NCLEX-RN Practice Exam 7
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:
The client’s palms should rest lightly on the handles. The elbows should be flexed no more than 30° but should not be extended. Option B: A 0° is not a relaxed angle for the elbows and will not facilitate correct walker use. Option C: The client should walk to the middle of the walker, not to the front of the walker. Option D: The client should be taught not to carry the walker because this would not provide stability.
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’s hips should be off the bed approximately 15° in Bryant’s traction. Option A is incorrect because this does not indicate that the traction is working correctly, nor does C. Option D is incorrect because Bryant’s traction is a skin traction, not a skeletal traction.
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?
There is no reason that the client’s friends should not be allowed to autograph the cast; it will not harm the cast in any way, so answers B, C, and D are incorrect.
A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?
A body cast or spica cast extends from the upper abdomen to the knees or below. Bowel sounds should be checked to ensure that the client is not experiencing a paralytic ileus. Options B, C, and D: Checking the blood pressure is a treatment for any client, offering pain medication is not called for, and checking for swelling isn’t specific to the stem.
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:
Following epidural anesthesia, the client should be checked for hypotension and signs of shock every 5 minutes for 15 minutes. Option A: The client can be checked for cervical dilation later after she is stable. Option B: The client should not be positioned supine because the anesthesia can move above the respiratory center and the client can stop breathing. Option D: Fetal heart tones should be assessed after the blood pressure is checked.
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:
Narcan is the antidote for narcotic overdose. Option A: If hypoxia occurs, the client should have oxygen administered by mask, not cannula. Options C and D: There is no data to support the administration of blood products or cardiac resuscitation.
The nurse is aware that the best way to prevent postoperative wound infection in the surgical client is to:
The best way to prevent post-operative wound infection is hand washing. Option A: Use of prescribed antibiotics will treat infection, not prevent infections. Options C and D: Wearing a mask and asking the client to cover her mouth are good practices but will not prevent wound infections.
The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:
After menopause, women lack hormones necessary to absorb and utilize calcium. Options A and C: Doing weight-bearing exercises and taking calcium supplements can help to prevent osteoporosis but are not causes. Option D: Body types that frequently experience osteoporosis are thin Caucasian females, but they are not most likely related to osteoporosis.
A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?
Cox II inhibitors have been associated with heart attacks and strokes. Any changes in cardiac status or signs of a stroke should be reported immediately, along with any changes in bowel or bladder habits because bleeding has been linked to use of Cox II inhibitors. Options A, C, and D: The client does not have to take the medication with milk, remain upright, or allow 6 weeks for optimal effect.