NCLEX-RN Practice Test 9 — Questions and Answers
Question 1: The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?
- Russell’s traction
- Buck’s traction
- Halo traction (Correct answer)
- Crutchfield tong traction
Correct answer: Halo traction
Halo traction is a type of cervical traction that provides rigid stabilization for cervical fractures and can be worn for an extended period, including at the time of discharge. It allows for patient mobility while maintaining spinal alignment, unlike other forms of traction (like Russell's, Buck's, or Crutchfield tong traction) which are typically used for shorter durations or are more restrictive and not suitable for discharge.
Question 2: A client with a total knee replacement has a CPM (continuous passive motion device) applied during the post-operative period. Which statement made by the nurse indicates understanding of the CPM machine?
- “Use of the CPM will permit the client to ambulate during the therapy.”
- “The CPM machine controls should be positioned distal to the site.” (Correct answer)
- "If the client complains of pain during the therapy, I will turn off the machine and call the doctor.”
- “Use of the CPM machine will alleviate the need for physical therapy after the client is discharged.”
Correct answer: “The CPM machine controls should be positioned distal to the site.”
CPM machines are designed to provide continuous passive motion to a joint, often post-operatively. Positioning the controls distal to the site allows for easy access and adjustment by the client or nurse without disturbing the surgical area or the machine's primary function. This ensures convenience and minimizes the risk of injury or discomfort during therapy.
Question 3: Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell’s traction?
- 16-year-old female with scoliosis
- 12-year-old male with a fractured femur (Correct answer)
- 10-year-old male with sarcoma
- 6-year-old male with osteomyelitis
Correct answer: 12-year-old male with a fractured femur
When assigning roommates, nurses prioritize client safety, age appropriateness, and infection control. A 12-year-old male with a fractured femur is the most suitable choice as he is in a similar age group and has a non-infectious condition, minimizing the risk of cross-contamination and providing a more compatible environment for the 6-year-old.
Question 4: Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates understanding of the nurse’s teaching?
- “I must flush the tube with water after feedings and clamp the tube.” (Correct answer)
- “I must check placement four times per day.”
- “I will report to the doctor any signs of indigestion.”
- “If my father is unable to swallow, I will discontinue the feeding and call the clinic.”
Correct answer: “I must flush the tube with water after feedings and clamp the tube.”
Flushing a percutaneous gastrostomy tube with water after feedings is essential to prevent clogging and maintain patency. Clamping the tube afterward prevents leakage of gastric contents and air from entering the stomach, ensuring proper function and client comfort. This indicates a correct understanding of critical gastrostomy tube care.
Question 5: A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client’s cervix is 5 cm dilated with 75% effacement. Based on the nurse’s assessment the client is in which phase of labor?
- Active (Correct answer)
- Latent
- Transition
- Early
Correct answer: Active
The active phase of labor is characterized by more rapid cervical dilation and effacement. A cervix dilated to 5 cm with 75% effacement falls within the typical parameters of the active phase, which generally begins around 4-6 cm dilation and progresses more quickly than the latent phase.
Question 6: A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?
- High-seat commode (Correct answer)
- Recliner
- TENS unit
- Abduction pillow
Correct answer: High-seat commode
After a total hip replacement, clients must adhere to hip precautions, including avoiding hip flexion beyond 90 degrees to prevent dislocation. A high-seat commode elevates the seating surface, ensuring the hip joint remains in a safe position when sitting or standing, thereby assisting with activities of daily living while maintaining precautions.
Question 7: The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?
- The client has traveled out of the country in the last 6 months.
- The client’s parents are skilled stained-glass artists. (Correct answer)
- The client lives in a house built in 1976
- The client has several brothers and sisters.
Correct answer: The client’s parents are skilled stained-glass artists.
Plumbism is lead poisoning, and exposure to lead is a common cause. Stained-glass artistry involves working with lead solder, which can release lead dust or fumes into the environment. Children living in such households are at a high risk of lead exposure through inhalation or ingestion, making this the most likely related factor.
