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Nclex Mastery Class Quiz

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Nclex Academy Mastery Day 1 – Morning

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NCLEX ACADEMY MASTERY DAY 1 – MORNING

DAY ONE – MORNING ASSESSMENT

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1 / 30

The nurse is assessing an infant on the first office visit after birth. The mother asks the nurse when the chickenpox vaccination should be given. What is the best nursing response?

2 / 30

You are caring for a young client with diabetes who has sustained injuries when she tried to commit suicide by crashing her car. Her blood glucose level is 650 mg/dL, but she refuses insulin; however, she wants the pain medication. What is the best action?

3 / 30

You are caring for a young man with a history of substance abuse who had exploratory abdominal surgery 4 days ago for a knife wound. There is an order to discontinue the PCA-delivered morphine and to start oral pain medication. The client begs, “Please don’t stop the morphine. My pain is really a lot worse today than it was yesterday.” What is the best response?

4 / 30

A client has severe pain and bladder distention related to urinary retention and possible obstruction. An experienced UAP states that she received training in Foley catheter insertion at a previous job. What task can be delegated to this UAP?

5 / 30

Pain disorder and depression have been diagnosed for a client. He reports chronic low back pain and states, “None of these doctors has done anything to help.” Which client statement concerns you the most?

6 / 30

A client’s family member says to you, “He needs more pain medicine. He is still having a lot of pain.” What is your best response?

7 / 30

Which clients can be appropriately assigned to a newly graduated RN who has recently completed orientation? (Select all that apply.)

8 / 30

You are caring for a client who had abdominal surgery yesterday. The client is restless and anxious and tells you that the pain is getting worse despite the pain medication. Physical assessment findings include the following: temperature, 100.3° F (38° C); pulse rate, 110 beats/min; respiratory rate, 24 breaths/min; and blood pressure, 140/90 mm Hg. The abdomen is rigid and tender to the touch. You decide to notify the client’s provider. Place the following report information in the correct order according to the SBAR format.

9 / 30

Which clients can be appropriately assigned to an LPN/LVN who will function under the supervision of an RN or team leader? (Select all that apply.)

10 / 30

What is the best way to schedule medication for a client with constant pain?

11 / 30

The team is providing emergency care to a client who received an excessive dose of narcotic pain medication. Which task is best to delegate to the LPN/LVN?

12 / 30

On the first day after surgery, a client receiving an analgesic via PCA pump reports that the pain control is inadequate. What is the first action you should take?

13 / 30

You have received the shift report from the night nurse. Prioritize the order in which you will check on the following clients.

14 / 30

For a cognitively impaired client who cannot accurately report pain, what is the first action that you should take?

15 / 30

The physician has ordered a placebo for a client with chronic pain. You are a newly hired nurse and you feel very uncomfortable administering the medication. What is the first action that you should take?

16 / 30

In the care of clients with pain and discomfort, which task is most appropriate to delegate to the UAP?

17 / 30

A client’s opioid therapy is being tapered off, and the nurse is watchful for signs of withdrawal. What is one of the first signs of withdrawal?

18 / 30

A client is crying and grimacing but denies pain and refuses pain medication, because “my sibling is a drug addict and has ruined our lives.” What is the priority intervention for this client?

19 / 30

Which client is at greatest risk for respiratory depression while receiving opioids for analgesia?

20 / 30

A client received “as needed” (PRN) morphine, lorazepam (Ativan), and cyclobenzaprine (Flexeril). The UAP reports that the client has a respiratory rate of 10/min. What is the priority action?

21 / 30

For client education about nonpharmaceutical alternatives, which topic could you delegate to an experienced LPN/LVN, who will function with your continued support and supervision?

22 / 30

When an analgesic is titrated to manage pain, what is the priority goal?

23 / 30

Which client has the most immediate need for IV access to deliver immediate analgesia with rapid titration?

24 / 30

In application of the principles of pain treatment, what is the first consideration?

25 / 30

Which clients must be assigned to an experienced RN? (Select all that apply.)

26 / 30

As the charge nurse, you are reviewing the charts of clients who were assigned to the care of a newly graduated RN. The RN has correctly charted dose and time of medication, but there is no documentation regarding nonpharmaceutical measures. What action should you take first?

27 / 30

Which client is most likely to receive opioids for extended periods of time?

28 / 30

A client with diabetic neuropathy reports a burning, electrical-type pain in the lower extremities that is worse at night and not responding to nonsteroidal anti-inflammatory drugs. Which medication will you advocate for first?

29 / 30

Family members are encouraging your client to “tough out the pain” rather than risk drug addiction to narcotics. The client is stoically abiding. You recognize that the sociocultural dimension of pain is the current priority for the client. Which question will you ask?

30 / 30

You are the charge nurse. A client with chronic pain reports to you that the nurses have not been responding to requests for pain medication. What is your initial action?

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Nclex Academy Mastery Day 1 – Evening

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NCLEX ACADEMY MASTERY DAY 1 – EVENING

DAY ONE – EVENING ASSESSMENT

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1 / 21

What would the nurse expect to find when exploring a 9-year-old’s concept of death?

2 / 21

The nurse is caring for an older adult client who is on bed rest. What considerations should be made for the client’s nutritional intake?

3 / 21

A preschool child has a history of an appendectomy and is scheduled for an open reduction and internal fixation of the femur. What would be appropriate for preoperative teaching?

4 / 21

A preschool-age child is admitted to the hospital for treatment of pneumonia. The mother is embarrassed because the child has voided in the bed, which the child has not done since he was toilet-trained. Which of the following statements by the nurse would be appropriate?

5 / 21

Which of the following is a priority teaching topic for the parents of a school-age child?

6 / 21

A client who is scheduled for a colonoscopy is instructed to take nothing except clear liquids for 6 hours before the procedure. What comment by the client would indicate to the nurse that the client does not understand the concept of clear liquids?

7 / 21

A child is diagnosed with a severe case of rubeola. The nurse would question which of the following orders.

8 / 21

In clients 65 years of age and older, how is death most commonly viewed?

9 / 21

An infant with a diagnosis of acquired immunodeficiency disease syndrome (AIDS) has a nursing diagnosis of altered growth and development on the nursing care plan. Which nursing measure would enhance growth and development in the infant?

10 / 21

A toddler is admitted after taking an unknown number of acetaminophen tablets. Which of the following symptoms would the nurse expect to find on her assessment? Select all that apply.

11 / 21

A client comes to the emergency department with a deep penetrating wound he received in his garden. What is an important nursing action?

12 / 21

A mother brings her 5-year-old daughter to the wellness clinic complaining of a rash covering the child’s body. The nurse recognizes the rash as chickenpox (varicella), which is characterized by:

13 / 21

The nurse is assisting in the discharge preparation of a new mother and her infant. The mother asks when the immunizations will begin for her infant. What is the best nursing response?

14 / 21

Planning anticipatory guidance is an important nursing function. Considering the teaching for the family of an 18-month-old girl, which comment by the mother indicates she understands safety concerns?

15 / 21

The nurse is serving a food tray to a client who has glomerulonephritis and azotemia. Which food selection would the nurse question?

16 / 21

The nurse is discussing nutrition with a woman who is 50 years old, perimenopausal, and has a history of hypertension. What food choices would be best to help meet the dietary needs of this client?

17 / 21

What are appropriate toys for an 18-month-old infant to have for play while in isolation?

18 / 21

Which of the following actions would the nurse recommend to provide a 12-month-old infant with nutrients for growth?

19 / 21

When obtaining a health history from an older client, the nurse must take which characteristics of the older client into consideration?

20 / 21

An 8-month-old infant is sitting contentedly on the mother’s lap. The nurse is preparing to perform a well-baby checkup. Which of the following steps should the nurse do first?

21 / 21

Which behavior indicates that an 18-month-old infant is developing a nonadaptive reaction to hospitalization?

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Nclex Academy Mastery Day 2 – Morning

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NCLEX ACADEMY MASTERY DAY 2 – MORNING

DAY TWO – MORNING ASSESSMENT

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1 / 25

You are the charge nurse. Two hours into the shift you discover that two nurses have switched patients because Nurse A does “not like to take care of patients with prostate cancer.” Which action should you take first?

2 / 25

You are caring for a patient with uterine cancer who is being treated with intracavitary radiation therapy. The UAP reports that the patient insisted on ambulating to the bathroom and now “something feels like it is coming out.” What is the priority action?

3 / 25

You are asked to float to a different nursing unit. During report, you are told that the patient is receiving IV administration of vincristine (Oncovin) that should be completed within the next 15 minutes. The IV site is intact, and the patient is not having any problems with the infusion. You are not certified in chemotherapy administration. What is your priority action?

4 / 25

You are providing end-of-life-care for a patient with terminal liver cancer. The patient is weak and restless. Her skin is cool and mottled. Dyspnea develops and the patient appears anxious and frightened. What should you do?

5 / 25

A primary nursing responsibility is the prevention of lung cancer by assisting patients in cessation of smoking or other tobacco use. Which task would be appropriate to delegate to an LPN/LVN?

6 / 25

In the care of a patient with neutropenia, what tasks can be delegated to a UAP? (Select all that apply.)

7 / 25

A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient?

8 / 25

People at risk are the target populations for cancer screening programs. Which of these asymptomatic patients need extra encouragement to participate in cancer screening? (Select all that apply.)

9 / 25

Following chemotherapy, a patient is being closely monitored for tumor lysis syndrome. Which laboratory value requires particular attention?

10 / 25

An athletic young man was recently diagnosed with Ewing sarcoma. He has pain, lowgrade fever, and anemia. The surgeon recommends amputation of the right lower leg for an operable tumor. The patient tells you he is leaving the hospital to go on a long hiking trip. What is the priority nursing diagnosis?

11 / 25

Which two cancer patients could potentially be placed together as roommates?

12 / 25

For a patient with osteogenic sarcoma, which laboratory value causes you the most concern?

13 / 25

The physician tells the patient with cancer that there will be an initial course of treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a prolonged period of time. Which patient statement would concern you the most?

14 / 25

You are monitoring your patient who is at risk for spinal cord compression related to tumor growth. Which patient statement is most likely to suggest an early manifestation?

15 / 25

You have just received the morning report from the night shift nurse. List the order of priority for assessing and caring for the following patients.

16 / 25

When staff assignments are made for the care of patients who are receiving chemotherapy, what is the major consideration regarding chemotherapeutic drugs?

17 / 25

For care of a patient who has oral cancer, which task would be appropriate to delegate to an LPN/LVN?

18 / 25

For a patient who is receiving chemotherapy, which laboratory result is of particular importance?

19 / 25

For a patient receiving the chemotherapeutic drug vincristine (Oncovin), which side effects should be reported to the physician?

20 / 25

For a patient who is experiencing side effects of radiation therapy, which task would be the most appropriate to delegate to the UAP?

21 / 25

When care assignments are being made for patients with alterations related to gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/LVN under the supervision of a team leader RN?

22 / 25

Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease processes. Which actions are needed for patients who must be placed on bleeding precautions? (Select all that apply.)

23 / 25

Which patient is at greatest risk for pancreatic cancer?

24 / 25

A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history of colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?

25 / 25

By the age of 9 or 10 years, the child has developed the mental and emotional security to express an understanding of death as a final and inevitable outcome of life. The preschooler sees death as temporary or as a punishment.

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Nclex Academy Mastery Day 2 – Evening

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NCLEX ACADEMY MASTERY DAY 2 – EVENING

DAY TWO – EVENING ASSESSMENT

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1 / 14

A postoperative patient receives a dinner tray with gelatin, pudding, and vanilla ice cream. Based on the foods on the client’s tray, what would the nurse anticipate the client’s current diet order to be?

