NCLEX Practice Exam 7 — Questions and Answers

Question 1: The nurse is aware that the best way to prevent postoperative wound infection in the surgical client is to:

Administer a prescribed antibiotic
Wash her hands for 2 minutes before care (Correct answer)
Wear a mask when providing care
Ask the client to cover her mouth when she coughs

Correct answer: Wash her hands for 2 minutes before care

Thorough handwashing is recognized as the single most effective measure to prevent the spread of infection in healthcare settings. By physically removing transient microorganisms, it significantly reduces the risk of transmitting pathogens to surgical wounds. While other measures are important, hand hygiene forms the foundation of infection control practices.

Question 2: A client with a fractured hip is being taught correct use of the walker. The nurse is aware that the correct use of the walker is achieved if the:

Palms rest lightly on the handles (Correct answer)
Elbows are flexed 0°
Client walks to the front of the walker
Client carries the walker

Correct answer: Palms rest lightly on the handles

Correct walker use requires the client's elbows to be slightly flexed (about 15-30 degrees) when their hands are on the grips. When the palms rest lightly on the handles, it indicates the walker is at the appropriate height, allowing for proper weight bearing and stability without stooping or overextending. This ensures the client can maintain balance and move safely.

Question 3: A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?

Take the medication with milk.
Report chest pain. (Correct answer)
Remain upright after taking for 30 minutes.
Allow 6 weeks for optimal effects.

Correct answer: Report chest pain.

Celecoxib (Celebrex) is a COX-2 inhibitor, a type of NSAID, which carries a black box warning due to an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke. Therefore, instructing the client to report chest pain is a critical safety measure. This warning highlights the importance of monitoring for cardiac symptoms.

Question 4: The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:

Lack of exercise
Hormonal disturbances (Correct answer)
Lack of calcium
Genetic predisposition

Correct answer: Hormonal disturbances

In postmenopausal women, the significant decrease in estrogen levels is the primary factor contributing to osteoporosis. Estrogen plays a crucial role in maintaining bone density by inhibiting bone resorption and promoting bone formation. The decline in this hormone after menopause accelerates bone loss, making hormonal disturbances the most likely cause of increased susceptibility.

Question 5: A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse indicates that the traction is working properly?

The infant no longer complains of pain.
The buttocks are 15° off the bed. (Correct answer)
The legs are suspended in the traction.
The pins are secured within the pulley.

Correct answer: The buttocks are 15° off the bed.

Bryant's traction is a form of skin traction used for infants and young children with fractured femurs. For the traction to be effective and provide continuous pull and counter-traction, the child's buttocks must be slightly elevated off the bed, typically 15-20 degrees. This elevation confirms that the correct amount of weight is being applied and the traction is working properly.

Question 6: An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration, the nurse should:

Administer oxygen via nasal cannula
Have narcan (naloxone) available (Correct answer)
Prepare to administer blood products
Prepare to do cardio resuscitation

Correct answer: Have narcan (naloxone) available

Anesthesia and narcotic administration commonly cause respiratory depression, which can be a life-threatening complication. Naloxone (Narcan) is an opioid antagonist that rapidly reverses the effects of opioid-induced respiratory depression. Having it readily available allows for immediate intervention to restore adequate breathing and prevent further complications.

Question 7: A client elects to have epidural anesthesia to relieve the discomfort of labor. Following the initiation of epidural anesthesia, the nurse should give priority to:

Checking for cervical dilation
Placing the client in a supine position
Checking the client’s blood pressure (Correct answer)
Obtaining a fetal heart rate

Correct answer: Checking the client’s blood pressure

A common and potentially serious side effect of epidural anesthesia is maternal hypotension, which can compromise placental perfusion and fetal oxygenation. Therefore, closely monitoring the client's blood pressure immediately after epidural initiation is the priority. Prompt detection and management of hypotension are crucial for both maternal and fetal well-being.

Question 8: The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?

“It will be alright for your friends to autograph the cast.” (Correct answer)
“Because the cast is made of plaster, autographing can weaken the cast.”
“If they don’t use chalk to autograph, it is okay.”
“Autographing or writing on the cast in any form will harm the cast.”

Correct answer: “It will be alright for your friends to autograph the cast.”

Fiberglass casts are known for their durability and water-resistant properties, making them quite robust. Writing on a fiberglass cast with markers or pens will not compromise its structural integrity or effectiveness. Unlike plaster casts, which can be weakened by moisture, fiberglass casts can be safely autographed without harm.

Question 9: A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?

Check the bowel sounds (Correct answer)
Assess the blood pressure
Offer pain medication
Check for swelling

Correct answer: Check the bowel sounds

A spica cast, especially a hip spica cast, covers a large area of the torso and legs, which can lead to complications like cast syndrome (superior mesenteric artery syndrome). This condition involves compression of the duodenum, causing abdominal distention, nausea, and vomiting. Checking bowel sounds helps the nurse assess for potential gastrointestinal complications early.

