Exam (elaborations) NR 322 PASSPOINT NCLEX QUESTIONS

NR 322 PASSPOINT NCLEX QUESTIONS Question 1 See full question The nurse is assessing a neonate born to a mother with type 1 diabetes. Which finding is expected? You Selected:  large size Correct response:  large size Explanation: Remediation: Question 2 See full question A client with chest pain, dyspnea, and an irregular heartbeat comes to the emergency department. An electrocardiogram shows a heart rate of 110 beats/minute (sinus tachycardia) with frequent premature ventricular contractions. Shortly after admission, the client has ventricular tachycardia and becomes unresponsive. After successful resuscitation, the client is taken to the intensive care unit (ICU). Which nursing diagnosis is the priority at this time? You Selected:  Fear related to threat of death Correct response:  Ineffective tissue perfusion (cardiopulmonary) related to arrhythmia Explanation: Remediation: Question 3 See full question The nurse is instructing the client on insulin administration. The client is performing a return demonstration for preparing the insulin. The client’s morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units? Record your answer using a whole number. NR 322 PASSPOINT NCLEX QUESTIONS Your Response:  32 Correct response:  32 Explanation: Remediation: Question 4 See full question The nurse is assessing a client during a home health visit. The client reports a severe burning on urination. What is the most important action by the nurse? You Selected:  Obtain a urine specimen from the client Correct response:  Obtain a urine specimen from the client Explanation: Remediation: Question 5 See full question A drug must enter the bloodstream before it can act within the body. Which parenteral administration route places a drug directly into the circulation, requiring no absorption? You Selected:  I.V. Correct response:  I.V. Explanation: Remediation: Question 6 See full question When documenting information in a client's medical record, which of the following should the nurse do consistently for each entry? You Selected:  Sign each entry by name and title. Correct response:  Sign each entry by name and title. Explanation: Remediation: Question 7 See full question Which of the following measures should a home healthcare nurse implement to minimize the potential for lawsuits? You Selected:  Perform thorough, accurate, and timely documentation. Correct response:  Perform thorough, accurate, and timely documentation. Explanation: Remediation: Question 8 See full question A nurse manager of the pediatric unit discovers that she is overbudget on supplies. How could each nurse assigned to the unit help with cost containment? You Selected:  Use care pathways to specify care and identify daily outcomes. Correct response:  Use care pathways to specify care and identify daily outcomes. Explanation: Question 9 See full question A pregnant adolescent admitted with premature uterine contractions was successfully treated with I.V. fluids. She is eager to return to high school to take a math test. The nurse's discharge examination reveals vaginal blood pooling under the adolescent's buttocks that's painless to the client. Which action should the nurse take? You Selected:  Stop the discharge process and notify the physician immediately. Correct response:  Stop the discharge process and notify the physician immediately. Explanation: Remediation: Question 10 See full question The nurse is conducting a routine risk assessment at a prenatal visit. Which question would be the best to screen for intimate partner violence? You Selected:  “How safe do you feel in your home?” Correct response:  “How safe do you feel in your home?” Explanation: Question 11 See full question Following a simple mastectomy, the nurse is totaling the amount of drainage in 24 hours from a suction drain in the incision. The nurse notes there is 200 mL of serosanguinous drainage for the first 24 hours. The nurse should: Correct response:  document the findings. Explanation: Remediation: Question 12 See full question When assessing an 18-year-old primipara who gave birth to a viable neonate under epidural anesthesia 24 hours ago, the nurse determines that the fundus is firm but to the right of midline. Based on this finding, the nurse should further assesses for: You Selected:  urinary retention. Correct response:  urinary retention. Explanation: Remediation: Question 13 See full question Parents of a school-age child with asthma express concern about letting the child participate in sports. What should the nurse tell the parents about the relationship between exercise and asthma? You Selected:  Taking prophylactic drugs before the activity can prevent asthma attacks and enable the child to engage in most sports. Correct response:  Taking prophylactic drugs before the activity can prevent asthma attacks and enable the child to engage in most sports. Explanation: Remediation: Question 14 See full question The nurse is assessing a client who is in her first trimester of pregnancy. The client states that her nausea has been problematic at times, but says that she is able to partially control it using ginger supplements. What is the nurse's best response? You Selected:  "Have you let your care provider know that you are taking ginger?" Correct response:  "Have you let your care provider know that you are taking ginger?" Explanation: Remediation: Question 15 See full question During the immediate postpartum period after giving birth to twins, the client experiences uterine atony. What should the nurse do first? You Selected:  Gently massage the fundus. Correct response:  Gently massage the fundus. Explanation: Remediation: Question 16 See full question A nurse is counseling a client at a crisis center after her house burned down and her daughter was killed. Which action by the nurse is a priority? You Selected:  To assist in psychological resolution of the immediate crisis Correct response:  To assist in psychological resolution of the immediate crisis Explanation: Question 17 See full question A client is suspected of having amyotrophic lateral sclerosis (ALS). To help confirm this disorder, the nurse prepares the client for various diagnostic tests. The nurse expects the physician to order: You Selected:  electromyography (EMG). Correct response:  electromyography (EMG). Explanation: Remediation: Question 18 See full question A child with type 1 diabetes is admitted to the emergency department with hot and dry skin, rapid and deep respirations, and a fruity odor to her breath. Which task, when performed by a new-graduate registered nurse (RN), requires the RN preceptor to intervene? You Selected:  Verification of child’s glucose by finger stick. Correct response:  Providing encouragement to the child to drink some orange juice. Explanation: Remediation: Question 19 See full question A client has been hospitalized with pancreatitis for 3 days. The nurse assesses the client and documents the accompanying results. The nurse realizes these findings are a manifestation of what sign? You Selected:  Chvostek's sign Correct response:  Cullen's sign Explanation: Remediation: Question 20 See full question A nurse is caring for a client who is exhibiting signs and symptoms characteristic of a myocardial infarction (MI). Which statement describes priorities the nurse should establish while performing the physical assessment? You Selected:  Correct response:  Assess the client's level of pain, and administer prescribed analgesics. Explanation: Remediation: Question 21 See full question A physician performs a bone marrow aspiration from the posterior iliac crest on a client with a platelet count of 80,000 mm3. Which intervention should the nurse perform after the procedure? You Selected:  Correct response:  Place pressure over the aspiration site for 5–10 minutes Explanation: Remediation: Question 22 See full question A laboratory assistant who is trying to view the electronic record of a client's personal history gets an error message: "You are not authorized to view this information." What is the reason for this message? You Selected:  The laboratory assistant can retrieve medical records but cannot view the details. Correct response:  The laboratory assistant can retrieve medical records but cannot view the details. Explanation: Question 23 See full question A client is discharged after an aortic aneurysm repair with a synthetic graft to replace part of the aorta. The nurse should instruct the client to notify the health care provider (HCP) before having: You Selected:  major dental work. Correct response:  major dental work. Explanation: Remediation: Question 24 See full question The nurse is teaching a client with multiple sclerosis about prevention of urinary tract infection (UTI) and renal calculi. Which of the following nutrition recommendations by the nurse would be the most likely to reduce the risk of these conditions? You Selected:  Increase fluids (2500 mL/day) and maintain urine acidity by drinking cranberry juice. Correct response:  Increase fluids (2500 mL/day) and maintain urine acidity by drinking cranberry juice. Explanation: Remediation: Question 25 See full question A nurse caring for a client diagnosed with schizophrenia should perform which of the following interventions when