Question 8: A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates understanding of a plaster-of-Paris cast? The nurse:
- Handles the cast with the fingertips
- Petals the cast
- Dries the cast with a hair dryer
- Allows 24 hours before bearing weight (Correct answer)
Correct answer: Allows 24 hours before bearing weight
Plaster-of-Paris casts require a significant amount of time to fully dry and achieve maximum strength. It typically takes 24 to 72 hours for a plaster cast to dry completely, depending on its thickness and environmental conditions. Bearing weight too soon can deform the cast, compromise immobilization, and potentially injure the client.
Question 9: After the physician performs an amniotomy, the nurse’s first action should be to assess the:
- Degree of cervical dilation
- Fetal heart tones (Correct answer)
- Client’s vital signs
- Client’s level of discomfort
Correct answer: Fetal heart tones
After an amniotomy, the most immediate and serious risk is umbilical cord prolapse, which can lead to fetal hypoxia. Therefore, the nurse's first action is to assess fetal heart tones to ensure fetal well-being and detect any signs of distress, such as bradycardia, indicating potential cord compression or prolapse.
Question 10: The nurse is caring for a client with systemic lupus erythematosus (SLE). The major complication associated with systemic lupus erythematosus is:
- Nephritis (Correct answer)
- Cardiomegaly
- Desquamation
- Meningitis
Correct answer: Nephritis
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organ systems. Renal involvement, specifically lupus nephritis, is one of the most serious complications and a major cause of morbidity and mortality in SLE patients, often leading to kidney damage and failure.
Question 11: The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid:
- Holding the infant
- Offering a pacifier (Correct answer)
- Providing a mobile
- Offering sterile water
Correct answer: Offering a pacifier
After a cleft lip repair, it is crucial to protect the surgical site and prevent tension on the delicate sutures. Offering a pacifier involves sucking motions that can put stress on the incision line, potentially disrupting the repair and impairing healing. Therefore, activities involving sucking should be avoided.
Question 12: The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by:
- Giving the medication as ordered
- Providing extra water with the medication
- Giving the medication with an antacid
- Requesting an alternate form of the medication (Correct answer)
Correct answer: Requesting an alternate form of the medication
Esophageal varices are fragile, dilated blood vessels in the esophagus that are highly prone to rupture and bleeding. Administering a capsule can cause mechanical irritation or trauma to these varices, significantly increasing the risk of hemorrhage. Requesting an alternate, safer form of medication, such as a liquid, is essential.
Question 13: The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron?
- Tomatoes (Correct answer)
- Legumes
- Dried fruits
- Nuts
Correct answer: Tomatoes
While tomatoes contain vitamin C, which enhances iron absorption, they are not a significant source of iron themselves. Legumes, dried fruits, and nuts are all recognized as good plant-based sources of iron. Therefore, tomatoes are the poor source of iron among the given options.
Question 14: The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to:
- Periodically lie prone without a neck pillow (Correct answer)
- Sleep only in dorsal recumbent position
- Rest in supine position with his head elevated
- Sleep on either side but keep his back straight
Correct answer: Periodically lie prone without a neck pillow
Parkinson's disease often leads to a characteristic stooped posture with spinal flexion. Lying prone without a neck pillow helps to counteract this flexion by promoting spinal and neck extension, stretching anterior muscles, and maintaining proper alignment. This can help prevent contractures and improve posture.
Question 15: The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client?
- Low calorie, low carbohydrate
- High calorie, low fat (Correct answer)
- High protein, high fat
- Low protein, high carbohydrate
Correct answer: High calorie, low fat
In pancreatitis, the inflamed pancreas has difficulty producing digestive enzymes, especially lipase for fat digestion. A low-fat diet reduces the workload on the pancreas, minimizing enzyme stimulation and decreasing pain. A high-calorie diet is often necessary to meet nutritional needs due to malabsorption and increased metabolic demands.
Question 16: A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
- Uses an electric blanket at night
- Dresses in extra layers of clothing (Correct answer)
- Applies a heating pad to her feet
- Takes a hot bath morning and evening
Correct answer: Dresses in extra layers of clothing
Hypothyroidism causes a decreased metabolic rate, leading to a common symptom of cold intolerance. Dressing in extra layers of clothing provides effective insulation, trapping body heat and helping the client maintain a comfortable body temperature. This is a practical and safe method for managing this symptom.
NCLEX-RN Practice Test 9
The client with a cervical fracture is placed in traction.
Which type of traction will be utilized at the time of discharge?