NCLEX NCLEX-PN
Nclex Exam Cram Practice Questions
1. Which of the following tasks are appropriate for an LPN to perform? Select all that apply.
- A. Adjusting the cervical traction device of a 68-year-old client as instructed by the charge nurse.
- B. Teaching a 24-year-old first-time mother how to properly care for her new baby.
- C. Assessing a 36-year-old man newly admitted for chest pain.
- D. Obtaining an occult blood sample from a 16-year-old client with ulcerative colitis.
Correct answer: B, D
Rationale: Tasks appropriate for an LPN to perform include teaching, obtaining samples, and documenting. LPNs can educate clients on care practices, such as teaching a new mother how to care for her baby. Obtaining samples, like an occult blood sample, falls within the scope of an LPN's responsibilities. Assessments, especially initial assessments, should be conducted by a registered nurse or physician, making option C incorrect. Adjusting devices like a cervical traction device should be done based on direct orders from prescribing providers, not charge nurses, making option A inappropriate for an LPN's role.
2. At what age are yearly mammograms recommended to start?
- A. Yearly mammograms are recommended starting at age 25.
- B. Yearly mammograms are recommended starting at age 40.
- C. Yearly mammograms are not necessary unless there is a family history of breast cancer.
- D. Yearly mammograms are recommended starting at age 20 and continuing until menopause begins.
Correct answer: Yearly mammograms are recommended starting at age 40.
Rationale: The correct answer is B. The American Cancer Society recommends yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. Clinical breast examination should be done about every 3 years for women in their 20s and 30s and every year for women age 40 and older. Women should know how their breasts normally look and feel and report any breast change promptly to the healthcare provider. Breast self-examination should be done monthly starting when a woman is in her 20s. Choice A is incorrect as mammograms are not recommended to start at age 25. Choice C is incorrect as yearly mammograms are still recommended even without a family history of breast cancer. Choice D is incorrect as the recommended age for starting yearly mammograms is 40, not 20.
3. The client is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin?
- A. Cyanocobalamin
- B. Protamine sulfate
- C. Streptokinase
- D. Sodium warfarin
Correct answer: Protamine sulfate
Rationale: The correct answer is Protamine sulfate. Protamine sulfate is the antidote for heparin, as it reverses its effects. Cyanocobalamin is a form of Vitamin B12 and is not used to reverse heparin effects. Streptokinase is a thrombolytic agent that is used to dissolve blood clots, not to reverse heparin effects. Sodium warfarin is an anticoagulant, but it is not the antidote for heparin. Therefore, answers A, C, and D are incorrect as they do not reverse the effects of heparin.
4. A case management clinical pathway for congestive heart failure might include all of the following except:
- A. physician follow-up appointments with transportation
- B. client education regarding medication use
- C. a nutritional consult for diet review and accommodation
- D. insurance review for reimbursement
Correct answer: insurance review for reimbursement
Rationale: In a case management clinical pathway for congestive heart failure, the focus is on providing medical care and support to the patient. Choices A, B, and C are integral parts of managing congestive heart failure. Physician follow-up appointments with transportation ensure continuity of care, client education about medication use is crucial for adherence, and a nutritional consult helps in managing the patient's diet. However, insurance review for reimbursement is not typically part of the clinical pathway as it pertains to financial aspects and is usually handled by billing departments or external agencies. Therefore, the correct answer is 'insurance review for reimbursement.'
5. How should the LPN document pain for a non-verbal client using the FLACC pain scale with these findings?
- A. 1
- B. 4
- C. 3
- D. 2
Correct answer: B
Rationale: The correct answer is B: '4'. The FLACC pain scale assesses pain in non-verbal patients based on five categories: Face, Legs, Activity, Cry, and Consolability. In this case, the client exhibits occasional grimacing (1 point), relaxed legs (0 points), squirming (1 point), moans and whimpers (1 point), and is distractible (1 point). Adding these points together results in a total pain score of 4. Therefore, the LPN should document a pain score of 4 for this non-verbal client. Choices A, C, and D are incorrect as they do not accurately reflect the total pain score based on the given findings.
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