NCSBN Practice Questions 76-90
Exam With Correct Detailed Answers
100% Pass.
300
Using ratio proportion:First, convert 22 pounds to kilograms (22/2.2) = 10 kg20 mL/kg = 20 x 10 kg = 200
mL200 mL/40 minutes = x mL/60 minutes (in an hour)200 x 60 = 12000/40 = 300 mL/hrUsing
dimensional analysis:20 mL/kg x 1 kg/2.2 lb x 22 lb x 60 min/hr x 1/40 min = 300 mL/hr - correct answers
An 18 month-old weighing 22 pounds is admitted to the pediatric unit with a diagnosis of dehydration. A
replacement bolus of normal saline at 20 mL/kg is ordered to be administered intravenously over 40
minutes.
In mL/hour, what will be the setting for the IV delivery system?
A
DTaP immunization is a vaccine that protects against diptheria, tetanus and pertussis (whooping cough).
The majority of reactions described in this question occur with the administration of the DTaP
vaccination. Contraindications to giving repeat DTaP immunizations include the occurrence of severe
side effects after a previous dose, as well as signs of encephalopathy within seven days of the
immunization. - correct answers The mother of a 2 month-old baby calls a pediatrician's nurse two days
after the first DTaP, inactivated polio vaccine (IPV), Hepatitis B and Haemophilus influenzae type B (HIB)
immunizations. She reports that the baby feels very warm, cries inconsolably for as long as three hours,
and has had several shaking spells. Which immunization would the nurse expect to be primarily
responsible with these findings?
A. DTaP
B. IPV
C. Hepatitis B
D. HIB
D
Clients must understand that just one sublingual tablet should be taken at a time and placed under the
tongue. After rest and a five-minute interval, a second and then eventually a third tablet may be
,necessary. - correct answers A client diagnosed with angina has been instructed about the use of
sublingual nitroglycerin. Which statement made by the client is incorrect and indicates a need for
further teaching?
A. "I'll call the health care provider if pain continues after three tablets five minutes apart."
B. "I will rest briefly right after taking one tablet."
C. "I understand that the medication should be kept in the dark bottle."
D. "I can swallow two or three tablets at once if I have severe pain."
C
Signs of domestic violence or emotional abuse may not be clearly manifested and include many series of
a minor complaints such as headache, abdominal pain, insomnia, back pain and dizziness. These may be
covert indications of violence or abuse that go undetected. These complaints may be vague and reflect
ambivalence about the disclosure of any violence or abuse. - correct answers The nurse is working with
victims of domestic abuse. The nurse should understand which of these factors is a reason why domestic
violence or emotional abuse remains extensively undetected?
A. The expenses due to police and court costs are prohibitive
B. Little knowledge is known about batterers and battering relationships
C. There are typically many series of minor, vague complaints
D. Few people who have been battered seek medical care
B
After removing the dressing and performing hand hygiene, the wound needs to be irrigated to remove
surface pathogens before the nurse can obtain a wound culture. Cultures are not obtained from wound
exudate on the dressing or wounds that have not been irrigated since the exudate may be contaminated
with normal skin flora. - correct answers The nurse is obtaining an aerobic wound culture from a client
with stage two pressure injury. The nurse first removes a gauze dressing and observes a moderate
amount of purulent drainage on the dressing and then the nurse performs hand hygiene. What is the
next correct step in the procedure?
A. Swab the gauze dressing that was removed from the wound
B. Irrigate the wound with normal saline
,C. Obtain a culture by rotating a sterile swab in the open wound
D. Remove wound exudate from the wound edges with a cotton tip applicator
A
Encouragement of a family member or a close friend to stay with the client in a quiet surrounding
cannot only help increase orientation, but can also minimize confusion and anxiety. The visitor could
also report to the nurse any unusual findings of the client. This would be the most supportive approach
for this client. - correct answers The nurse is caring for a client who is experiencing frightening
hallucinations that are markedly increased at night. The client's partner asks to stay a few hours beyond
the visiting time, in the client's private room. What would be the best response by the nurse?
A. "Yes, staying with the client and orienting the client to the surroundings may decrease any anxiety."
B. "No, your presence may cause the client to become more anxious."
C. "No, it would be best if you brought the client some reading material that the client could read at
night."
D. "Yes, would you like to spend the night when the client's behavior indicates that the client is or will be
frightened?"
A
The definition of assignment is the routine care, activities and procedures that are within the authorized
scope of practice of the RN or LPN/LVN. The RN must determine the needs of the clients and make
assignments not only based on scope of practice, but also education, demonstrated competency and
skill level. Regardless if the LPN received education and training to perform specific skills, the RN needs
to determine the LPN's experience with caring for clients with similar diagnoses. While the RN is
responsible for ensuring an assignment given to a delegatee is carried out completely and correctly, the
LPN must be able to perform the skills or tasks independently. - correct answers The RN, who is
functioning as the charge nurse, needs to determine shift assignments. How will the charge nurse
determine which client assignments are appropriate for the licensed practical nurse (LPN)?
