NCLEX-PN Test #4 2

Question 1

A client with active pulmonary tuberculosis is admitted to the hospital. Which type of isolation precautions should the nurse implement?

Accepted Answer

Airborne precautions with negative pressure room

Answer

Active pulmonary TB is transmitted via airborne droplet nuclei (small particles that remain suspended in air). Airborne precautions require a negative-pressure room, N95 respirator (not surgical mask) for staff, and keeping the door closed. Droplet precautions are for larger droplets (influenza, pertussis).

Question 2

The PN is performing a well-child visit for an 18-month-old. Which developmental milestone is expected at this age?

Accepted Answer

Walks independently and uses 10–20 words

Answer

By 18 months, a child should walk independently without support and have a vocabulary of approximately 10–20 words. Two-word phrases typically develop by 24 months. Tricycle riding is a 3-year milestone; hopping on one foot develops around age 4.

Question 3

During a home visit, the PN observes an elderly client with multiple unexplained bruises in various stages of healing. What is the nurse's priority action?

Accepted Answer

Document observations and report suspected elder abuse to the appropriate authority

Answer

Multiple bruises in various stages of healing are a classic indicator of elder abuse. The PN is a mandated reporter and must document objective findings and report to the designated authority (adult protective services or state agency). Confronting the caregiver directly can escalate danger for the client.

Question 4

Which hand hygiene technique is most effective for preventing the spread of Clostridioides difficile (C. diff) spores?

Accepted Answer

Soap and water handwashing for at least 20 seconds

Answer

C. difficile forms spores that are NOT killed by alcohol-based hand sanitizers. Soap and water with vigorous friction for at least 20 seconds is required to physically remove spores from the hands. This is a critical distinction from most other pathogens where alcohol rub is equally effective.

Question 5

The PN is educating a community group about colorectal cancer screening. At what age should average-risk adults begin routine screening?

Accepted Answer

45 years

Answer

Current guidelines (ACS 2018, USPSTF 2021) recommend colorectal cancer screening beginning at age 45 for average-risk adults. This was lowered from 50 due to rising incidence in younger populations. Higher-risk individuals (family history, IBD) should begin earlier.

NCLEX Practice Test

NCLEX Practice Test

NCLEX-PN Test #4 2