Question 10: When critiquing a qualitative study, which of the following questions are helpful in determining the study’s auditability? Select all that apply.

Has adequate time been allowed to understand the phenomenon fully?
Can the reader follow the researcher’s thinking? (Correct answer)
Are the results meaningful to individuals not involved in the research? (Correct answer)
Does the researcher document the research process?

Correct answer: Can the reader follow the researcher’s thinking?

Auditability in qualitative research refers to the transparency and logical consistency of the research process. If a study is auditable, an independent researcher should be able to follow the investigator's decision trail, methods, and interpretations, and arrive at similar conclusions given the same data. Therefore, the question 'Can the reader follow the researcher’s thinking?' directly assesses this criterion.

Question 11: Which question is helpful in determining the study’s credibility?

Do the participants recognize the experience as their own? (Correct answer)
What strategies were used to analyze the data?
How were human subjects protected?
Are the findings applicable outside the study situation?

Correct answer: Do the participants recognize the experience as their own?

Credibility in qualitative research refers to the truth value of the findings, ensuring that the research accurately represents the experiences of the participants. A key way to establish credibility is through member checking, where the researcher shares findings with participants to confirm that the descriptions and interpretations resonate with their own experiences. This ensures the participants recognize the experience as their own.

Question 12: Which criteria are used to determine testability of a hypothesis? Select all that apply.

Use of quantifiable words such as greater than or less than (Correct answer)
A hypothesis stated in such a way that it can be clearly supported or not supported (Correct answer)
The use of value-laden words in a hypothesis
Data-collection efforts that prove the validity of the hypothesis

Correct answer: Use of quantifiable words such as greater than or less than

For a hypothesis to be testable, it must be stated in a way that allows for empirical investigation and can be either supported or refuted by observable data. This requires using quantifiable terms (e.g., 'greater than,' 'less than') to allow for measurement and comparison. Furthermore, the hypothesis must be clearly formulated so that research findings can unequivocally indicate whether it is supported or not supported, avoiding ambiguity.

Question 13: What are the advantages to using directional hypotheses? Select all that apply.

The indication of the use of a theory base to derive the hypothesis (Correct answer)
The provision of a specific theoretical frame of reference (Correct answer)
Ensurance that findings will be generalizable
The indication of a nonbiased selection of subjects

Correct answer: The indication of the use of a theory base to derive the hypothesis

Directional hypotheses predict a specific relationship or difference between variables, often indicating a clear direction (e.g., 'more than,' 'less than'). This specificity typically arises from existing theoretical frameworks or prior research, meaning the hypothesis is grounded in a theory base. Therefore, directional hypotheses provide a specific theoretical frame of reference, guiding the research with an informed prediction.

Question 14: Which type of research allows researchers to be neutral observers?

Qualitative research
Ethnographic research
Quantitative research (Correct answer)
Case studies

Correct answer: Quantitative research

Quantitative research aims for objectivity and control, often using structured methods and statistical analysis to test hypotheses. Researchers strive to remain neutral observers, minimizing their personal bias and influence on the study outcomes to ensure the generalizability and reliability of the findings. This approach seeks to establish facts and relationships that are independent of the researcher's perspective.

Question 15: Which type of research study can be affected by detracting values of the researcher?

Qualitative
Naturalistic
Ethnographic
Quantitative (Correct answer)

Correct answer: Quantitative

While qualitative research acknowledges the researcher's role, quantitative research strives for strict objectivity and neutrality. However, a researcher's personal values can subtly influence quantitative studies, for instance, in the selection of research questions, the design of interventions, or the interpretation of statistical results. If these values introduce bias, they can detract from the study's objectivity and validity, despite the quantitative paradigm's aim for neutrality.

Question 16: What are the uses of qualitative research methods? Select all that apply.

Guiding nursing practice (Correct answer)
Studying the effects of nursing care on an outcome variable
Developing survey instruments (Correct answer)
Developing nursing theory (Correct answer)

Correct answer: Guiding nursing practice

Qualitative research methods are invaluable for exploring complex human experiences, perceptions, and meanings, which directly helps in guiding nursing practice by providing a deeper understanding of patient needs and perspectives. They are also crucial for developing new nursing theories by generating rich, descriptive data that can form the basis of conceptual frameworks. Furthermore, qualitative approaches, such as interviews or focus groups, are often used in the initial stages of developing survey instruments to ensure the questions are relevant and capture the intended constructs.

NCLEX Practice Exam 7

The nurse is aware that the best way to prevent postoperative wound infection in the surgical client is to: