NCLEX-PN Test Prep Questions and Answers with ExplanationsV2 PRACTICE EXAM 1 |2022/2023 UPDATE

NCLEX-PN Test Prep Questions and Answers with ExplanationsV2 PRACTICE EXAM 1 |2022/2023 UPDATE NCLEX-PN Test Prep Questions and Answers with Explanations V2 PRACTICE EXAM 1 (STUDY MODE) 1. A papular lesion is noted on the perineum of the laboring client. Which initial action is most appropriate? A. Document the finding B. Report the finding to the doctor C. Prepare the client for a C-section D. Continue primary care as prescribed Answer B: Any lesion should be reported to the doctor. This can indicate a herpes lesion. Clients with open lesions related to herpes are delivered by Cesarean section because there is a possibility of transmission of the infection to the fetus with direct contact to lesions. It is not enough to document the finding, so answer A is incorrect. The physician must make the decision to perform a C-section, making answer C incorrect. It is not enough to continue primary care, so answer D is incorrect. 2. A client with a diagnosis of human papillomavirus (HPV) is at risk for which of the following? A. Lymphoma B. Cervical and vaginal cancer C. Leukemia D. Systemic lupus Answer B: The client with HPV is at higher risk for cervical and vaginal cancer related to this STI. She is not at higher risk for the other cancers mentioned in answers A, C, and D, so those are incorrect. 3. The client seen in the family planning clinic tells the nurse that she has a painful lesion on the perineum. The nurse is aware that the most likely source of the lesion is: A. Syphilis B. Herpes C. Candidiasis D. Condylomata Answer B: A lesion that is painful is most likely a herpetic lesion. A chancre lesion associated with syphilis is not painful, so answer A is incorrect. In answer C, candidiasis is a yeast infection and does not present with a lesion, but it is exhibited by a white, cheesy discharge. Condylomata lesions are painless warts, so answer D is incorrect. 4. A client visiting a family planning clinic is suspected of having an STI. The most diagnostic test for treponema pallidum is: A. Venereal Disease Research Lab (VDRL) B. Rapid plasma reagin (RPR) C. Florescent treponemal antibody (FTA) D. Thayer-Martin culture (TMC) Answer C: FTA is the only answer choice for treponema pallidum. Answers A and B are incorrect because VDRL and RPR are screening tests for syphilis but are not conclusive of the disease; they only indicate exposure to the disease. The Thayer-Martin culture is a test for gonorrhea, so answer D is incorrect. 5. Which laboratory finding is associated with HELLP syndrome in the obstetric client? A. Elevated blood glucose B. Elevated platelet count C. Elevated creatinine clearance D. Elevated hepatic enzymes Answer D: The criteria for HELLP is hemolysis, elevated liver enzymes, and low platelet count. In answer A, an elevated blood glucose level is not associated with HELLP. Platelets are decreased in HELLP syndrome, not elevated, as stated in answer B. The creatinine levels are elevated in renal disease and are not associated with HELLP syndrome, as stated in answer C. 6. The nurse is assessing the deep tendon reflexes of the client with hypomagnesemia. Which method is used to elicit the biceps reflex? A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer. B. The nurse loosely suspends the client’s arm in an open hand while tapping the back of the client’s elbow. C. The nurse instructs the client to dangle her legs as the nurse strikes the area below the patella with the blunt side of the reflex hammer. D. The nurse instructs the client to place her arms loosely at her side as the nurse strikes the muscle insert just above the wrist. Answer A: The answer can only be A because the other methods elicit different reflexes. Answer B elicits the triceps reflex, answer C elicits the patella reflex, and answer D elicits the radial nerve. 7. Which medication should be used with caution in the obstetric client with diabetes? A. Magnesium sulfate B. Brethine C. Stadol D. Ancef Answer B: Brethine is used cautiously because it raises the blood glucose levels. Answers A, C, and D are all medications that are commonly used in the diabetic client, so there is no need to question the order for these medications. 8. A multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1. The nurse’s assessment of this data is: A. The infant is at low risk for congenital anomalies. B. The infant is at high risk for intrauterine growth retardation. C. The infant is at high risk for respiratory distress syndrome. D. The infant is at high risk for birth trauma. Answer C: When the L/S ratio reaches 2:1, the lungs are considered to be mature. The infant will most likely be small for gestational age and will not be at risk for birth trauma, so answer B is incorrect. The L/S ratio does not indicate congenital anomalies, as stated in answer A, and the infant is not at risk for intrauterine growth retardation, as stated in answer D. 9. Which observation in the newborn of a mother who is alcohol dependent would require immediate nursing intervention? A. Crying B. Wakefulness C. Jitteriness D. Yawning Answer C: Jitteriness is a sign of seizure in the neonate. Answers A, B, and D are incorrect because crying, wakefulness, and yawning are expected in the newborn. 10. The nurse caring for a client receiving magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is: A. Decreased urinary output B. Hypersomnolence C. Absence of knee jerk reflex D. Decreased respiratory rate Answer B: The client is expected to become sleepy, have hot flashes, and experience lethargy. A decreasing urinary output, absence of the knee jerk reflex, and decreased respirations are signs of toxicity and are not expected side effects of magnesium sulfate. Therefore, answers A, C, and D are incorrect. 11. The 57-year-old male client has elected to have epidural anesthesia as the anesthetic during a hernia repair. If the client experiences hypotension, the nurse would: A. Place him in the Trendelenburg position B. Obtain an order for Benedryl C. Administer oxygen per nasal cannula D. Speed the IV infusion of normal saline Answer D: If the client experiences hypotension after an injection of epidural anesthetic, the nurse should turn him to the left side if possible, apply oxygen by mask, and speed the IV infusion. Epinephrine, not Benedryl, in answer B, should be kept for emergency administration. A is incorrect because placing the client in Trendelenburg position (head down) will allow the anesthesia to move up above the respiratory center, thereby decreasing the diaphragm’s ability to move up and down, ventilating the client. Answer C is incorrect because the oxygen should be applied by mask, not cannula. 12. A client has cancer of the pancreas. The nurse should be most concerned with which nursing diagnosis? A. Alteration in nutrition B. Alteration in bowel elimination C. Alteration in skin integrity D. Ineffective individual coping Answer A: Cancer of the pancreas frequently leads to severe nausea and vomiting. Answers B, C, and D are incorrect because although they are a concern to the client, they are not the priority nursing diagnosis. 13. The nurse is caring for a client with ascites. Which is the best method to use for determining early ascites? A. Inspection of the abdomen for enlargement