A. Ask the LPN about prior experience caring for clients with similar diagnoses
B. Determine how many nursing assistants are available to help the LPN with client care
C. Refer to the list of technical tasks LPNs are trained to perform
D. Review the procedure manual with the LPN prior to making an assignment
, C
The parathyroid regulates the calcium and phosphorus serum levels. Calcium and phosphorous levels
will be elevated in hyperfunction of this gland until the client is stabilized. To recall this information
think of a see-saw. Associate that calcium is first in the alphabet and thus calcium follows the direction
of the abnormality - hyper or hypo function - of the parathyroid. Put the calcium on one side and the
phosphorus on the other side of the see-saw. - correct answers The nurse is caring for a school-aged
child with a diagnosis of secondary hyperparathyroidism after treatment for chronic renal disease.
Which serum lab data should receive priority attention by the nurse?
A. Osmolality and sodium
B. Blood urea nitrogen and magnesium
C. Calcium and phosphorus
D. Glucose and potassium
D
Complications of central catheter insertion include pneumothorax and hemothorax. Air embolism is
another potential complication. Dyspnea, shallow respirations, sudden sharp chest pain that worsens
with coughing or deep breathing are indications of pneumothorax. Other potential complications of
central catheters may include thrombosis, local or systemic infection, or even cardiac tamponade (if the
central line perforates the heart). When considering the options listed, the client who is dyspneic after
central line insertion would be the greatest concern for the nurse. - correct answers The nurse is caring
for a client who just had a central venous catheter line inserted at the bedside. Which of these
assessments requires immediate attention by the nurse?
A. Pallor in the extremities
B. Increased temperature by one degree
C. Involuntary coughing spells
D. Dyspnea at rest
D
A barium enema involves filling the large intestine (lower GI tract) with diluted barium liquid while x-ray
images are taken. After the procedure, a small amount of barium will be immediately expelled and the
remainder will be excreted in the stool. Because barium liquid may cause constipation, clients should eat
foods high in fiber and drink plenty of fluids to help expel the barium from the body. - correct answers
Exam With Correct Detailed Answers
100% Pass.
300
Using ratio proportion:First, convert 22 pounds to kilograms (22/2.2) = 10 kg20 mL/kg = 20 x 10 kg = 200
mL200 mL/40 minutes = x mL/60 minutes (in an hour)200 x 60 = 12000/40 = 300 mL/hrUsing
dimensional analysis:20 mL/kg x 1 kg/2.2 lb x 22 lb x 60 min/hr x 1/40 min = 300 mL/hr - correct answers
An 18 month-old weighing 22 pounds is admitted to the pediatric unit with a diagnosis of dehydration. A
replacement bolus of normal saline at 20 mL/kg is ordered to be administered intravenously over 40
minutes.
In mL/hour, what will be the setting for the IV delivery system?
A
DTaP immunization is a vaccine that protects against diptheria, tetanus and pertussis (whooping cough).
The majority of reactions described in this question occur with the administration of the DTaP
vaccination. Contraindications to giving repeat DTaP immunizations include the occurrence of severe
side effects after a previous dose, as well as signs of encephalopathy within seven days of the
immunization. - correct answers The mother of a 2 month-old baby calls a pediatrician's nurse two days
after the first DTaP, inactivated polio vaccine (IPV), Hepatitis B and Haemophilus influenzae type B (HIB)
immunizations. She reports that the baby feels very warm, cries inconsolably for as long as three hours,
and has had several shaking spells. Which immunization would the nurse expect to be primarily
responsible with these findings?
A. DTaP
B. IPV
C. Hepatitis B
D. HIB
D
Clients must understand that just one sublingual tablet should be taken at a time and placed under the
tongue. After rest and a five-minute interval, a second and then eventually a third tablet may be
,necessary. - correct answers A client diagnosed with angina has been instructed about the use of
sublingual nitroglycerin. Which statement made by the client is incorrect and indicates a need for
further teaching?
A. "I'll call the health care provider if pain continues after three tablets five minutes apart."
B. "I will rest briefly right after taking one tablet."
C. "I understand that the medication should be kept in the dark bottle."
D. "I can swallow two or three tablets at once if I have severe pain."
C
Signs of domestic violence or emotional abuse may not be clearly manifested and include many series of
a minor complaints such as headache, abdominal pain, insomnia, back pain and dizziness. These may be
covert indications of violence or abuse that go undetected. These complaints may be vague and reflect
ambivalence about the disclosure of any violence or abuse. - correct answers The nurse is working with
victims of domestic abuse. The nurse should understand which of these factors is a reason why domestic
violence or emotional abuse remains extensively undetected?
