NCLEX-RN Practice Quiz Test Bank #9 (75
Questions)
1. 1. Question
Which roommate would be most suitable for the 6-year-old male with
a fractured femur in Russell’s traction?
o A. 16-year-old female with scoliosis
o B. 12-year-old male with a fractured femur
o C. 10-year-old male with sarcoma
o D. 6-year-old male with osteomyelitis
Incorrect
Correct Answer: B. 12-year-old male with a fractured femur
The 6-year-old should have a roommate as close to the same age as
possible, so the 12-year-old is the best match. A bed is available and
the patient gets assigned. There are certain constraints—sex, semi-
private versus private, isolation issues, acuity, telemetry and specialty
needs. All need to be taken into account to ensure that each patient
goes to the right place and receives the proper care. But good capacity
management demands that bed assignment be carefully considered
and executed.
Option A: The client is too old and is female. Bed assignment
simply provides the proper location based on specific patient
attributes like sex, isolation, telemetry, acuity, and specialty
needs.
Option C: The 10-year-old with sarcoma has cancer and will be
treated with chemotherapy that makes him immune suppressed.
Bed managers aim at finding an assignment of patients to rooms
that strikes a balance between patients’ preferences and comfort
on the one hand, and patients’ clinical conditions and the
resulting required room facilities on the other.
Option D: The 6-year-old with osteomyelitis is infectious. Rooms
and beds belong to the critical assets of just any hospital. They
account for a considerable part of a hospital’s infrastructure, and
a large amount of financial resources are invested in equipping
, them with medical apparatus to facilitate patient care.
Furthermore, they also represent the place where most patients
will spend a large part of their stay, as they recover from surgery,
wait for examinations to take place, etc.
2. 2. Question
A client with osteoarthritis has a prescription for celebrex (Celecoxib).
Which instruction should be included in the discharge teaching?
A. Take the medication with milk.
B. Report chest pain.
C. Remain upright after taking for 30 minutes.
D. Allow 6 weeks for optimal effects.
Incorrect
Correct Answer: B. Report chest pain.
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. Like all
NSAIDs, celecoxib carries an FDA boxed warning for cardiovascular
risk, including the increased risk of heart attacks and strokes. As a
selective COX-2 inhibitor, celecoxib also faces scrutiny for increased
cardiovascular risk, since another selective COX-2 inhibitor, rofecoxib,
was withdrawn from production in 2004 due to cardiovascular risk
concerns.
Options A: The medication can be taken with water. Celecoxib is
a medication that is taken orally and comes in 50, 100, 200, and
400 mg doses. In rare cases, celecoxib can also be added to
customized compounds for topical administration with or without
the use of iontophoresis or other topical delivery mechanisms. It
is not available via any other route of administration.
Option C: The client may remain upright but not necessarily for
30 minutes. Symptoms of celecoxib overdose would likely be
similar to overdoses of other NSAIDs, which include lethargy,
drowsiness, nausea, vomiting, and epigastric pain. Activated
charcoal may be administered for overdose treatment at the
discretion of emergency medical providers if the patient presents
, within 4 hours of known or suspected ingestion of significant
amounts of celecoxib.
Option D: Allow 6 weeks for optimal effect. In the inpatient
setting, as mentioned above, celecoxib is increasingly being used
as part of pre-operative and post-operative multimodal pain
management algorithms. Research has shown in several small
randomized trials that administering celecoxib peri-operatively
for elective procedures such as total hip arthroplasties, total knee
arthroplasties, and other procedures with some success in
reducing pain and improving functionality such as early
ambulation.
3. 3. Question
A client with a fractured tibia has a plaster-of-Paris cast applied to
immobilize the fracture. Which action by the nurse indicates an
understanding of a plaster-of-Paris cast? The nurse:
A. Handles the cast with the fingertips
B. Petals the cast
C. Dries the cast with a hair dryer
D. Allows 24 hours before bearing weight
Incorrect
Correct Answer: D. Allows 24 hours before bearing weight
A plaster-of-Paris cast takes 24 hours to dry, and the client should not
bear weight for 24 hours. After the process of applying the casting
material is completed, the material will start to dry in about 10 to 15
minutes. The temperature of the skin might rise as the plaster is drying
because of a chemical reaction that occurs. When plaster is used, it
can take from 1 to 2 days for the cast to harden completely.
