NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 471:

  In teaching clients with Buck's Traction, the major areas of importance should be __________.

  A. nutrition, ROM exercises

  B. ROM exercises, transportation

  C. nutrition, elimination, comfort, safety

  D. elimination, safety, isotonic exercises

  Correct Answer: C

  Nutrition, elimination, comfort, and safety are the major areas of importance. The diet should be high in protein with adequate fluids.

• Question 472:

  Assessment of a client with a cast should include __________.

  A. capillary refill, warm toes, no discomfort

  B. posterior tibial pulses, warm toes

  C. moist skin essential, pain threshold

  D. discomfort of the metacarpals

  Correct Answer: A

  Assessment for adequate circulation is necessary.

  Signs of impaired circulation include slow capillary refill, cool fingers or toes, and pain.

• Question 473:

  A safety measure to implement when transferring a client with hemiparesis from a bed to a wheelchair is __________.

  A. standing the client and walking him or her to the wheelchair.

  B. moving the wheelchair close to client's bed and standing and pivoting the client on his unaffected extremity to the wheelchair.

  C. moving the wheelchair close to client's bed and standing and pivoting the client on his affected extremity to the wheelchair.

  D. having the client stand and push his body to the wheelchair.

  Correct Answer: B

  Moving the wheelchair close to client's bed and having him stand and pivot on his unaffected extremity to the wheelchair is safer because it provides support with the unaffected limb.

• Question 474:

  Assessment of the client with an arteriovenous fistula for hemodialysis should include __________.

  A. inspection for visible pulsation

  B. palpation of thrill

  C. percussion for dullness

  D. auscultation of blood pressure

  Correct Answer: B

  Thrill should be present. The client should be taught to check this daily at home.

  Pulsation is not typically visible.

  Percussion gives no information about the patency of a fistula.

  Blood pressure is not auscultated in a limb with an AVF.

  Auscultation of the AVF, for a bruit, is part of an assessment for patency.

• Question 475:

  Which is considered an internal disaster?

  A. A patient fall.

  B. The massive spread of pneumonia.

  C. A computer hacking episode.

  D. Unexpected staff absences due to illness.

  Correct Answer: C

  A computer hacking episode is considered an internal disaster. It threatens patient privacy of information

  and the secure ongoing manner of communication within the healthcare facility. Other internal disasters

  include utility failures, a power outage, workplace violence and a tornado or other environmental threat.

  A fall is an incident, accident and sentinel event.

  The spread of infections, like pneumonia, is an infection control concern but not considered an internal

  disaster.

  Unexpected staff absences disrupt the facility but they are not considered internal disaster.

• Question 476:

  Which healthcare associated infection is the greatest risk for patients?

  A. Pneumonia

  B. Catheter related infections

  C. Intravenous line infections

  D. C difficile

  Correct Answer: B

  Catheter related infection is the most commonly occurring healthcare associated infection, therefore, these

  infections are the greatest risk for patients. For this reason, indwelling urinary catheters are used only

  when necessary and, then, they remain in place for the briefest period of time possible.

  Pneumonia, intravenous line catheters and C difficile are all healthcare associated infections, however,

  they do not occur as frequently as indwelling urinary catheters do.

• Question 477:

  Select the type of skeletal fracture that is correctly paired with its description.

  A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.

  B. A pathological fracture: A fracture that results from some physical trauma.

  C. A greenstick fracture: This bends but does not fracture the bone.

  D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament

  Correct Answer: D

  An avulsion fracture pulls a part of the fractured bone from the ligament or tendon.

  A complete fracture is one with which the whole cross section of the bone is fractured;

  a compound or opened fracture pierces through the skin;

  a pathological fracture results from an underlying disease or disorder not physical trauma or stressors.

  Lastly, a greenstick fracture is a skeletal bone fracture that affects only one side of the bone.

• Question 478:

  Idiopathic thrombocytopenia purpura is __________.

  A. highly similar to disseminated intravascular coagulation (DIC)

  B. caused by the over production of platelets

  C. a bleeding disorder that is characterized with too few platelets

  D. treated with immune system boosting medications

  Correct Answer: C

  Idiopathic thrombocytopenia purpura is bleeding disorder that is characterized with too few platelets, not the over production of platelets. Disseminated intravascular coagulation (DIC) is characterized with blood coagulation and not bleeding. The treatments of idiopathic thrombocytopenia purpura can include immune system depressants, not stimulants, prednisone, high-dose gamma globulin and anti RhD therapy.

• Question 479:

  Clumsiness, difficulty running, climbing, and riding a bicycle are some of the earliest signs and symptoms of __________.

  A. duchennes's muscular dystrophy

  B. osteomyelitis

  C. talipes or clubfoot

  D. septic joint, suppurative arthritis

  Correct Answer: A

  Clumsiness, difficulty running, climbing, and riding a bicycle are some of the earliest signs and symptoms

  of Duchenne's muscular dystrophy. This disorder is a sex-linked inherited genetic skeletal muscle wasting

  disorder and it is the most severe and most common of all dystrophies.

  Osteomyelitis is an infection with the bone.

  Talipes is a deformity of the foot and ankle and it is physically discernible.

  Septic arthritis is an infection of a joint that will also show visible signs of its presence.

• Question 480:

  You will be reinforcing teaching and instructing the patient.

  Which basic principle of teaching should you follow?

  A. Sequence the instruction from the least complex to the most complex.

  B. Assume that the patient knows little or nothing about the topic.

  C. Tell the patient to call their significant other so you can instruct them.

  D. Use medically oriented terms so the patient will be able to speak with the doctor.

  Correct Answer: A

  You should sequence the instruction from the least complex to the most complex when reinforcing teaching and instructing the patient. For example, if you are instructing the patient about coughing and deep breathing, you should begin the instruction by demonstrating normal breathing, then deep breathing and finally combining deep breathing with coughing. You should not assume that the patient knows little or nothing about the topic, you should determine what they know. It is not necessary to have the patient call their significant other so you can instruct them; this is only necessary when the patient is not able to understand the instructions. Lastly, you should not use medically oriented terms and medical jargon, but instead, terms that the patient understands.