2 / 14

At the beginning of the shift, the nurse receives a report on a client.
He is receiving IV therapy at 125 mL/hr. The nasogastric tube is patent and draining green drainage at about 75 mL/hr. New physician orders include the following: Vancomycin (Vancocin) 500 mg IVPB in 50 mL D5W over 60 minutes, every 8 hours. Metoclopramide (Reglan) 10 mg IVPB in 50 mL D5W over 30 minutes, every 8 hours. One unit of 250 mL of packed red blood cells to run concurrent with the IV; infuse unit over 4 hours. Irrigate the nasogastric tube with 30 mL NS every 2 hours.
How many milliliters should the nurse document as the intake for the 8- hour shift?

3 / 14

The nurse is admitting a woman who is scheduled for a total hip replacement. What is the most effective way to initiate the health interview?

4 / 14

A client is admitted with a diagnosis of terminal cancer, and he is experiencing severe pain. The doctor has written an order for pain medication every 3 hours PRN. How will the nurse plan to administer the pain medication?

5 / 14

A client is scheduled for major surgery. What is most important for the nurse to do before surgery?

6 / 14

The nurse is designing a teaching plan for a 3-year-old in preparation for a surgical procedure. What teaching strategies should be included in the plan of care? Select all that apply:

7 / 14

The nurse is preparing the preoperative client for surgery. Which of the following statements indicate to the nurse that the client is knowledgeable about his impending surgery? Select all that apply:

8 / 14

A 1-year-old infant has ibuprofen (Advil) ordered every 6 hours. It has been 6 hours since the last dose, and his parent has requested that the child receive his pain medication. When the nurse enters the room, the child is asleep. The parent requests that the pain medication be given because the child is still restless in sleep. What is the best nursing action?

9 / 14

In the recovery room, the postoperative client suddenly becomes restless with circumoral cyanosis. What is the first nursing action?

10 / 14

Which of the following clients would be at an increased risk for the development of a pulmonary embolus?

11 / 14

The nurse has received a report on assigned clients. In planning the initial assessment of each client, what is the best approach?

12 / 14

The nurse is preparing a client for surgery. Which of the following items on the client’s presurgery lab results would indicate a need to contact the surgeon?

13 / 14

The nurse is caring for a client who is dying. How will the nurse provide psychosocial comfort for the family and the client in the period before death?

14 / 14

The nurse is preparing to take a blood pressure on a client who is obese. What is the most effective method for obtaining an accurate blood pressure reading from this client?

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Nclex Academy Mastery Day 3 – Morning

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NCLEX ACADEMY MASTERY DAY 3 – MORNING

DAY THREE – MORNING ASSESSMENT

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1 / 20

A patient seen in the sexually-transmitted disease clinic has just tested positive for HIV with a rapid HIV test. Which action will you take next?

2 / 20

A patient who is HIV-positive and is taking nucleoside reverse transcriptase inhibitors and a protease inhibitor is admitted to the psychiatric unit with a panic attack. Which information about the patient is most important to discuss with the health care provider?

3 / 20

As the hospital employee health nurse, you are completing a health history for a newly-hired staff member. Which information given by the new employee most indicates the need for further nursing action before he or she begins orientation to patient care?

4 / 20

A patient with SLE is admitted to the hospital for evaluation and management of acute joint inflammation. Which information obtained in the admission laboratory testing concerns you most?

5 / 20

A patient with wheezing and coughing caused by an allergic reaction to penicillin is admitted to the emergency department. Which medication do you anticipate administering first?

6 / 20

An 18-year-old college student with an exacerbation of systemic lupus erythematosus (SLE) has been receiving prednisone (Deltasone) 20 mg daily for 4 days. Which medical order should you question?

7 / 20

You assess a 24-year-old patient with RA who is considering using methotrexate (Rheumatrex) for treatment. Which patient information is most important to communicate to the health care provider?

8 / 20

A hospitalized patient with AIDS has a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements related to nausea and anorexia. Which nursing action is most appropriate to delegate to an LPN/LVN who is providing care to this patient?

9 / 20

An HIV-positive patient who has been started on HAART is seen in the clinic for follow-up. Which test will be most helpful in determining the response to therapy?

10 / 20

A patient with a history of liver transplantation is receiving cyclosporine
(Sandimmune), prednisone (Deltasone), and mycophenolate (CellCept). Which finding is of most concern?

11 / 20

A patient with chronic hepatitis C has been receiving interferon alfa-2a (Roferon-A) injections for the last month. Which information gathered during a home visit is most important to communicate to the physician?

12 / 20

Your patient with rheumatoid arthritis (RA) is taking prednisone (Deltasone) and naproxen (Aleve) to reduce inflammation and joint pain. Which symptom is most important to communicate to the health care provider?

13 / 20

A patient who has received a kidney transplant has been admitted to the medical unit with acute rejection and is receiving IV cyclosporine (Sandimmune) and methylprednisolone (Solu-Medrol). Which staff member is best to assign to care for this patient?

14 / 20

You are working in an AIDS hospice facility that is also staffed with LPNs/LVNs and UAPs. Which nursing action will you delegate to the LPN/LVN you are supervising?

15 / 20

A patient with newly diagnosed acquired immunodeficiency syndrome (AIDS) has a negative result on a skin test for tuberculosis (TB). Which action will you anticipate taking next?

16 / 20

After interviewing an HIV-positive patient who is considering starting highly active antiretroviral therapy (HAART), which patient information concerns you the most?

17 / 20

You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a treatment for Pneumocystis jiroveci (PCP) pneumonia. Which information is most important to communicate to the physician?

18 / 20

You are working with a student nurse to care for an HIV-positive patient with severe esophagitis caused by Candida albicans. Which action by the student indicates that you need to intervene most quickly?

19 / 20

A few minutes after you have given an intradermal injection of an allergen to a patient who is undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and dizzy. Which action included in the emergency protocol should you take first?

20 / 20

As the nurse manager in a public health department, you are implementing a plan to reduce the incidence of infection with human immunodeficiency virus (HIV) in the community. Which nursing action will you delegate to health assistants working for the agency?

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Nclex Academy Mastery Day 3 – Evening

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NCLEX ACADEMY MASTERY DAY 3 – EVENING

DAY THREE – EVENING ASSESSMENT

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1 / 13

A nurse manager has been notified to obtain a bed for a client. Of the following clients, which one would the nurse anticipate being able to discharge?

2 / 13

The charge nurse is planning assignments for the nursing staff. One of the staff nurses is pregnant. Which client would not be appropriate to assign to this nurse?

3 / 13

The nurse receives a hand-off communication report for the change of shift. Which client should the nurse see first?

4 / 13

Which of the following most clearly represents a situation of assault?

5 / 13

The physician asks the nurse to give a client a medication that the nurse knows the client is allergic to. When the nurse tries to point this out to the physician, the physician threatens to tell the nurse’s supervisor. What is the best response?

6 / 13

The nurse stopped on the highway at a multiple fatal accident to provide assistance. Immediately after the incident, the family members were appreciative of the help the nurse provided. They offered to replace the nurse’s soiled clothes. If the nurse accepts, which rights were in violation?

7 / 13

The nurse is involved in a legal case against the hospital. Which judgment error by the nurse would be considered most damaging?

8 / 13

What is the nurse’s best approach to avoid claims of negligence?

9 / 13

While caring for an 8-year-old child with a broken wrist, the nurse notices red, raised streaks on the child’s back. The child’s father enters the room and the child becomes quiet and distant, leaning away from the father as he approaches. What is the best nursing action?

10 / 13

Which of the following would the nurse identify as an indication that the client understands the informed consent document?

11 / 13

Which of the following would not be considered a violation of HIPAA?

12 / 13

Most states have reporting laws that require health care workers to report certain situations and behavior to authorities. Which is not usually a reportable matter?

13 / 13

The nurse enters data on a paper chart and then discovers he or she has written on the wrong chart. How this error is best corrected?

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Nclex Academy Mastery Day 4 – Morning

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NCLEX ACADEMY MASTERY DAY 4 – MORNING

DAY FOUR – MORNING ASSESSMENT

The number of attempts remaining is 1

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1 / 23

The RN is providing care for a patient diagnosed with dehydration and hypovolemic shock. Which order should the RN question?

2 / 23

Which blood test result would you be sure to monitor for the client taking HCTZ?

3 / 23

The client has an order for hydrochlorothiazide (HCTZ, Microzide) 10 mg orally every day. What should you be sure to include in a teaching plan for this drug? (Select all that apply.)

4 / 23

The client has a nasogastric (NG) tube connected to intermittent wall suction. The student nurse asks why the client’s respiratory rate has decreased. What is your best response?

5 / 23

A client is admitted to your unit for chemotherapy. To prevent an acid-base problem, which finding would you instruct the UAP to report?

6 / 23

The UAP reports to you that a client seems very anxious, and vital sign measurement included a respiratory rate of 38 breaths/min. Which acid-base imbalance should you suspect?

7 / 23

A client with lung cancer has received oxycodone (Roxicodone) 10 mg orally for pain. When the student nurse assesses the client, which finding would you instruct the student to report immediately?

8 / 23

You are admitting an older adult client to the medical unit. Which assessment factor alerts you that this client has a risk for acid-base imbalances?

9 / 23

Which action should you delegate to a UAP for the client with diabetic ketoacidosis?
(Select all that apply.)

10 / 23

You have been floated to the telemetry unit for the day. The monitor watcher informs you that the client has developed prominent U waves. Which laboratory value should you check immediately?

11 / 23

38-year-old on a ventilator with narcotic overdose and respiratory alkalosis

12 / 23

As the charge nurse, you would assign which client to the step-down unit nurse floated to the intensive care unit for the day?

13 / 23

You are reviewing the client’s morning laboratory results. Which of these results is of most concern to you?

14 / 23

The UAP asks you why the client with a chronically low phosphorus level needs so much assistance with activities of daily living. What is your best response?

15 / 23

You are preparing to discharge a client whose calcium level was low but is now just barely within the normal range (9 to 10.5 mg/dL). Which statement by the client indicates to you the need for additional teaching?

16 / 23

An experienced LPN/LVN reports to you that a client’s blood pressure and heart rate have decreased, and when his face is assessed, one side twitches. What action should you take at this time?

17 / 23

The charge nurse assigned the care of a client with acute kidney failure and
hypernatremia to you, a newly-graduated RN. Which action can you delegate to the UAP?

18 / 23

A client is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). For which electrolyte abnormality would you be sure to monitor?

19 / 23

A client’s potassium level is 6.7 mEq/L. Which intervention should you delegate to the first-year student nurse whom you are supervising?

20 / 23

The health care provider has written all of these orders for a client with a diagnosis of Excess Fluid Volume. The client’s morning assessment reveals bounding peripheral pulses, weight gain of 2 lb, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time?

21 / 23

The nursing care plan for the client with dehydration includes interventions for oral health. Which interventions are within the scope of practice for an LPN/LVN being s upervised by a nurse? (Select all that apply.)

22 / 23

The client also has the nursing diagnosis Decreased Cardiac Output related to decreased plasma volume. Which assessment finding supports this nursing diagnosis?

23 / 23

The client’s nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to fluid management should be delegated to a UAP?

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The average score is 57%

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Nclex Academy Mastery Day 4 – Evening

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NCLEX ACADEMY MASTERY DAY 4 – EVENING

DAY FOUR – EVENING ASSESSMENT

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1 / 14

What term describes the sorting of clients according to medical need when resources are unavailable for all persons to be treated?

