing problems. Floating is necessary to provide appropriate coverage of the patient load within a health care setting. It is the nurse’s responsibility to not take on an assignment which is beyond her scope of expertise. The nurse may be given a more appropriate assignment. It is the nurse’s responsibility to inform her supervisor regarding any lack of knowledge, experience, or unfamiliarity to the floor. The nurse should ask and be given an orientation to the new floor so that she will be comfortable providing nursing care there.
The nurse should understand regulations of nursing practice as put forth by the Nurse Practice Act. Identify the statement which is incorrect.
The Nurse Practice Act is a series of statutes enacted by the federal government in order to regulate the practice of nursing. The Nurse Practice Act is a series of statutes enacted by each state legislature in order to regulate the practice of nursing in that particular state. All the other statements are true and correct.
The Boards of Nursing have the right to revoke, deny, or suspend any license to practice as a practical/vocational nurse within their jurisdiction. There are several causes or actions which are considered to be causes for disciplinary action by the Board of Nursing. Identify the cause for disciplinary action which is incorrect.
Informing your supervisor that you cannot assume nursing duties until sufficient preparation for the specific duty has been provided. It is the nurse’s responsibility to inform the supervisor of an inappropriate assignment. The nurse should let the supervisor know that they are uncomfortable performing these duties until they have been prepared to handle them. The supervisor may then make a more appropriate assignment. All the other statements are correct and are reasons for the Board of Nursing to take disciplinary action towards the nurse.
A nurse is planning assignments for the upcoming shift. Which of the following would be the most appropriate assignment for the nursing assistant?
Assist a diabetic client on bedrest with a bed bath. This would be the MOST appropriate assignment to give to the nursing assistant with the information which has been provided. It would be inappropriate for the nursing assistant to record the vital signs in the medical chart. Since the patient requiring feeding had a stroke three days earlier, there is a greater risk of choking and/or aspiration of food material. The Alzheimer’s patient may be confused and may have the potential for difficulties in regards to bathroom assistance.
Vitamin K is typically given during the immediate post delivery period to the healthy newborn infant. The IM injection is administered in the vastus lateralis muscle of the infant’s thigh. What is the MOST appropriate response for the nurse to give if questioned by the parents about the reason for the injection?
“This is a Vitamin K injection. Infants are deficient in Vitamin K for the first 5- 8 days of life. Vitamin K helps their blood clot. This injection is administered to all healthy newborns to help their blood clot better.” Telling the parents that the injection is for their child’s own good is an unprofessional explanation. It is untrue that infants do not feel pain. They are able to feel pain and discomfort. Telling the parents that the injection is a “necessary evil” creates a negative view of the procedure and again an unprofessional explanation. This would not be the most appropriate answer. The last response is an example of the nurse assuming that the parents do not wish for their child to receive the injection. The parents simply asked for its purpose and an explanation of why it needed to be given.
A nurse has received orders to administer a RhoGAM injection IM to a postpartum patient. Which situation is NOT a contraindication for administration of this injection?
Administration of the injection within 72 hours after delivery. The injection is given to an Rh-negative mother to prevent isoimmunization from the possibility of exposure to Rh-positive blood. Exposure can occur not only through delivery of an Rh-positive infant but also by transfusion, amniocentesis, chorionic villus sampling, abdominal injury or trauma, bleeding during pregnancy, and termination of a pregnancy. The injection should never be administered to an Rh-positive patient, a patient with an elevated temperature, or a patient with a history of an allergic reaction to preparations containing human immunoglobulins. The injection should never be administered to a newborn.
A nursing student is asked by her nursing instructor to explain and give an example of Erik Erikson’s Identity vs. Role Confusion psychosocial development stage. The MOST appropriate answer would be:
"This stage occurs in adolescence (12-20 years), when the adolescent is confused about who he is. An example is when the adolescent obtains a tattoo, which he feels shows the world who he really is.” The school age child (6-12 years) is in the stage or psychosocial crisis of “industry vs. inferiority”. In early adulthood (20-35 years), they are experiencing the “intimacy vs. isolation” stage or crisis. In middle adulthood (35-65 years), they are experiencing the “generativity vs. stagnation” stage or crisis.
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