A. The expenses due to police and court costs are prohibitive
B. Little knowledge is known about batterers and battering relationships
C. There are typically many series of minor, vague complaints
D. Few people who have been battered seek medical care
B
After removing the dressing and performing hand hygiene, the wound needs to be irrigated to remove
surface pathogens before the nurse can obtain a wound culture. Cultures are not obtained from wound
exudate on the dressing or wounds that have not been irrigated since the exudate may be contaminated
with normal skin flora. - correct answers The nurse is obtaining an aerobic wound culture from a client
with stage two pressure injury. The nurse first removes a gauze dressing and observes a moderate
amount of purulent drainage on the dressing and then the nurse performs hand hygiene. What is the
next correct step in the procedure?
A. Swab the gauze dressing that was removed from the wound
B. Irrigate the wound with normal saline
,C. Obtain a culture by rotating a sterile swab in the open wound
D. Remove wound exudate from the wound edges with a cotton tip applicator
A
Encouragement of a family member or a close friend to stay with the client in a quiet surrounding
cannot only help increase orientation, but can also minimize confusion and anxiety. The visitor could
also report to the nurse any unusual findings of the client. This would be the most supportive approach
for this client. - correct answers The nurse is caring for a client who is experiencing frightening
hallucinations that are markedly increased at night. The client's partner asks to stay a few hours beyond
the visiting time, in the client's private room. What would be the best response by the nurse?
A. "Yes, staying with the client and orienting the client to the surroundings may decrease any anxiety."
B. "No, your presence may cause the client to become more anxious."
C. "No, it would be best if you brought the client some reading material that the client could read at
night."
D. "Yes, would you like to spend the night when the client's behavior indicates that the client is or will be
frightened?"
A
The definition of assignment is the routine care, activities and procedures that are within the authorized
scope of practice of the RN or LPN/LVN. The RN must determine the needs of the clients and make
assignments not only based on scope of practice, but also education, demonstrated competency and
skill level. Regardless if the LPN received education and training to perform specific skills, the RN needs
to determine the LPN's experience with caring for clients with similar diagnoses. While the RN is
responsible for ensuring an assignment given to a delegatee is carried out completely and correctly, the
LPN must be able to perform the skills or tasks independently. - correct answers The RN, who is
functioning as the charge nurse, needs to determine shift assignments. How will the charge nurse
determine which client assignments are appropriate for the licensed practical nurse (LPN)?
A. Ask the LPN about prior experience caring for clients with similar diagnoses
B. Determine how many nursing assistants are available to help the LPN with client care
C. Refer to the list of technical tasks LPNs are trained to perform
D. Review the procedure manual with the LPN prior to making an assignment
, C
The parathyroid regulates the calcium and phosphorus serum levels. Calcium and phosphorous levels
will be elevated in hyperfunction of this gland until the client is stabilized. To recall this information
think of a see-saw. Associate that calcium is first in the alphabet and thus calcium follows the direction
of the abnormality - hyper or hypo function - of the parathyroid. Put the calcium on one side and the
phosphorus on the other side of the see-saw. - correct answers The nurse is caring for a school-aged
child with a diagnosis of secondary hyperparathyroidism after treatment for chronic renal disease.
Which serum lab data should receive priority attention by the nurse?
A. Osmolality and sodium
B. Blood urea nitrogen and magnesium
C. Calcium and phosphorus
D. Glucose and potassium
D
Complications of central catheter insertion include pneumothorax and hemothorax. Air embolism is
another potential complication. Dyspnea, shallow respirations, sudden sharp chest pain that worsens
with coughing or deep breathing are indications of pneumothorax. Other potential complications of
central catheters may include thrombosis, local or systemic infection, or even cardiac tamponade (if the
central line perforates the heart). When considering the options listed, the client who is dyspneic after
central line insertion would be the greatest concern for the nurse. - correct answers The nurse is caring
for a client who just had a central venous catheter line inserted at the bedside. Which of these
assessments requires immediate attention by the nurse?
A. Pallor in the extremities
B. Increased temperature by one degree
C. Involuntary coughing spells
D. Dyspnea at rest
D
A barium enema involves filling the large intestine (lower GI tract) with diluted barium liquid while x-ray
images are taken. After the procedure, a small amount of barium will be immediately expelled and the
remainder will be excreted in the stool. Because barium liquid may cause constipation, clients should eat
foods high in fiber and drink plenty of fluids to help expel the barium from the body. - correct answers