2 / 14

Which of the following biologic agents are disseminated by airborne release?

3 / 14

The nurse understands that there are no isolation precautions for clients with:

4 / 14

Which of the following potential bioterrorism agents has three routes of exposure to humans?

5 / 14

Which of the following is not considered a component of the medical assets stored in a Strategic National Stockpile?

6 / 14

The National Preparedness goal has now focused efforts in preparing for, responding to, and recovering from:

7 / 14

Hospitals and health care facilities were required by The Joint Commission to be compliant with this program by the end of calendar year 2007. This program is called:

8 / 14

Which of the following conditions satisfies a “green” triage tag in an emergency triage scenario?

9 / 14

Which of the following events is an example of a Level III disaster?

10 / 14

Which of the following is an example of a Level II disaster?

11 / 14

Which of the following is an example of a Level I disaster?

12 / 14

What is the most likely source of exposure in a biologic weapon attack?

13 / 14

Which of the following is a Centers for Disease Control and Prevention (CDC) Category A biologic agent?

14 / 14

which of the following are agents listed by the CDC as agents most likely to be involved in bioterrorism? Select all that apply.

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Nclex Academy Mastery Day 5 – Morning

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NCLEX ACADEMY MASTERY DAY 5 – MORNING

DAY FIVE – MORNING ASSESSMENT

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1 / 30

You are caring for a patient with emphysema and respiratory failure who is receiving mechanical ventilation through an endotracheal tube. To prevent ventilator-associated pneumonia (VAP), which action is most important to include in the plan of care?

2 / 30

You have just finished assisting the physician with a thoracentesis for a patient with recurrent left pleural effusion caused by lung cancer. The thoracentesis removed 1800 mL of fluid. Which patient assessment information is important to report to the physician?

3 / 30

When assessing a 22-year-old patient who required emergency surgery and multiple transfusions 3 days ago, you find that the patient looks anxious and has labored respirations at a rate of 38 breaths/min. The oxygen saturation is 90% with the oxygen delivery at 6 L/min via nasal cannula. Which action is most appropriate?

4 / 30

The high-pressure alarm on a patient’s ventilator goes off. When you enter the room to assess the patient, who has ARDS, the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should you take next?

5 / 30

You are making a home visit to a 50-year-old patient who was recently hospitalized with a right leg deep vein thrombosis and a pulmonary embolism. The patient’s only medication is enoxaparin (Lovenox) subcutaneously. Which assessment information will you need to communicate to the physician?

6 / 30

After the respiratory therapist performs suctioning on a patient who is intubated, the UAP measures vital signs for the patient. Which vital sign value should the UAP report to the RN immediately?

7 / 30

You are assigned to provide nursing care for a patient receiving mechanical ventilation. Which action should you delegate to an experienced UAP?

8 / 30

You are the preceptor for an RN who is undergoing orientation to the intensive care unit. The RN is providing care for a patient with ARDS who has just been intubated in preparation for mechanical ventilation. You observe the nurse perform all of these actions. For which action must you intervene immediately?

9 / 30

A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by nonrebreather mask, but arterial blood gas measurements still show poor oxygenation. As the nurse responsible for this patient’s care, you would anticipate a physician order for what action?

10 / 30

A patient with a pulmonary embolus is receiving anticoagulation with IV heparin.
What instructions would you give the UAP who will help the patient with ADLs? (Select all that apply.)

11 / 30

Which intervention for a patient with a pulmonary embolus could be delegated to the
LPN/LVN on your patient care team?

12 / 30

You are admitting a patient for whom a diagnosis of pulmonary embolus must be ruled out. The patient’s history and assessment reveal all of these findings. Which finding supports the diagnosis of pulmonary embolus?

13 / 30

When a patient with TB is being prepared for discharge, which statement by the patient indicates a need for further teaching?

14 / 30

The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months of experience) floated from the surgical unit to the medical unit?

15 / 30

You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to the UAP?

16 / 30

After change of shift, you are assigned to care for the following patients. Which patient should you assess first?

17 / 30

You are supervising a nursing student who is providing care for a thoracotomy patient with a chest tube. What finding would you clearly instruct the nursing student to notify you about immediately?

18 / 30

You are responsible for the care of a postoperative patient with a thoracotomy. The patient has been given the nursing diagnosis of Activity Intolerance. Which action should you delegate to the UAP?

19 / 30

The patient with COPD tells the UAP that he did not get his annual flu shot this year and has not had a pneumonia vaccination. You would be sure to instruct the UAP to report which vital sign value?

20 / 30

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern.
Which is an appropriate action to delegate to the experienced LPN/LVN under your supervision?

21 / 30

A patient has chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to the UAP?

22 / 30

You are the team leader RN working with a student nurse. The student nurse is to teach a patient how to use an MDI without a spacer. Put in correct order the steps that the student nurse should teach the patient.

23 / 30

You are providing care for a patient with recently diagnosed asthma. Which key points would you be sure to include in your teaching plan for this patient? (Select all that apply.

24 / 30

You are acting as preceptor for a newly-graduated RN during her second week of orientation. You would assign the new RN under your supervision to provide nursing care to which patients? (Select all that apply.)

25 / 30

A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the UAP?

26 / 30

You are supervising an RN who floated from the medical-surgical unit to the emergency department. The nurse is providing care for a patient admitted with anterior epistaxis (nosebleed). Which directions would you clearly provide to the RN? (Select all that apply.)

27 / 30

You are supervising a student nurse who is performing tracheostomy care for a patient. Which action by the student would cause you to intervene?

28 / 30

The UAP tells you that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is reporting nasal passage discomfort. What intervention should you suggest to improve the patient’s comfort for this problem?

29 / 30

You are evaluating and assessing a patient with a diagnosis of chronic emphysema.
The patient is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you
immediately?

30 / 30

An experienced LPN/LVN, under the supervision of the team leader RN, is providing nursing care for a
patient with a respiratory problem. Which actions are appropriate to the scope of practice of an
experienced LPN/LVN? (Select all that apply.)

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Nclex Academy Mastery Day 5 – Evening

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NCLEX ACADEMY MASTERY DAY 5 – EVENING

DAY FIVE – EVENING ASSESSMENT

The number of attempts remaining is 1

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1 / 17

There is an order for digoxin 0.5 mg PO. The nurse has 250 mcg tablets on hand. How many tablets will the nurse give?

2 / 17

client is receiving IV antibiotic therapy. The order is for methicillin 750 mg IV. The nurse has a vial on hand that contains 1 g. The instructions for reconstitution say to add 1.5 mL sterile water. Reconstituted solution will contain 500 mg methicillin per milliliter. How much will the nurse give?

3 / 17

The physician calls the unit and leaves an order for a client. The order is for Cefaclor 0.1 gm PO. The dose available in the unit is 125 mg/5 mL. How many milliliters will the nurse give?

4 / 17

The physician orders an IV piggyback of Cefotan 1 gm in 100 mL D5W to run over 30 minutes. The drop factor for the tubing is 10 gtt/mL. At what rate in drops per minute would you run the IV?

5 / 17

Which of the following would be important to include in a continuing service education program on prevention of needle-stick injuries? Select all that apply:

6 / 17

client is scheduled for a total hip replacement and he has a history of utilization of several herbal and vitamin products. What would the nurse advise the client to discontinue at least 2 weeks before surgery?
Select all that apply.

7 / 17

The nurse is verifying whether to give a medication to a client. What would be the first nursing action?

8 / 17

A client is receiving IV antibiotic therapy. The order is for methicillin 750 mg IV. The nurse has a vial on hand that contains 1 gm. The instructions for reconstitution say to add 1.5 mL sterile water. Reconstituted solution will contain 500 mg methicillin per milliliter. How much will the nurse give?

9 / 17

The nurse is preparing medications for a client. The medication order is for cefaclor (Ceclor) 0.1 gm PO. The dose available in the unit is 125 mg/5 mL. How many milliliters will the nurse need to give?

10 / 17

The nurse is caring for a client who had a stroke (brain accident) 3 months ago and is taking Coumadin. The client tells the nurse she has started taking some herbal and vitamin supplements. She gives the nurse a list of the supplements she is taking. What supplements would cause concern for the client who is on Coumadin? Select all that apply:

11 / 17

The nurse is working in the pediatric unit and receives a phone order from the doctor for a 10-year-old client who weighs 40 kg. The order is for ceftazidime (Fortaz) 1.5 gm every 8 hours IV. The therapeutic dosage range is 90-150 mg/kg/24 hr. What would be the best nursing action?

12 / 17

The nurse prepares a liquid medication and then finds that the client no longer needs the medication. What is the most appropriate nursing action?

13 / 17

What is the first step the nurse should take to ensure that the right medication is being given to a client?

14 / 17

What should the nurse take into consideration when giving medication to an older adult client?

15 / 17

At the shift hand-off report, a nurse is told that one of her clients is becoming tolerant to his pain medication. What nursing observation would be in agreement with this conclusion?

16 / 17

The doctor has indicated that ampicillin and gentamicin are to be given piggyback in the same hour, every 6 hours (12-6-12-6). How would the nurse administer these drugs?

17 / 17

The nurse is preparing to administer an intramuscular injection to an infant who is 8 months old. Which muscle would be the most appropriate injection site?

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Nclex Academy Mastery Day 6 – Morning

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NCLEX ACADEMY MASTERY DAY 6 – MORNING

DAY SIX – MORNING ASSESSMENT

The number of attempts remaining is 1

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1 / 31

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be most useful to monitor?

2 / 31

You are preparing to administer the following medications to a client with multiple health problems who has been hospitalized with deep vein thrombosis. Which medication is most important to double-check with another licensed nurse?

3 / 31

You are developing a standardized care plan for the postoperative care of clients undergoing cardiac surgery. Which nursing activity included in the care plan will need to be performed by RN staff members?

4 / 31

During the initial postoperative assessment of a client who has just been transferred to the postanesthesia care unit after repair of an abdominal aortic aneurysm, you obtain these data. Which finding has the most immediate implications for the client’s care?

5 / 31

A resident in a long-term care facility who has venous stasis ulcers is treated with an Unna boot. Which nursing activity included in the resident’s care is best for you to delegate to the UAP?

6 / 31

A client who has endocarditis with vegetation on the mitral valve suddenly reports severe left foot pain. You note that no pulse is palpable in the left foot and that it is cold and pale. Which action should you take next?

7 / 31

You are ambulating a cardiac surgery client who has a telemetry cardiac monitor when another staff member tells you that the client has developed supraventricular tachycardia at a rate of 146 beats/min. In which order will you take the following actions?

8 / 31

During a home visit to an 88-year-old client who is taking digoxin (Lanoxin) 0.25 mg daily to treat heart failure and atrial fibrillation, you obtain this assessment information. Which finding is most important to communicate to the health care provider?

9 / 31

As the charge nurse in a long-term care facility that employs RNs, LPNs/LVNs, and UAPs, you have developed a plan for the ongoing assessment of all residents with a diagnosis of heart failure. Which activity included in the plan is most appropriate to delegate to an LPN/LVN team member?

10 / 31

You have just received a change-of-shift report about these clients on the coronary step-down unit. Which one will you assess first?

11 / 31

Two weeks ago, a 63-year-old client with heart failure received a new prescription for carvedilol (Coreg) 3.125 mg orally. When evaluating the client in the cardiology clinic, you obtain the following data. Which finding is of most concern?