Option A: The cast should be handled with the palms, not the
fingertips. Use the palm of hand to apply, hold, or move cast and
support on pillows after application. Uneven plaster is irritating to
the skin and may result in abrasions.
Option B: Petaling a cast is covering the end of the cast with
cast batting or a sock, to prevent skin irritation and flaking of the
skin under the cast. Trim excess plaster from edges of the cast as
soon as casting is completed; prevents skin breakdown caused by
prolonged moisture trapped under the cast.
, Option C: The client should be told not to dry the cast with a hair
dryer because this causes hot spots and could burn the client.
This also causes unequal drying. Promote cast drying by
removing bed linen, exposing it to circulating air; pressure can
cause ulcerations, necrosis, or nerve palsies. Pad (petal) the
edges of the cast with waterproof tape; provides an effective
barrier to cast flaking and moisture. Helps prevent the breakdown
of cast material at the edges and reduce skin irritation and
excoriation.
4. 4. Question
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?
A. "It will be alright for your friends to autograph the cast."
B. "Because the cast is made of plaster, autographing can weaken
the cast."
C. "If they don’t use chalk to autograph, it is okay."
D. "Autographing or writing on the cast in any form will harm the
cast."
Incorrect
Correct Answer: A. “It will be alright for your friends to
autograph the cast.”
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. Fiberglass has several advantages compared to
plaster. It weighs less, so the cast made from it will be lighter. More
durable and porous, fiberglass allows air to flow in and out. Fiberglass
is the better choice in case the limb must be X-rayed during the
healing process. It is also available in a variety of colors.
Option B: Plaster costs less than fiberglass and is more
malleable (is more easily shaped) than fiberglass in certain cases.
Plaster comes in strips or rolls that are moistened and rolled on
over the padding. Plaster materials are made from dry muslin
that is treated with starch or dextrose and calcium sulfate.
Option C: Keep the cast clean and dry. A hair dryer with a cool
setting may be used to dry a fiberglass cast if it becomes damp.
Call a doctor if the cast does not dry or if the skin under the cast
Questions)
1. 1. Question
Which roommate would be most suitable for the 6-year-old male with
a fractured femur in Russell’s traction?
o A. 16-year-old female with scoliosis
o B. 12-year-old male with a fractured femur
o C. 10-year-old male with sarcoma
o D. 6-year-old male with osteomyelitis
Incorrect
Correct Answer: B. 12-year-old male with a fractured femur
The 6-year-old should have a roommate as close to the same age as
possible, so the 12-year-old is the best match. A bed is available and
the patient gets assigned. There are certain constraints—sex, semi-
private versus private, isolation issues, acuity, telemetry and specialty
needs. All need to be taken into account to ensure that each patient
goes to the right place and receives the proper care. But good capacity
management demands that bed assignment be carefully considered
and executed.
Option A: The client is too old and is female. Bed assignment
simply provides the proper location based on specific patient
attributes like sex, isolation, telemetry, acuity, and specialty
needs.
Option C: The 10-year-old with sarcoma has cancer and will be
treated with chemotherapy that makes him immune suppressed.
Bed managers aim at finding an assignment of patients to rooms
that strikes a balance between patients’ preferences and comfort
on the one hand, and patients’ clinical conditions and the
resulting required room facilities on the other.
Option D: The 6-year-old with osteomyelitis is infectious. Rooms
and beds belong to the critical assets of just any hospital. They
account for a considerable part of a hospital’s infrastructure, and
a large amount of financial resources are invested in equipping
, them with medical apparatus to facilitate patient care.
Furthermore, they also represent the place where most patients
will spend a large part of their stay, as they recover from surgery,
wait for examinations to take place, etc.
2. 2. Question
A client with osteoarthritis has a prescription for celebrex (Celecoxib).
Which instruction should be included in the discharge teaching?
A. Take the medication with milk.
B. Report chest pain.
C. Remain upright after taking for 30 minutes.
D. Allow 6 weeks for optimal effects.
Incorrect
Correct Answer: B. Report chest pain.
