NCLEX NCLEX-PN
Best NCLEX Next Gen Prep
1. When assisting the physician in performing transillumination of a client's scrotum, how should the nurse prepare for this procedure?
- A. Obtaining a flashlight and darkening the room
- B. Instructing the client to drink three glasses of water
- C. Instructing the client to take several deep breaths and bear down
- D. Telling the client that the procedure is very uncomfortable but that the discomfort will only last for a few moments
Correct answer: Obtaining a flashlight and darkening the room
Rationale: When preparing for transillumination of the scrotum, the nurse should obtain a flashlight and darken the room. This is done to allow the strong flashlight to be shined from behind the scrotal contents. Normal scrotal contents do not appear on transillumination. Instructing the client to drink fluids or to take deep breaths and bear down is not part of the preparation for this procedure. Additionally, it is not necessary to inform the client that the procedure is uncomfortable as transillumination is a painless procedure.
2. A 2-year-old child diagnosed with HIV comes to a clinic for immunizations. Which of the following vaccines should the nurse expect to administer in addition to the scheduled vaccines?
- A. pneumococcal vaccine
- B. hepatitis A vaccine
- C. Lyme disease vaccine
- D. typhoid vaccine
Correct answer: pneumococcal vaccine
Rationale: For a 2-year-old child diagnosed with HIV, in addition to the scheduled vaccines, the nurse should expect to administer the pneumococcal vaccine. Children with HIV are at an increased risk of infections, including pneumococcal disease. The pneumococcal vaccine helps protect against serious pneumococcal infections like pneumonia, meningitis, and bacteremia. The hepatitis A vaccine is not specifically recommended for all children with HIV unless there are specific risk factors. The Lyme disease vaccine is for individuals at risk for Lyme disease, typically between the ages of 15 and 70, transmitted by ticks. The typhoid vaccine is usually recommended for individuals traveling to endemic areas or working in specific high-risk occupations like microbiology laboratories dealing with Salmonella typhi.
3. A patient reports, “I tore 3 of my 4 Rotator cuff muscles in the past.” Which of the following muscles cannot be considered as possibly being torn?
- A. Teres minor
- B. Teres major
- C. Supraspinatus
- D. Infraspinatus
Correct answer: Teres major
Rationale: The correct answer is Teres major. The Rotator Cuff consists of Teres Minor, Infraspinatus, Supraspinatus, and Subscapularis muscles, not Teres major. Teres major is not part of the rotator cuff, so it cannot be considered as possibly being torn. The other choices, Teres minor, Supraspinatus, and Infraspinatus, are all part of the Rotator Cuff and could potentially be torn in this patient's case.
4. While observing a client using crutches for a leg injury, which action would indicate a need for more education by the LPN?
- A. The client places the top padding 1–2 inches below the axilla with a firm grip on the handles.
- B. The client rests the axilla on the top padding and loosely grips the handles with hands.
- C. The client has a slight bend in the elbow when using the handles.
- D. When going down the stairs, the client leads with the injured leg.
Correct answer: The client rests the axilla on the top padding and loosely grips the handles with hands.
Rationale: The correct answer is B. Resting the axilla on the top padding can cause nerve damage; instead, the client should place the top padding 1–2 inches below the axilla with a firm grip on the handles for proper support and stability while using crutches. Having a slight bend in the elbow when using the handles (choice C) is a correct technique to ensure proper weight distribution. Leading with the uninjured leg when going down the stairs (choice D) is the correct way to maintain balance and prevent further injury to the injured leg. Therefore, choice B indicates a need for more education to prevent potential nerve damage and ensure safe crutch use.
5. Which of the following represents a normal serum potassium level?
- A. 1.5 mEq/L
- B. 3.0 mEq/L
- C. 4.0 mEq/L
- D. 6.0 mEq/L
Correct answer: 4.0 mEq/L
Rationale: The correct answer is 4.0 mEq/L. Normal serum potassium levels typically range from 3.5–5.5 mEq/L. Choice A (1.5 mEq/L) is below the normal range, Choice B (3.0 mEq/L) is also below the normal range, and Choice D (6.0 mEq/L) is above the normal range. Therefore, the only option within the normal range is Choice C (4.0 mEq/L).
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