12 / 31

Ventricular fibrillation is identified in an unresponsive 50-year-old client who has just arrived in the ED. Which action will you take first?

13 / 31

You are monitoring the cardiac rhythms of clients in the coronary care unit. Which client will need immediate intervention?

14 / 31

While working on the cardiac step-down unit, you are serving as preceptor to a newly graduated RN who has been in a 6-week orientation program. Which client will be best to assign to the new graduate?

15 / 31

You are working in an outpatient clinic where many vascular diagnostic tests are performed. Which task associated with vascular testing is most appropriate to delegate to an experienced UAP?

16 / 31

You assess a client who has just returned to the recovery area after undergoing coronary arteriography. Which information is of most concern?

17 / 31

At 10:00 AM, a hospitalized client receives a new order for transesophageal echocardiography (TEE) as soon as possible. Which action will you take first?

18 / 31

The health care provider telephones you with new prescriptions for a client with unstable angina who is already taking clopidogrel (Plavix). Which medication is most important to clarify further with the health care provider?

19 / 31

You are caring for a hospitalized client with heart failure who is receiving captopril (Capoten) and spironolactone (Aldactone). Which laboratory value will be most important to monitor?

20 / 31

You are preparing to implement teaching about a heart-healthy diet and activity levels for a client who has had an MI and her husband. The client says, “I don’t see why I need any teaching. I don’t think I need to change anything right now.” Which response is most appropriate?

21 / 31

You have given morphine sulfate 4 mg IV to a client who has an acute MI. When you evaluate the client’s response 5 minutes after giving the medication, which finding indicates a need for immediate further action?

22 / 31

An 80-year-old client on the coronary step-down unit tells you that he does not want to take the ordered docusate (Colace) because he does not have any problems with constipation. Which action is most appropriate?

23 / 31

You are working in the ED caring for a client who was just admitted with left anterior chest pain, possible ACS. Which action will you take first?

24 / 31

You are working with an experienced UAP and an LPN/LVN on the telemetry unit. A client who had an acute MI 3 days ago has a nursing diagnosis of Activity Intolerance related to fatigue and chest pain. Which nursing activity included in the care plan is best delegated to the LPN/LVN?

25 / 31

At 9:00 pm, you admit a 63-year-old with a diagnosis of acute MI. Which finding is most important to communicate to the health care provider who is considering the use of fibrinolytic therapy with tissue plasminogen activator (alteplase [Activase]) for the client?

26 / 31

You are the charge nurse for the coronary care step-down unit. Which client is best to assign to a float RN who has come for the day from the general medical-surgical unit?

27 / 31

While admitting a client, you obtain this information about her cardiovascular risk factors: Her mother and two siblings have had myocardial infarctions (MIs). The client smokes and has a 20 pack-year history of cigarette use. Her work as a mail carrier involves a lot of walking. She takes metoprolol (Lopressor) for hypertension, and her blood pressure has been in the range of 130/60 to 138/85 mm Hg. Which interventions will be important to include in the discharge plan for this client? (Select all that apply.)

28 / 31

You make a home visit to evaluate a hypertensive client who has been taking enalapril (Vasotec). Which finding indicates that you need to contact the health care provider about a change in the drug therapy?

29 / 31

The health care provider prescribes these actions for a client who was admitted with acute substernal chest pain. Which actions are appropriate to delegate to an experienced LPN/LVN who is working with you in the ED? (Select all that apply.)

30 / 31

You are monitoring a 53-year-old client who is undergoing a treadmill stress test. Which client finding
will require the most immediate action?

31 / 31

You are working in the emergency department (ED) when a client arrives, reporting substernal and
left arm discomfort that has been going on for about 3 hours. Which laboratory test will be most useful
in determining whether you should anticipate implementing the acute coronary syndrome (ACS)
standard protocol?

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Nclex Academy Mastery Day 6 – Evening

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NCLEX ACADEMY MASTERY DAY 6 – EVENING

DAY SIX – EVENING ASSESSMENT

The number of attempts remaining is 1

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1 / 18

The nurse is assessing an IV site after the client has complained of increased tenderness. The site is inflamed, streaks of inflammation are progressing up the inside of the client’s arm, and the fluid is continuing to infuse at the prescribed rate. What is the best nursing action?

2 / 18

The nurse is documenting information regarding an IV insertion.
What information is important to include? Select all that apply:

3 / 18

A client is being seen in the emergency department after an accident. He has no obvious physical injuries, and his blood pressure is 158/90 mm Hg. He is crying loudly, wringing his hands, and pacing the floor. His respiratory rate is 32 breaths/min, and he complains of being lightheaded. What is the best nursing response?

4 / 18

A client is complaining of pain at the peripheral IV site. The nurse determines the IV is not infusing; assesses the site; and finds the area swollen, pale, and cool to touch. What is the best nursing action?

5 / 18

The nurse is admitting a 15-year-old client with type 1 diabetes for control of his diabetes. What values on the arterial blood gases would indicate the client is developing a complication as a result of his poorly controlled diabetes?

6 / 18

A client has returned to the room from the postoperative recovery area. He is lethargic but responsive. He has O2 via nasal cannula at 4 L/min and an IV infusing at 125 mL/hr. On the initial nursing assessment, the nurse notes that the O2 saturation on the pulse oximetry is 82%. What is the priority nursing action?

7 / 18

The client is receiving an IV of 0.9% NaCl at 125 mL per hour. The client had a colon resection this morning. He has a nasogastric tube to suction and an ileostomy, and he is becoming increasingly restless. The nurse reviews the serum laboratory values. Which value would cause the nurse the most concern?

8 / 18

The nurse is performing a dressing change on a client who has a Staphylococcus infection in an abdominal incision. What infection control precautions will the nurse implement? Select all that apply:

9 / 18

An older adult client has an order for continuous fluid replacement at 75 mL per hour. The nurse is preparing to start the IV. What site would be appropriate, and what is the equipment of choice?

10 / 18

A client’s condition has put him at an increased risk for development of a problem with excess fluid volume. What nursing intervention would provide the most accurate information for evaluating the clients’ fluid status?

11 / 18

The nurse is admitting a 5-month-old infant. The physician has ordered an IV solution of normal saline. There is also an order for potassium chloride (KCl) to be added to the solution. The infant’s temperature is 101° F rectally, and the pulse is 120 beats/min; the infant is irritable and has not voided. What would be the next best nursing action?

12 / 18

Which client would most likely experience a problem with maintaining a normal electrolyte balance?

13 / 18

What information is most important to teach a client who is receiving steroid therapy?

14 / 18

The nurse is assisting a client to ambulate. Upon standing at the bedside, the client becomes weak and sits back down on the bed. The nurse should assess the client for what problem?

15 / 18

The nurse is reviewing the health care provider’s orders for a new client. The client has just returned from the surgical recovery area. The client is NPO. He has a nasogastric tube, and his vital signs are stable. Which order would the nurse question?

16 / 18

The nurse is admitting a client from the postoperative recovery area. Postoperative orders are D5 ½ NS with 40 mEq/L of KCl. The current liter of lactated Ringer’s solution has 450 mL left to infuse. What should the nurse do?

17 / 18

An older adult client is experiencing difficulty with edema and fluid overload. What nursing intervention would be the most accurate in evaluating the client’s fluid balance?

18 / 18

The nurse would identify which set of blood gas values as consistent with a diagnosis of respiratory acidosis in a client?

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Nclex Academy Mastery Day 7 – Morning

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NCLEX ACADEMY MASTERY DAY 7 – MORNING

DAY SEVEN – MORNING ASSESSMENT

The number of attempts remaining is 1

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1 / 20

The nurse receives report on assigned clients. One client is reported to be at the nadir for his cancer chemotherapy. How will this affect the nursing care plan?

2 / 20

A client with AIDS has several cutaneous lesions identified as Kaposi’s sarcoma. How will the nurse care for these areas?

3 / 20

The nurse is caring for a client who is experiencing a severe anaphylactic reaction caused by an allergy to peanuts. After administering subcutaneous epinephrine and beginning oxygen administration, what would be the next most important nursing action?

4 / 20

The nurse is assisting a client with his antiretroviral therapy. What can the nurse do to help the client take his medications as prescribed?

5 / 20

The nurse is reviewing with a certified nursing assistant (CNA) the care for a child who is diagnosed with acquired immunodeficiency syndrome (AIDS) and has developed P. jiroveci pneumonia (PJP, PCP). Which of the following precautions would the nurse review with the CNA?

6 / 20

A client is experiencing difficulty breathing, periorbital swelling, flushing, and itching. He had a diagnostic test in which an iodine-based dye was used about an hour earlier. What medication will the nurse anticipate administering immediately?

7 / 20

A woman explains to the nurse that she thinks she has been exposed to HIV. However, she had a test 1 week after the exposure and the result was negative. What is most important for the nurse to explain to this client?

8 / 20

The nurse is caring for a client who is categorized as HIV-positive, acute infection. What would the nurse anticipate finding on the nursing assessment?

9 / 20

A client is worried he may have been exposed to AIDS. What will be important for the nurse to explain to this client?

10 / 20

A client with a diagnosis of AIDS has developed P. jiroveci pneumonia
(PJP, PCP). What will be important for the nurse to include in the nursing care plan?

11 / 20

Which of the following statements are correct about latex allergy?
Select all that apply.

12 / 20

The nurse is preparing discharge teaching for a woman newly diagnosed with SLE. What will be important for the nurse to include in the teaching plan? Select all that apply.

13 / 20

An infant has an acquired active immunity. Which statement best explains this type of immunity?

14 / 20

A client is diagnosed with an immunodeficiency disease. The nurse would understand what is characteristic of this condition?

15 / 20

A client has systemic lupus erythematosus (SLE). What statement best describes this client’s immune response?

16 / 20

The nurse is administering medications to a client who has no allergy band on his arm. The nurse tells the client she has his penicillin medication. The client states that the last time he had penicillin, it made his mouth tingle and his hands itch. What would be the best nursing action?

17 / 20

A nurse is caring for a client who received a penicillin injection about 15 minutes earlier. The client complains of itching around the mouth, and this rapidly progresses to severe dyspnea and respiratory distress. What are the priority nursing actions?

18 / 20

A client returns to the clinic to receive evaluation of his routine purified protein derivative (PPD) test for tuberculosis screening. The test result is positive. What is the best nursing interpretation of this information?

19 / 20

The mother of a 15-month-old child who is immunosuppressed asks about continuation of the
childhood vaccines. Which immunizations are not recommended to be given to the child during
immunosuppression?

20 / 20

To evaluate the progress of the client’s systemic lupus erythematosus
(SLE), the nurse evaluates which data?

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Nclex Academy Mastery Day 7 – Evening

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NCLEX ACADEMY MASTERY DAY 7 – EVENING

DAY SEVEN – EVENING ASSESSMENT

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1 / 16

The nurse is caring for a client who is being treated with chemotherapy for his lung cancer. The client has had two treatments in the last 2 days, and the nurse notes hyperkalemia and hyperuricemia on the latest serum lab values. The nurse understands that these are symptoms of:

2 / 16

A client is being referred to the hospice nurse for care. The nurse explains to the client and the family that the primary goal of hospice differs from the goal of traditional care in what way? Hospice care:

3 / 16

The nurse understands what major difference between benign and malignant tumors? Malignant tumors:

4 / 16

What is a common side effect of radiation therapy that is not associated with the effect of radiation in the treatment field?

5 / 16

A client asks the nurse why he has to take several chemotherapy agents at the same time. The nurse’s response would be based on which principle?

