NCLEX-RN Practice Test 22
Which information should be reported to the state Board of Nursing?
The Joint Commission on Accreditation of Hospitals will probably be interested in the problems in answers A and C. The failure of the nursing assistant to care for the client with hepatitis might result in termination, but is not of interest to the Joint Commission.
Which assignment should not be performed by the licensed practical nurse?
The licensed practical nurse should not be assigned to begin a blood transfusion. Options A, B, and C: The licensed practical nurse can insert a Foley catheter, discontinue a nasogastric tube, and collect sputum specimen.
The nurse is discussing meal planning with the mother of a 2-year-old toddler. Which of the following statements, if made by the mother, would require a need for further instruction?
Remember the ABCs (airway, breathing, circulation) when answering this question. Answer C because a hotdog is the size and shape of the child’s trachea and poses a risk of aspiration. Options A, B, and D: A white grape juice, grilled cheese sandwich, and ice cream do not pose a risk of aspiration for a child.
The nurse is providing dietary instructions to the mother of an 8-year-old child diagnosed with celiac disease. Which of the following foods, if selected by the mother, would indicate her understanding of the dietary instructions?
The child with celiac disease should be on a gluten-free diet. Options A, B, and C: These food items all contain gluten.
Which instruction should be given to the client who is fitted for a behind-the-ear hearing aid?
The hearing aid should be stored in a warm, dry place. Option A: It should be cleaned daily but should not be moldy. Option C: A toothpick is inappropriate to use to clean the aid; the toothpick might break off in the hearing aid. Option D: Changing the batteries weekly is not necessary.
The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labor. Which one would be most appropriate for the primigravida as she completes the early phase of labor?
Clients admitted in labor are told not to eat during labor, to avoid nausea and vomiting. Ice chips may be allowed, but this amount of fluid might not be sufficient to prevent fluid volume deficit. Option A: Impaired gas exchange related to hyperventilation would be indicated during the transition phase. Options B and C: Impaired physical mobility and fluid volume deficit are not correct in relation to the stem.
The nurse is caring for a 6-year-old client admitted with a diagnosis of conjunctivitis. Before administering eye drops, the nurse should recognize that it is essential to consider which of the following?
Before instilling eye drops, the nurse should cleanse the area with water. Option B: A 6-year-old child is not developmentally ready to instill his own eyedrops. Option C: Although the mother of the child can instill the eye drops, the area must be cleansed before administration. Option D: Although the eye might appear to be clear, the nurse should instill the eyedrops, as ordered, so answer D is incorrect.
A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?
The best method of birth control for the client with diabetes is the diaphragm. Options A, B, and D: Permanent intrauterine device can cause a continuing inflammatory response in diabetics that should be avoided, oral contraceptives tend to elevate blood glucose levels, and contraceptive sponges are not good at preventing pregnancy.
The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?
All of the choices are tasty, but the pregnant client needs a diet that is balanced and has increased amounts of calcium. This food item contains meat, fruit, potato salad, and yogurt, which has about 360 mg of calcium. Option A: These food items are lacking in fruits and milk. Option B: The potato chips, which contain a large amount of sodium. Option D: These food items are lacking vegetables and milk products.