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. Like all
NSAIDs, celecoxib carries an FDA boxed warning for cardiovascular
risk, including the increased risk of heart attacks and strokes. As a
selective COX-2 inhibitor, celecoxib also faces scrutiny for increased
cardiovascular risk, since another selective COX-2 inhibitor, rofecoxib,
was withdrawn from production in 2004 due to cardiovascular risk
concerns.
Options A: The medication can be taken with water. Celecoxib is
a medication that is taken orally and comes in 50, 100, 200, and
400 mg doses. In rare cases, celecoxib can also be added to
customized compounds for topical administration with or without
the use of iontophoresis or other topical delivery mechanisms. It
is not available via any other route of administration.
Option C: The client may remain upright but not necessarily for
30 minutes. Symptoms of celecoxib overdose would likely be
similar to overdoses of other NSAIDs, which include lethargy,
drowsiness, nausea, vomiting, and epigastric pain. Activated
charcoal may be administered for overdose treatment at the
discretion of emergency medical providers if the patient presents
, within 4 hours of known or suspected ingestion of significant
amounts of celecoxib.
Option D: Allow 6 weeks for optimal effect. In the inpatient
setting, as mentioned above, celecoxib is increasingly being used
as part of pre-operative and post-operative multimodal pain
management algorithms. Research has shown in several small
randomized trials that administering celecoxib peri-operatively
for elective procedures such as total hip arthroplasties, total knee
arthroplasties, and other procedures with some success in
reducing pain and improving functionality such as early
ambulation.
3. 3. Question
A client with a fractured tibia has a plaster-of-Paris cast applied to
immobilize the fracture. Which action by the nurse indicates an
understanding of a plaster-of-Paris cast? The nurse:
A. Handles the cast with the fingertips
B. Petals the cast
C. Dries the cast with a hair dryer
D. Allows 24 hours before bearing weight
Incorrect
Correct Answer: D. Allows 24 hours before bearing weight
A plaster-of-Paris cast takes 24 hours to dry, and the client should not
bear weight for 24 hours. After the process of applying the casting
material is completed, the material will start to dry in about 10 to 15
minutes. The temperature of the skin might rise as the plaster is drying
because of a chemical reaction that occurs. When plaster is used, it
can take from 1 to 2 days for the cast to harden completely.
Option A: The cast should be handled with the palms, not the
fingertips. Use the palm of hand to apply, hold, or move cast and
support on pillows after application. Uneven plaster is irritating to
the skin and may result in abrasions.
Option B: Petaling a cast is covering the end of the cast with
cast batting or a sock, to prevent skin irritation and flaking of the
skin under the cast. Trim excess plaster from edges of the cast as
soon as casting is completed; prevents skin breakdown caused by
prolonged moisture trapped under the cast.
, Option C: The client should be told not to dry the cast with a hair
dryer because this causes hot spots and could burn the client.
This also causes unequal drying. Promote cast drying by
removing bed linen, exposing it to circulating air; pressure can
cause ulcerations, necrosis, or nerve palsies. Pad (petal) the
edges of the cast with waterproof tape; provides an effective
barrier to cast flaking and moisture. Helps prevent the breakdown
of cast material at the edges and reduce skin irritation and
excoriation.
4. 4. Question
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?
A. "It will be alright for your friends to autograph the cast."
B. "Because the cast is made of plaster, autographing can weaken
the cast."
C. "If they don’t use chalk to autograph, it is okay."
D. "Autographing or writing on the cast in any form will harm the
cast."
Incorrect
Correct Answer: A. “It will be alright for your friends to
autograph the cast.”
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. Fiberglass has several advantages compared to
plaster. It weighs less, so the cast made from it will be lighter. More
durable and porous, fiberglass allows air to flow in and out. Fiberglass
is the better choice in case the limb must be X-rayed during the
healing process. It is also available in a variety of colors.
Option B: Plaster costs less than fiberglass and is more
malleable (is more easily shaped) than fiberglass in certain cases.
Plaster comes in strips or rolls that are moistened and rolled on
over the padding. Plaster materials are made from dry muslin
that is treated with starch or dextrose and calcium sulfate.
Option C: Keep the cast clean and dry. A hair dryer with a cool
setting may be used to dry a fiberglass cast if it becomes damp.
Call a doctor if the cast does not dry or if the skin under the cast