6 / 16

A client is receiving busulfan (Myleran). The nurse would notify the physician regarding which assessment finding?

7 / 16

The nurse is updating a teaching plan for a client who has cancer and has been taking doxorubicin (Adriamycin) for the past several months. What is important to review with the client?

8 / 16

The nurse understands that the following are general adverse effects of antineoplastic drugs. Select all that apply.

9 / 16

The nurse is evaluating a central venous line before administering the client’s chemotherapy. What observation would cause the nurse the most concern?

10 / 16

A client is going to begin external radiation therapy for his lung cancer. Which comment by the client would indicate to the nurse the need for additional teaching?

11 / 16

A client is receiving chemotherapy with several antineoplastic agents. Which nursing observation is considered a common side effect of chemotherapy?

12 / 16

What is an important aspect of client teaching regarding external radiation therapy?

13 / 16

What are the nursing interventions regarding care of a client with a vaginal radium implant?

14 / 16

The nurse is assessing a client after beginning external radiation. What is a nursing observation that confirms the presence of early side effects of the radiation?

15 / 16

What is an allergic reaction that can quickly deteriorate into shock and death?

16 / 16

A client has just received 250 mL of packed cells and is now receiving 1000 mL of D5W at 150 mL/hour. The client tells the nurse that he feels dizzy and has a headache. The nurse observes the distended jugular veins with the client in a semi-Fowler’s position. What would be the nurse’s initial response?

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Nclex Academy Mastery Day 8 – Morning

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NCLEX ACADEMY MASTERY DAY 8 – MORNING

DAY EIGHT – MORNING ASSESSMENT

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1 / 24

After you receive the change-of-shift report, which patient will you assess first?

2 / 24

A patient with Hodgkin lymphoma who is receiving radiation therapy to the groin area has skin redness and tenderness in the area being irradiated. Which nursing activity should you delegate to the UAP caring for the patient?

3 / 24

A patient who has been receiving cyclosporine (Sandimmune) following an organ transplantation is experiencing the following symptoms. Which one is of most concern?

4 / 24

A patient with acute myelogenous leukemia is receiving induction-phase chemotherapy. Which assessment finding requires the most rapid action?

5 / 24

You are transferring a patient with newly-diagnosed chronic myeloid leukemia to an LTC facility. Which information is most important to communicate to the LTC charge nurse before transferring the patient?

6 / 24

You are the charge nurse on an oncology unit when a patient with an absolute neutrophil count of 300/μL is admitted. Which staff member should you assign to provide care for this patient, under the supervision of an experienced oncology RN?

7 / 24

A patient with graft-versus-host disease (GVHD) after bone marrow transplantation is being cared for on the medical unit. Which nursing activity is best delegated to a travel RN?

8 / 24

The nurse in the outpatient clinic is assessing a 22-year-old who required a splenectomy after a recent motor vehicle accident. Which information obtained during the assessment will be of most immediate concern to the nurse?

9 / 24

You obtain the following data about a patient admitted with multiple myeloma. Which information has the most immediate implications for the patient’s care?

10 / 24

A group of patients is assigned to an RN-LPN/LVN team. The LPN/LVN should be assigned to provide patient care and administer medications to which patient?

11 / 24

A transfusion of PRBCs has been infusing for 5 minutes when the patient becomes flushed and tachypneic and says, “I’m having chills. Please get me a blanket.” Which action should you take first?

12 / 24

A patient in a long-term care (LTC) facility who has chronic lymphocytic leukemia has a nursing diagnosis of Activity Intolerance related to weakness and anemia. Which nursing activity will you delegate to the UAP?

13 / 24

You receive a change-of-shift report about the following patients. Which one will you assess first?

14 / 24

A 22-year-old with stage I Hodgkin disease is admitted to the oncology unit for radiation therapy. During the initial assessment, the patient tells you, “Sometimes I’m afraid of dying.” Which response is most appropriate at this time?

15 / 24

A patient is admitted to the intensive care unit with disseminated intravascular coagulation associated with a gram-negative infection. Which assessment information has the most immediate implications for the patient’s care?

16 / 24

As a home health nurse, you are obtaining an admission history for a patient who has deep vein thrombosis and is taking warfarin (Coumadin) 2 mg daily. Which statement by the patient is the best indicator that additional teaching about warfarin may be needed?

17 / 24

After a car accident, a patient with a medical alert bracelet indicating hemophilia A is admitted to the emergency department (ED). Which action prescribed by the health care provider will you implement first?

18 / 24

A 67-year-old who is receiving chemotherapy for lung cancer is admitted to the hospital with thrombocytopenia. Which statement made by the patient when you are obtaining the admission history is of most concern?

19 / 24

You are making a room assignment for a newly arrived patient whose laboratory test results indicate pancytopenia. Which patient will be the best roommate for the new patient?

20 / 24

As charge nurse, you are making the daily assignments on the medical-surgical unit.
Which patient is best assigned to a float nurse who has come from the postanesthesia care unit (PACU)?

21 / 24

These activities are included in the care plan for a 78-year-old patient admitted to the hospital with anemia caused by possible gastrointestinal bleeding. Which activity can you delegate to an experienced UAP?

22 / 24

32-year-old patient with sickle cell anemia is admitted to the hospital during a sickle cell crisis. Which action prescribed by the health care provider will you implement first?

23 / 24

You are providing orientation for a new RN who is preparing to administer packed red blood cells
(PRBCs) to a patient who had blood loss during surgery. Which action by the new RN requires that you
intervene immediately?

24 / 24

You are reviewing the complete blood count for a patient who has been admitted for knee arthroscopy. Which value is most important to report to the physician before surgery?

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Nclex Academy Mastery Day 8 – Evening

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NCLEX ACADEMY MASTERY DAY 8 – EVENING

DAY EIGHT – EVENING ASSESSMENT

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1 / 11

A client is experiencing a lack of logical thought progression, resulting in disorganized and chaotic thinking. The nurse understands this to be:

2 / 11

When preparing a client for electroconvulsive therapy (ECT), the nurse would include which of the following actions?

3 / 11

A client with a diagnosis of schizophrenia repeatedly states, “There are flies eating my brain and making me feel weird.” The client is most likely experiencing which of the following?

4 / 11

A client is admitted to the inpatient psychiatric unit for medically monitored detoxification from alcohol. Which of the following actions would be included in the client’s plan of care?

5 / 11

When caring for a client admitted for medically monitored detoxification from alcohol, the nurse would assess for which of the following signs and symptoms of withdrawal?

6 / 11

Which of the following signs and symptoms would the nurse assess for in a client with possible lithium toxicity?

7 / 11

A client experiencing severe depression is admitted to the inpatient psychiatric unit. During the initial assessment, she says, “I feel like killing myself, but I wouldn’t do that because of my kids.” The nurse’s priority action would be to:

8 / 11

Which of the following nursing interventions should be instituted for a client experiencing a manic episode?

9 / 11

The nurse notes that a client is quite suspicious during an assessment interview and believes that her family is under investigation by the CIA. What would be appropriate nursing interventions with this client? Select all that apply:

10 / 11

The nurse is about to conduct an admission assessment on an 85-yearold female client who is admitted after falling down in her home. When determining the amount of time to set aside for the interview, the nurse will consider which of the following?

11 / 11

A nurse case worker suspects older adult neglect. What assessment findings during a home visit would confirm this?

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Nclex Academy Mastery Day 9 – Morning

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NCLEX ACADEMY MASTERY DAY 9 – MORNING

DAY NINE – MORNING ASSESSMENT

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1 / 34

Which client in the neurologic ICU will be best to assign to an RN who has been floated from the medical unit?

2 / 34

A 70-year-old alcoholic client who has become lethargic, confused, and incontinent during the last week is admitted to the ED. His wife tells you that he fell down the stairs about a month ago, but that “he didn’t have a scratch afterward.” Which collaborative interventions will you implement first?

3 / 34

You are caring for a client with a glioblastoma who is receiving dexamethasone
(Decadron) 4 mg IV every 6 hours to relieve symptoms of right arm weakness and headache. Which assessment information will concern you the most?

4 / 34

A client who has Alzheimer disease is hospitalized with new-onset angina. Her husband tells you he does not sleep well because he needs to be sure she does not wander during the night. He insists on checking each of the medications you give the client to be sure they are “the same pills she takes at home.” Based on this information, which nursing diagnosis is most appropriate for this client?

5 / 34

You are in charge of developing a standard plan of care in an Alzheimer disease care facility and are responsible for delegating and supervising resident care given by LPNs/LVNs and UAPs. Which activity is best to delegate to the LPN/LVN team leaders?

6 / 34

All of these nursing activities are included in the care plan for a 78-year-old man with Parkinson disease who has been referred to your home health agency. Which activities will you delegate to the UAP? (Select all that apply.)

7 / 34

After you receive the change-of-shift report at 7:00 am, which client will you assess first?

8 / 34

A client who recently started taking phenytoin to control simple partial seizures is seen in the outpatient clinic. Which information obtained during her chart review and assessment will be of greatest concern?

9 / 34

Which nursing action will be implemented first if a client has a generalized tonicclonic seizure?

10 / 34

A 23-year-old with a recent history of encephalitis is admitted to the medical unit with new-onset generalized tonic-clonic seizures. Which nursing activities included in the client’s care will be best to delegate to an LPN/LVN whom you are supervising? (Select all that apply.)

11 / 34

You are mentoring a student nurse in the intensive care unit (ICU) while caring for a client with meningococcal meningitis. Which action by the student requires that you intervene most rapidly?

12 / 34

You have just admitted a client with bacterial meningitis who reports a severe headache with photophobia and has a temperature of 102.6° F (39.2° C) orally. Which prescribed intervention should be implemented first?

13 / 34

A client who had a stroke needs to be fed. What instruction should you give to the UAP who will feed the client?

14 / 34

Which actions should you delegate to an experienced UAP when caring for a client with a thrombotic stroke who has residual left-sided weakness? (Select all that apply.)

15 / 34

You are supervising a senior nursing student who is caring for a client with a right hemisphere stroke. Which action by the student nurse requires that you intervene?

16 / 34

You are providing care for a client with an acute hemorrhagic stroke. The client’s spouse tells you that he has been reading a lot about strokes and asks why his wife has not received alteplase (Activase). What is your best response?

17 / 34

The UAP reports to you, the RN, that a client with myasthenia gravis has an elevated temperature (102.2° F [39° C]), an increased heart rate (120 beats/min), and a rise in blood pressure (158/94 mm Hg) and was incontinent of urine and stool. What is your best first action at this time?

18 / 34

An LPN/LVN, under your supervision, is providing nursing care for a client with GBS. What observation should you instruct the LPN/LVN to report immediately?

19 / 34

A client with MS tells the UAP after physical therapy that she is too tired to take a bath. What is the priority nursing diagnosis at this time?

20 / 34

Which client should be assigned to the traveling nurse, new to neurologic nursing care, who has been on the neurologic unit for 1 week?

21 / 34

You are preparing a nursing care plan for a client with an SCI for whom the nursing diagnoses of Impaired Physical Mobility and Toileting Self-Care Deficit have been identified. The client tells you, “I don’t know why we’re doing all this. My life’s over.” Based on this statement, which additional nursing diagnosis takes priority?

22 / 34

A client with a cervical SCI has been placed in fixed skeletal traction with a halo fixation device. When caring for this client, the nurse may delegate which actions to an LPN/LVN? (Select all that apply.)

23 / 34

You are helping a client with an SCI to establish a bladder retraining program. Which strategies may stimulate the client to void? (Select all that apply.)

