Exam Cram NCLEX RN Practice Questions

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A child diagnosed with Hepatitis A is under the care of a healthcare provider. Which of the following precautions would be most important to take to prevent the transmission of this infectious disease?

  • A. Encourage the Hepatitis A vaccine for family members and siblings
  • B. Use needleless systems if possible; otherwise, use careful needle precautionary measures
  • C. Teach the child and enforce strict and frequent hand washing
  • D. Teach the child and family about the dangers of contaminated food and water
Correct Answer: C

Rationale: The most crucial precaution to prevent the transmission of Hepatitis A is to emphasize strict and frequent hand washing. Hepatitis A is a virus that spreads through the oral-fecal route and can survive on human hands. Hand washing is the most effective measure to reduce the risk of transmission. Encouraging the Hepatitis A vaccine for family members and siblings (Choice A) is beneficial for prevention but not as directly impactful as hand washing. While needle precautions (Choice B) are important in healthcare settings, they are not directly relevant to preventing the spread of Hepatitis A. Teaching about the dangers of contaminated food and water (Choice D) is important for general hygiene but may not be as effective as emphasizing hand hygiene in preventing the spread of Hepatitis A.

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A child presents to the emergency department with colicky abdominal pain in the lower right quadrant. What disorder is suspected based on these symptoms?

  • A. Peritonitis
  • B. Appendicitis
  • C. Intussusception
  • D. Hirschsprung's disease
Correct Answer: B

Rationale: The child's presentation of colicky abdominal pain in the lower right quadrant is classic for appendicitis. Appendicitis typically presents with localized pain that starts near the umbilicus and then shifts to the right lower quadrant. Peritonitis, on the other hand, is characterized by diffuse abdominal pain, tenderness, and guarding, usually resulting from organ perforation or intestinal obstruction. Intussusception is associated with acute, severe abdominal pain and currant jelly-like stools due to intestinal telescoping. Hirschsprung's disease, which lacks ganglion cells in the colon, manifests with symptoms like constipation, abdominal distension, and foul-smelling, ribbon-like stools.

The nurse has just admitted a client with severe depression. From which focus should the nurse identify a priority nursing diagnosis?

  • A. Nutrition
  • B. Elimination
  • C. Activity
  • D. Safety
Correct Answer: D

Rationale: In caring for a client with severe depression, safety is a critical priority. The nurse must address precautions to prevent suicide as part of the care plan. While nutrition, elimination, and activity are important aspects of care, safety takes precedence due to the immediate risk of harm associated with depression. Ensuring the client's safety by implementing measures to prevent self-harm or suicide is the priority intervention. Addressing nutrition, elimination, and activity can follow once the client's safety is assured.

During an intake screening for a patient with hypertension who has been taking ramipril for 4 weeks, which statement made by the patient would be most important for the nurse to pass on to the physician?

  • A. ''I get dizzy when I get out of bed.''
  • B. ''I'm urinating much more than I used to.''
  • C. ''I've been running on the treadmill for 10 minutes each day.''
  • D. ''I can't get rid of this cough.''
Correct Answer: D

Rationale: The correct answer is ''I can't get rid of this cough.'' Ramipril, an ACE inhibitor, commonly causes a persistent, dry cough as an adverse effect. This symptom can be indicative of bradykinin accumulation caused by ACE inhibitors. It is important for the nurse to inform the physician about this side effect so that a medication change to another class of antihypertensives, such as an ARB, may be considered. Choices A, B, and C are not directly related to the common adverse effects of ramipril and are not as concerning for a patient on this medication.

A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse expects to provide teaching about which client problem?

  • A. Odor
  • B. Nausea
  • C. Malaise
  • D. Diarrhea
Correct Answer: A

Rationale: Encopresis is the repeated voluntary or involuntary passage of feces of normal or near-normal consistency in places not appropriate for that purpose according to the individual's own sociocultural setting. Signs of encopresis include evidence of soiled clothing, scratching or rubbing the anal area due to irritation, fecal odor without apparent awareness by the child, and social withdrawal. Teaching about odor is essential to address the issue of encopresis. Choices B, C, and D are incorrect because encopresis is not typically associated with nausea, malaise, or diarrhea. Therefore, teaching about these symptoms would not be relevant in the context of encopresis.

Which of the following diseases or disorders is acute?

  • A. Pneumonia
  • B. Paralysis
  • C. Alzheimer's disease
  • D. Diabetes
Correct Answer: A

Rationale: The correct answer is Pneumonia. Pneumonia is an acute illness characterized by inflammation of the air sacs in the lungs. It comes on suddenly and typically lasts for a short duration. Treatment can help cure pneumonia. Paralysis, Alzheimer's disease, and Diabetes are chronic conditions. Paralysis is the loss of muscle function in part of the body, usually permanent. Alzheimer's disease is a progressive brain disorder leading to memory loss and cognitive decline, and it is incurable. Diabetes is a chronic condition that affects how your body turns food into energy, and it requires lifelong management. Therefore, Pneumonia is the only acute condition among the options provided.

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