24 / 34

You are floated from the ED to the neurologic floor. Which action should you delegate to the UAP when providing nursing care for a client with an SCI?

25 / 34

A client with an SCI at level C3-C4 is being cared for in the emergency department (ED). What is the priority assessment?

26 / 34

Which client should you, as charge nurse, assign to a new RN graduate who is on orientation to the neurologic unit?

27 / 34

A client with a spinal cord injury (SCI) reports sudden severe throbbing headache that started a short time ago. Assessment of the client reveals increased blood pressure (168/94 mm Hg) and decreased heart rate (48 beats/min), diaphoresis, and flushing of the face and neck. What action should you take first?

28 / 34

You are preparing to discharge a client with chronic low back pain. Which statement by the client indicates the need for additional teaching?

29 / 34

A client with Parkinson disease has received a nursing diagnosis of Impaired Physical Mobility related to neuromuscular impairment. You observe the UAP performing all of these actions. For which action must you intervene?

30 / 34

A nursing student is teaching a client and family about epilepsy before the client’s discharge. For which statement should you intervene?

31 / 34

You are preparing to admit a client with a seizure disorder. Which actions can you delegate to an LPN/LVN?

32 / 34

After a client has a seizure, which action can you delegate to the UAP?

33 / 34

You are creating a teaching plan for a client with newly-diagnosed migraine headaches. Which key items will you include in the teaching plan? (Select all that apply.)

34 / 34

What is the priority nursing diagnosis for a client experiencing a migraine headache?

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Nclex Academy Mastery Day 9 – Evening

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NCLEX ACADEMY MASTERY DAY 9 – EVENING

DAY NINE – EVENING ASSESSMENT

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1 / 12

A client has sustained a third-degree burn. What would the nurse expect to find during assessment of the burn?

2 / 12

What is the priority assessment finding for a client who has sustained burns on the face and neck?

3 / 12

The nurse is teaching self-care to an older adult client. What would the nurse encourage the client do for his dry, itchy skin?

4 / 12

Which nursing interventions will assist in reducing pressure points that may lead to pressure ulcers? Select all that apply:

5 / 12

Herpes zoster has been diagnosed in an older adult client. What will the nursing management include?

6 / 12

What physical characteristics of a client would place them at highest risk for development of malignant melanoma?

7 / 12

The nurse understands that scaling around the toes, blistering, and pruritus is characteristic of what condition?

8 / 12

An older adult client has an open wound over the coccyx that extends through the dermis and subcutaneous tissue, exposing the deep fascia.
The wound edges are distinct, and the wound bed is a pink-red color. There is no bruising or sloughing. The nurse would correctly document this ulcer as what stage?

9 / 12

What is the type of skin cancer that is most difficult to treat?

10 / 12

A teacher notifies the school nurse that many of the students in her third-grade class have been scratching their heads and complaining of intense itching of the scalp. The nurse notices tiny white material at the base of a student’s hair shaft. What condition does this assessment reflect?

11 / 12

A client comes to the outpatient clinic with impetigo on his left arm. What information would the nurse give this client?

12 / 12

A client has extensive burns with eschar on the anterior trunk. What is the nurse’s primary concern regarding eschar formation?

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Nclex Academy Mastery Day 10 – Morning

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NCLEX ACADEMY MASTERY DAY 10 – MORNING

DAY TEN – MORNING ASSESSMENT

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1 / 20

Place the following steps for ear irrigation in the correct order.

2 / 20

You performed postoperative stapedectomy teaching several days ago for a client. Which comment by the client concerns you the most?

3 / 20

Which description by a client reporting vertigo would concern you the most?

4 / 20

Which physical assessment findings should be reported to the physician?

5 / 20

A cheerful elderly widow comes to the community clinic for her annual checkup. She is in reasonably good health, but she has a hearing loss of 40 dB. She confides, “I don’t get out much. I used to be really active, but the older I get, the more trouble I have hearing. It can be really embarrassing.” What is the priority nursing diagnosis?

6 / 20

You are interviewing an elderly client who reports that “lately there has been a roaring sound in my ears.” What additional assessments should you include? (Select all that apply.)

7 / 20

Which tasks are appropriate to delegate to an LPN/LVN who is functioning under the supervision of a team leader or RN? (Select all that apply.)

8 / 20

You are supervising a new nurse who has just finished assessing a client who came to the clinic for redness and discomfort to the right eye. You review her documentation, which includes “visual acuity N/A.” What should you do next?

9 / 20

Before giving a beta-adrenergic blocking glaucoma agent, you would make additional assessments and notify the physician if the client makes which statement?

10 / 20

A client reports a sudden excruciating pain in the left eye with the visual change of colored halos around lights and blurred vision. Which interventions should you anticipate and perform for this emergency condition? (Select all that apply.)

11 / 20

In discharge teaching after cataract surgery, the client and family should be told to immediately report which symptom to the physician?

12 / 20

In the care of a client who has sustained recent blindness, which tasks would be appropriate to delegate to a UAP? (Select all that apply.)

13 / 20

Which finding should be immediately reported to the physician?

14 / 20

You are working in a community health clinic and a client needs instructions for the care of a hordeolum (sty) on the right upper eyelid. What is the first treatment that the client should try?

15 / 20

You are interviewing an elderly woman and discover that she has been taking her glaucoma eyedrops by mouth for the past week. What should you do first?

16 / 20

Which tasks are appropriate to delegate to an LPN/LVN who is functioning under the supervision of an RN? (Select all that apply.)

17 / 20

Place the following steps for eyedrop administration in the correct order.

18 / 20

Which clients would be best to assign to the most experienced nurse in an ambulatory care center that specializes in vision problems and eye surgery? (Select all that apply.)

19 / 20

At a community health clinic, you are teaching a community group about the prevention of accidental
eye injuries. What is the most important thing to stress?

20 / 20

You are working in an ambulatory care clinic. A client calls to report redness of the sclera, itching of
the eyes, and increased lacrimation for several hours. What should you direct the caller to do first?

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Nclex Academy Mastery Day 10 – Evening

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NCLEX ACADEMY MASTERY DAY 10 – EVENING

DAY TEN – EVENING ASSESSMENT

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1 / 21

A patient who underwent a right above-the-knee amputation 4 days ago also has a diagnosis of depression. Which order would you clarify with the health care provider?

2 / 21

During assessment of a patient with fractures of the medial ulna and radius, you find all of these data. Which assessment finding should you report to the health care provider immediately?

3 / 21

During morning care, a patient with a below-the-knee amputation asks the UAP about prostheses. How will you instruct the UAP to respond?

4 / 21

A patient with a right above-the-knee amputation asks you why he has phantom limb pain. What is your best response?

5 / 21

The charge nurse is assigning the nursing care of a patient who had a left below-the knee amputation 1 day ago to an experienced LPN/LVN, who will function under your supervision. What will you tell the LPN/LVN is the major focus for the patient’s care today?

6 / 21

The nursing diagnosis for a patient with a fracture of the right ankle is Impaired Physical Mobility. As charge nurse, you observe a newly-graduated RN perform all of these interventions. For which action should you intervene?

7 / 21

A patient with a fractured fibula is receiving skeletal traction and has skeletal pins in place. What would you instruct the UAP to report immediately?

8 / 21

After you receive the change-of-shift report, which patient should you assess first?

9 / 21

A patient has a fractured femur. Which finding would you instruct the UAP to report immediately?

10 / 21

When receiving discharge instructions, a patient with osteoporosis makes all of these statements. Which statement indicates to you that the patient needs additional teaching?

11 / 21

You are preparing the patient who had carpal tunnel release surgery for discharge. Which information is important to provide to this patient?

12 / 21

As charge nurse, you assign the nursing care of a patient who has just returned from open carpal tunnel release surgery to an experienced LPN/LVN, who will perform under the supervision of an RN. Which instructions would you provide for the LPN/LVN?
(Select all that apply.)

13 / 21

A patient is scheduled for endoscopic carpal tunnel release surgery in the morning. What would you be sure to teach the patient?

14 / 21

You observe a UAP performing all of these interventions for a patient with CTS. Which action requires that you intervene immediately?

15 / 21

You are caring for a patient with carpal tunnel syndrome (CTS) who has been admitted for surgery. Which intervention should you delegate to the UAP?

16 / 21

You delegate the measurement of vital signs to an experienced UAP. Osteomyelitis has been diagnosed in a patient. Which vital sign value would you instruct the UAP to report immediately?

17 / 21

As charge nurse, you are making assignments for the day shift. Which patient would you assign to the nurse who was floated from the postanesthesia care unit (PACU) for the day?

18 / 21

The charge nurse observes an LPN/LVN providing all of these interventions for a patient with Paget disease. Which action requires that the charge nurse intervene?

19 / 21

Your assessment reveals all of these data when you are admitting a patient with Paget disease. Which finding should you notify the physician about first?

20 / 21

You are preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points will you be sure to include? (Select all that apply.)

21 / 21

You are initiating a nursing care plan for a patient with osteoporosis. All of these nursing interventions apply to the nursing diagnosis Risk for falls. Which intervention should you delegate to the UAP?

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Nclex Academy Mastery Day 11 – Morning

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NCLEX ACADEMY MASTERY DAY 11 – MORNING

DAY ELEVEN – MORNING ASSESSMENT

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1 / 30

You are supervising a nursing student who is caring for a client who had a cholecystectomy. There is a T-tube in place. You would intervene if the student performs which action?

2 / 30

A client with end-stage liver disease is talking to you about being on the transplant list. Which statement by the client concerns you the most?

3 / 30

You are caring for a client who was admitted for advanced cirrhosis. The client has massive ascites, peripheral dependent edema in the lower extremities, nausea and vomiting, and dyspnea related to pressure on the diaphragm. For the nursing diagnosis of Excess Fluid Volume, which indicator is the most reliable for tracking fluid retention?

4 / 30

Clients who are undernourished or starved for prolonged periods are at risk for refeeding syndrome when nourishment is first given. What is the priority nursing assessment to prevent complications associated with this syndrome?

5 / 30

Place the steps for performing colostomy care in the correct order.

6 / 30

You are caring for a client who was admitted to your medical-surgical unit for observation after being evaluated in the emergency department for blunt trauma to the abdomen. Which instructions are appropriate to give to the UAP?

7 / 30

You are caring for a client who was recently admitted for severe diverticulitis. Which task is appropriate to delegate for the care of this client?

8 / 30

You must rearrange the room assignments for several clients. Which two clients would be best to put in the same room?

9 / 30

A client underwent an exploratory laparotomy 2 days ago. The physician should be called immediately for which physical assessment finding?

10 / 30

For clients coming to the ambulatory care GI clinic, which task would be most appropriate to assign to an LPN/LVN?

11 / 30

You are caring for a client with cirrhosis and portal hypertension. Which statement by the client concerns you the most?

12 / 30

In the care of a client with acute viral hepatitis, which task should be delegated to the UAP?

13 / 30

You are providing postoperative care for a client who underwent laparoscopic cholecystectomy. What should be reported immediately to the physician?

14 / 30

You are caring for an obese postoperative client who underwent surgery for bowel resection. As the client is moving in bed, he comments, “Something popped open.” Upon examination you note wound evisceration. Place in order the steps for handling this complication.

15 / 30

While transferring a dirty laundry bag, a UAP sustains a puncture wound to the finger from a contaminated needle. The unit has several clients with hepatitis and acquired immunodeficiency syndrome (AIDS); the needle source is unknown. Place in order of priority the instructions that should be given to the UAP.

16 / 30

A client hospitalized with ulcerative colitis reports 10 to 20 small diarrhea stools per day, with abdominal pain before defecation. The client appears depressed and underweight and is uninterested in self-care or suggested therapies. What is the priority nursing diagnosis?

17 / 30

You are planning a treatment and prevention program for chronic fecal incontinence for an elderly client. Which intervention should you try first?

18 / 30

You are caring for a client with a nasogastric (NG) tube. Which task can be delegated to an experienced UAP?

19 / 30

You are teaching the client and family how to perform colostomy irrigation. Place the following information in the correct order.

20 / 30

A client with proctitis needs a rectal suppository. A senior nursing student assigned to care for this client tells you that she is afraid to insert a suppository because she has never done it before. What is the most appropriate action in supervising this student?

21 / 30

The postoperative care of a morbidly obese client is being planned. Which task best utilizes the expertise of the LPN/LVN?

22 / 30

Which client is the most appropriate to assign to an LPN/LVN, under the supervision of an RN?

23 / 30

You are providing immediate postoperative care for a client who had fundoplication to reinforce the lower esophageal sphincter for the purpose of a hiatal hernia repair. What is the priority action for the care of this client?

24 / 30

In the care of a client with gastroesophageal reflux disease, which task would be appropriate to assign to a UAP?

25 / 30

You are taking report on an elderly client who was admitted with abdominal pain and nausea, vomiting, and diarrhea. The client also has a history of chronic dementia. Which comment by the night shift nurse concerns you the most?

26 / 30

You are taking an initial history for a client seeking surgical treatment for obesity. Which finding should be called to the attention of the surgeon before proceeding with additional history taking or physical assessment?

27 / 30

You are caring for a client with peptic ulcer disease. Which assessment finding is the most serious?

28 / 30

You are preparing to administer TPN through a central line. Place the following steps for administration in the correct order.

29 / 30

You would be most concerned about an order for a total parenteral nutrition (TPN) fat emulsion for a client with which condition?

30 / 30

When a client is being prepared for a colonoscopy procedure, which task is most suitable to delegate to the UAP?

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The average score is 42%

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Nclex Academy Mastery Day 11 – Evening

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NCLEX ACADEMY MASTERY DAY 11 – EVENING

DAY ELEVEN – EVENING ASSESSMENT

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1 / 18

The nurse prepares to irrigate the external auditory canal for a client with impacted cerumen. What would be included in the correct technique for irrigation?

2 / 18

A client is being admitted for problems with Ménière’s disease. What is most important for the nurse to assess to promote the client’s safety?

3 / 18

The nurse is evaluating a teenager for hearing loss. In reviewing the client’s history, the nurse knows that which finding is not associated with a hearing loss?

4 / 18

A 3-year-old child had a myringotomy about a week ago. The mother calls the nurse to report that one of the tubes fell out. She found the tube on the child’s pillow. After the nurse makes an appointment for the child to be seen in the clinic, what would be important to tell the mother?

5 / 18

A client is walking down the hall, and he begins to experience vertigo. What is the most important nursing action when this occurs?

6 / 18

The nurse is discharging a client with bilateral cataracts following cataract surgery on one eye. What statement by the client would indicate to the nurse the need for additional teaching?

7 / 18

A parent and an 8-month-old child come into a public health clinic for a well-child checkup. The parent tells the nurse the child has been crying more than usual. What information obtained during the nursing assessment would cause the nurse the most concern?

8 / 18

When teaching a family and a client about the use of a hearing aid, the nurse will base the teaching on what information regarding the hearing aid?

9 / 18

Which client is at highest risk for retinal detachment?

10 / 18

An unknown chemical was splashed into a client’s eyes. What is most important for the nurse to tell the client to do immediately?

11 / 18

A child is diagnosed with conjunctivitis. Which statement indicates that the child understood the nurse’s teaching?

12 / 18

A client’s eye has been anesthetized for an ophthalmology examination. What instructions will be important for the nurse to give the client?

13 / 18

The nurse is admitting a postoperative client after removal of an acoustic neuroma. What would be most important to include in the postoperative nursing care for this client?

14 / 18

A client comes to the clinic with decreased hearing. Examination of the ear canal reveals a large amount of cerumen. What is the recommended method for removal of the cerumen?

15 / 18

A child is scheduled for a myringotomy with placement of tympanostomy tubes. What is the long-term goal of this procedure that the nurse will discuss with the parents?

16 / 18

The nurse is evaluating a client recently diagnosed with primary open angle glaucoma (POAG). What will be an important nursing action(s)? Select all that apply.

17 / 18

A client who has glaucoma is concerned about her adult children “inheriting” the condition. What is the best nursing response?

18 / 18

The nurse would question which medication order for a client with PACG (primary angle-closure glaucoma)?

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The average score is 42%

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Nclex Academy Mastery Day 12 – Morning

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NCLEX ACADEMY MASTERY DAY 12 – MORNING

DAY TWELVE – MORNING ASSESSMENT

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1 / 28

You have received orders to initiate phototherapy on a 36-hour-old newborn with an elevated bilirubin level. What instructions will you give the student nurse who is assisting in the care of the infant? (Select all that apply.)

2 / 28

A full-term newborn is at the clinic with his parents. He is 4 days old. His birth weight was 7 pounds. Which assessment made by the RN is most significant?

3 / 28

A 3-day-old breast-fed infant is brought to the clinic by his parents for routine assessment following a normal full-term delivery without complications. Which statement by the parents suggests an abnormal finding on a newborn of this age?

4 / 28

A 23-year-old G1P0 patient at 10 weeks states that she exercises 5 days a week. You have discussed exercise in pregnancy with her. Which statement by the patient indicates that more teaching of evidence-based principles is needed?

5 / 28

A 22-year-old woman is 6 weeks postpartum. In the clinic she admits to crying every day, feeling overwhelmed, and sometimes thinking that she may hurt the baby. What would be the priority nursing action at this time?

6 / 28

A 30-year-old G6P5 woman at 12 weeks has just begun prenatal care, and her initial laboratory work reveals that she has tested positive for human immunodeficiency virus (HIV) infection. What would be priority evidence-based nursing education for this patient today?

7 / 28

A 25-year-old G2P1 patient has come to the obstetric triage room at 32 weeks reporting painless vaginal bleeding. You are providing orientation for a new RN on the unit. Which statement by the new RN to the patient would require your prompt intervention?

8 / 28

A 17-year-old G1P0 woman at 40 weeks is in labor. She has chosen natural childbirth with assistance from a doula. Her mother and her boyfriend are at the bedside. What nursing action can help the patient achieve her goal of an unmedicated labor and birth?

9 / 28

A 36-year-old G1P0 patient has received an epidural anesthetic. Her cervix is 6 cm dilated. Her blood pressure is currently 60/38 mm Hg. Which would be appropriate priority nursing actions? (Select all that apply.)

10 / 28

A 22-year-old G1P0 woman is being given an epidural anesthetic for pain control during labor and birth. Which are appropriate nursing actions when epidural anesthesia is used during labor? (Select all that apply.)

11 / 28

A 27-year-old patient underwent a primary cesarean section because of breech presentation 24 hours ago. Which assessment finding would be of the most concern?

12 / 28

A 30-year-old G1P0 woman at 39 weeks experienced a fetal demise and has just delivered a female infant. Her husband is at the bedside. Which are appropriate nursing actions at this time? (Select all that apply.)

13 / 28

While assessing a 29-year-old G2P2 patient who had a normal spontaneous vaginal delivery 30 minutes ago, you note a large amount of red vaginal bleeding. What would be your first priority nursing action?

14 / 28

As the charge nurse in the labor and delivery unit, you need to assign two patients to one of the RNs because of a staffing shortage. Normally on your unit the nurse-patient ratio is 1:1. Which two patients would you assign to the RN?

15 / 28

Which statements by a new father indicate that additional discharge teaching is needed for this family, who had their first baby 24 hours ago? (Select all that apply.)

16 / 28

You are the charge nurse in the labor and delivery unit. Which action by a newly graduated RN during a delivery complicated by shoulder dystocia would require your immediate intervention?

17 / 28

A 26-year-old G1P1 patient who underwent cesarean section 24 hours ago tells the nurse that she is having some trouble breast-feeding. Which tasks could be appropriately delegated to the UAP on the postpartum floor? (Select all that apply.)

18 / 28

A pregnant woman at 12 weeks’ gestation tells you that she is a vegetarian. What would be the first appropriate nursing action?

19 / 28

A 24-year-old G1P0 patient, who is receiving oxytocin (Pitocin), is in labor at 41 weeks’ gestation. Which are appropriate nursing actions in the presence of late fetal heart rate decelerations? (Select all that apply.)

20 / 28

What would be the appropriate first nursing action when caring for a 20-year-old G1P0 woman at 39 weeks’ gestation who is in active labor and for whom an assessment reveals mild variable fetal heart rate decelerations?

21 / 28

You are the RN in the labor and delivery unit caring for a 25-year-old G3P2 patient in active labor. You have identified late fetal heart decelerations and decreased variability in the fetal heart rate. You have notified the provider on call, who feels that the pattern is acceptable. What would be your priority action at this time?

22 / 28

You are working as a telephone triage nurse in the prenatal clinic. Which telephone call would require immediate notification of the provider?

23 / 28

A 24-year-old G2P1 woman is being admitted in active labor at 39 weeks’ gestation. What prenatal data would be most important to know in your care of this patient at this time?

24 / 28

Which action would best demonstrate evidence-based nursing practice in the care of a patient who is 1 day postpartum and reporting nipple soreness while breast-feeding?

25 / 28

A 19-year-old G1P0 patient at 40 weeks’ gestation who is in labor is being treated with magnesium sulfate for seizure prophylaxis in preeclampsia. Which are priority assessments with this medication? (Select all that apply.)

26 / 28

You are working in the obstetric triage area, and several patients have just come in. Which patient should you assess first?

27 / 28

Which task could be appropriately assigned to the UAP working with you at the obstetric clinic?

28 / 28

A 30-year-old woman with type 1 diabetes mellitus comes to the clinic for preconception care. What is the priority education for her at this time?

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Nclex Academy Mastery Day 12 – Evening

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NCLEX ACADEMY MASTERY DAY 12 – EVENING

DAY TWELVE – EVENING ASSESSMENT

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1 / 19

A client with diabetes receives a combination of regular and NPH insulin at 0700 hours. The nurse teaches the client to be alert for signs of hypoglycemia at:

2 / 19

Which medication will the nurse have available for emergency treatment of tetany in the client who has had a thyroidectomy?

3 / 19

When caring for a client in a thyroid crisis, the nurse would question an order for:

4 / 19

A client admitted with a pheochromocytoma returns from the operating room after adrenalectomy. The nurse should carefully assess this client for:

5 / 19

What is the nurse’s priority concern for a client admitted to the hospital with a diagnosis of diabetes insipidus?

6 / 19

A nurse assessing a client with syndrome of inappropriate antidiuretic hormone (SIADH) would expect to find which laboratory values?

7 / 19

It is important for the nurse to teach the client which of the following about metformin (Glucophage)?

8 / 19

The nurse is performing an assessment on a client who has been receiving long-term steroid therapy. What would the nurse expect to find during the assessment?

9 / 19

A client with a diagnosis of type 2 diabetes has been ordered a course of prednisone for severe arthritic pain. An expected change that requires close monitoring by the nurse is:

10 / 19

A client has been receiving inhalation desmopressin (DDAVP) therapy for hypothalamic diabetes insipidus. What will the nurse evaluate to determine the therapeutic response to this medication?

11 / 19

A client is scheduled for a routine glycosylated hemoglobin (HbA1C) test. What is important for the nurse to tell the client before this test?

12 / 19

What is a characteristic symptom of hypoglycemia that should alert the nurse to an early insulin reaction?

13 / 19

What will the nurse teach the client with diabetes regarding exercise in the treatment program? Select all that apply.

14 / 19

A patient is prescribed levothyroxine (Synthroid) daily. What is the most important instruction to teach for administration of this drug?

15 / 19

A nurse knows the clinical manifestations of a client with Addison’s disease include which of the following? Select all that apply.

16 / 19

A client is found to be comatose and hypoglycemic with a blood glucose level of 50 mg/dL. What nursing action is implemented first?

17 / 19

The nurse is assigned to care for a new client with acute pancreatitis. What would the nurse anticipate finding during the assessment of this client?

18 / 19

The nurse is caring for a client postoperative thyroidectomy. What would be an important nursing intervention?

19 / 19

A client is receiving NPH insulin 20 units subcutaneously at 0700 hours daily. At 1500 hours, the nurse finds the client apparently asleep. How would the nurse know whether the client was having a hypoglycemic reaction?

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The average score is 36%

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Nclex Academy Mastery Day 13 – Morning

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NCLEX ACADEMY MASTERY DAY 13 – MORNING

DAY THIRTEEN -MORNING ASSESSMENT

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1 / 50

The nurse is caring for a client who has hypersplenism. What laboratory test finding would indicate that the client has splenomegaly?

2 / 50

The nurse identifies which problem as most likely to lead to a sickle cell crisis?

3 / 50

The parents of a client with hemophilia are taking their child home. Which statement indicates a need for further education regarding hemophilia?

4 / 50

A client has been diagnosed with pernicious anemia. What will the nurse teach this client regarding the medication he will need to take after he goes home?

5 / 50

The nurse is assessing a client who has been diagnosed with polycythemia vera. What manifestations will the nurse anticipate finding?

6 / 50

A client has been diagnosed with disseminated intravascular coagulopathy (DIC). The nurse will anticipate administering which of the following fluids?

7 / 50

The nurse is providing teaching to a family whose child has been recently diagnosed with hemophilia. Which of the following would the nurse include in this discussion?

8 / 50

A client in sickle cell crisis is admitted to the emergency department (ED). What are the priorities of care in order of importance?

9 / 50

The nurse is providing discharge instructions to a client who has had a splenectomy. The teaching is based on the knowledge that splenectomy clients have:

10 / 50

The nurse is caring for a client with leukemia who is experiencing bleeding into the knee joints. What is the best nursing care for this client regarding joint mobility and activity?

11 / 50

The nurse is caring for a client who is receiving a blood transfusion. The transfusion was started 30 minutes ago at a rate of 100 mL/hr. The client begins to complain of low back pain and headache and is increasingly restless. What is the first nursing action?

12 / 50

A client has an order for one unit of packed cells. What is a correct nursing action?

13 / 50

A client with hemophilia comes to the emergency department after bumping his knee. The knee is rapidly swelling. What is the first nursing action?

14 / 50

Which client is most likely to have iron deficiency anemia?

15 / 50

A child with leukemia is being discharged after beginning chemotherapy. What instructions will the nurse include in the teaching plan for the parents of this child?

16 / 50

A young woman comes to the clinic complaining of dizziness, weakness, and palpitations. What will be important for the nurse to evaluate initially when obtaining the health history?

17 / 50

The nurse is preparing a teaching plan for a family with a child who has been diagnosed with sickle cell anemia and crisis. What will the nurse include in the teaching regarding the pathophysiology of sickle cell crisis?

18 / 50

A client is experiencing a sickle cell crisis during labor and delivery. What is the best nursing action?

19 / 50

The nurse is preparing discharge teaching for a client with aplastic anemia. What will be important to include in the teaching plan? Select all that apply.

20 / 50

A client and her husband are positive for the sickle cell trait. The client asks the nurse about the chances of her children having sickle cell disease. The nurse understands that this genetic problem will reflect what pattern in the client’s children?

21 / 50

You have just finished assisting the physician with a thoracentesis for a patient with recurrent left pleural effusion caused by lung cancer. The thoracentesis removed 1800 mL of fluid. Which patient assessment information is important to report to the physician?

22 / 50

You are the team leader RN working with a student nurse. The student nurse is to teach a patient how to use an MDI without a spacer. Put in correct order the steps that the student nurse should teach the patient.

23 / 50

You are the preceptor for an RN who is undergoing orientation to the intensive care unit. The RN is providing care for a patient with ARDS who has just been intubated in preparation for mechanical ventilation. You observe the nurse perform all of these actions. For which action must you intervene immediately?

24 / 50

You are supervising an RN who floated from the medical-surgical unit to the emergency department. The nurse is providing care for a patient admitted with anterior epistaxis (nosebleed). Which directions would you clearly provide to the RN? (Select all that apply.)

25 / 50

You are supervising a student nurse who is performing tracheostomy care for a patient. Which action by the student would cause you to intervene?

26 / 50

You are supervising a nursing student who is providing care for a thoracotomy patient with a chest tube. What finding would you clearly instruct the nursing student to notify you about immediately?

27 / 50

You are responsible for the care of a postoperative patient with a thoracotomy. The patient has been given the nursing diagnosis of Activity Intolerance. Which action should you delegate to the UAP?

28 / 50

You are providing care for a patient with recently diagnosed asthma. Which key points would you be sure to include in your teaching plan for this patient? (Select all that apply.)

29 / 50

You are making a home visit to a 50-year-old patient who was recently hospitalized with a right leg deep vein thrombosis and a pulmonary embolism. The patient’s only medication is enoxaparin (Lovenox) subcutaneously. Which assessment information will you need to communicate to the physician?

30 / 50

You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to the UAP?

31 / 50

You are evaluating and assessing a patient with a diagnosis of chronic emphysema. The patient is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you immediately?

32 / 50

You are caring for a patient with emphysema and respiratory failure who is receiving mechanical ventilation through an endotracheal tube. To prevent ventilator-associated pneumonia (VAP), which action is most important to include in the plan of care?

33 / 50

You are assigned to provide nursing care for a patient receiving mechanical ventilation. Which action should you delegate to an experienced UAP?

34 / 50

You are admitting a patient for whom a diagnosis of pulmonary embolus must be ruled out. The patient’s history and assessment reveal all of these findings. Which finding supports the diagnosis of pulmonary embolus?

35 / 50

You are acting as preceptor for a newly-graduated RN during her second week of orientation. You would assign the new RN under your supervision to provide nursing care to which patients? (Select all that apply.)

36 / 50

Which intervention for a patient with a pulmonary embolus could be delegated to the LPN/LVN on your patient care team?

37 / 50

When assessing a 22-year-old patient who required emergency surgery and multiple transfusions 3 days ago, you find that the patient looks anxious and has labored respirations at a rate of 38 breaths/min. The oxygen saturation is 90% with the oxygen delivery at 6 L/min via nasal cannula. Which action is most appropriate?

38 / 50

When a patient with TB is being prepared for discharge, which statement by the patient indicates a need for further teaching?

39 / 50

The UAP tells you that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is reporting nasal passage discomfort. What intervention should you suggest to improve the patient’s comfort for this problem?

40 / 50

The patient with COPD tells the UAP that he did not get his annual flu shot this year and has not had a pneumonia vaccination. You would be sure to instruct the UAP to report which vital sign value?

41 / 50

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN/LVN under your supervision?

42 / 50

The high-pressure alarm on a patient’s ventilator goes off. When you enter the room to assess the patient, who has ARDS, the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should you take next?

43 / 50

The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months of experience) floated from the surgical unit to the medical unit?

44 / 50

An experienced LPN/LVN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN/LVN? (Select all that apply.)

45 / 50

After the respiratory therapist performs suctioning on a patient who is intubated, the UAP measures vital signs for the patient. Which vital sign value should the UAP report to the RN immediately?

46 / 50

After change of shift, you are assigned to care for the following patients. Which patient should you assess first?

47 / 50

A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the UAP?

48 / 50

A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by nonrebreather mask, but arterial blood gas measurements still show poor oxygenation. As the nurse responsible for this patient’s care, you would anticipate a physician order for what action?

49 / 50

A patient with a pulmonary embolus is receiving anticoagulation with IV heparin. What instructions would you give the UAP who will help the patient with ADLs? (Select all that apply.)

50 / 50

A patient has chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to the UAP?

Your score is

The average score is 53%

Please rate this Quiz

Nclex Academy Mastery Day 13 – Evening

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NCLEX ACADEMY MASTERY DAY 13 – EVENING

DAY THIRTEEN – EVENING ASSESSMENT

The number of attempts remaining is 1

User Information

1 / 20

The nurse is caring for a client who has hypersplenism. What laboratory test finding would indicate that the client has splenomegaly?

2 / 20

The nurse identifies which problem as most likely to lead to a sickle cell crisis?

3 / 20

The parents of a client with hemophilia are taking their child home. Which statement indicates a need for further education regarding hemophilia?

4 / 20

A client has been diagnosed with pernicious anemia. What will the nurse teach this client regarding the medication he will need to take after he goes home?

5 / 20

The nurse is assessing a client who has been diagnosed with polycythemia vera. What manifestations will the nurse anticipate finding?

6 / 20

A client has been diagnosed with disseminated intravascular coagulopathy (DIC). The nurse will anticipate administering which of the following fluids?

7 / 20

The nurse is providing teaching to a family whose child has been recently diagnosed with hemophilia. Which of the following would the nurse include in this discussion?

8 / 20

A client in sickle cell crisis is admitted to the emergency department (ED). What are the priorities of care in order of importance?

9 / 20

The nurse is providing discharge instructions to a client who has had a splenectomy. The teaching is based on the knowledge that splenectomy clients have:

10 / 20

The nurse is caring for a client with leukemia who is experiencing bleeding into the knee joints. What is the best nursing care for this client regarding joint mobility and activity?

11 / 20

The nurse is caring for a client who is receiving a blood transfusion. The transfusion was started 30 minutes ago at a rate of 100 mL/hr. The client begins to complain of low back pain and headache and is increasingly restless. What is the first nursing action?

12 / 20

A client has an order for one unit of packed cells. What is a correct nursing action?

13 / 20

A client with hemophilia comes to the emergency department after bumping his knee. The knee is rapidly swelling. What is the first nursing action?

14 / 20

Which client is most likely to have iron deficiency anemia?

15 / 20

A child with leukemia is being discharged after beginning chemotherapy. What instructions will the nurse include in the teaching plan for the parents of this child?

16 / 20

A young woman comes to the clinic complaining of dizziness, weakness, and palpitations. What will be important for the nurse to evaluate initially when obtaining the health history?

17 / 20

The nurse is preparing a teaching plan for a family with a child who has been diagnosed with sickle cell anemia and crisis. What will the nurse include in the teaching regarding the pathophysiology of sickle cell crisis?

18 / 20

A client is experiencing a sickle cell crisis during labor and delivery. What is the best nursing action?

19 / 20

The nurse is preparing discharge teaching for a client with aplastic anemia. What will be important to include in the teaching plan? Select all that apply.

20 / 20

A client and her husband are positive for the sickle cell trait. The client asks the nurse about the chances of her children having sickle cell disease. The nurse understands that this genetic problem will reflect what pattern in the client’s children?

Your score is

The average score is 60%

Please rate this Quiz

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