Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 38

1. A 4-year-old child is being discharged from the hospital after being treated for severe croup. Which one of the following instructions should the nurse give to the childs mother for the home treatment of croup?

A) Take him in the bathroom, turn on the hot water, and close the door.
B) Give him a dose of antihistamine.
C) Give large amounts of clear liquids if drooling occurs.
D) Place him near a cool mist vaporizer and encourage crying.

2. A 7-year-old child is brought to the ER at midnight by his mother after symptoms appeared abruptly. The nurse - s initial assessment reveals a temperature of104.5¦F (40.3¦C), difficulty swallowing, drooling, absence of a spontaneous cough, and agitation. These symptoms are indicative of which one of the following?

A) Acute tracheitis
B) Acute spasmodic croup
C) Acute epiglottis
D) Acute laryngotracheobronchitis

3. The nurse is teaching a mother care of her childs spica cast. The mother states that he complains of itching under the edge of the cast. One nonpharmacological technique the nurse might suggest would be:

A) 'Blowing air under the cast using a hair dryer on cool setting often relieves itching.'
B) 'Slide a ruler under the cast and scratch the area.'
C) 'Guide a towel under and through the cast and moveit back and forth to relieve the itch.'
D) 'Gently thump on cast to dislodge dried skin that causes the itching.'

4. A 30-year-old client has just been treated in the ER for bruises and abrasions to her face and a broken arm from domestic violence, which has been increasing in frequency and intensity over the last few months. The nurse assesses her as being very anxious, fearful, bewildered, and feeling helpless as she states, 'I don - t know what to do, I - m afraid to go home.' The best response by the nurse to the client would be:

A) 'I wouldn - t want to go home either; call a friend who could help you.'
B) 'Did you do something that could have made him so angry?'
C) 'Let - s talk about people and resources available to you so that you don - t have to go home.'
D) 'I - ll call the police and they will take care of him, and you can go home and get some rest.'

5. A 26-year-old client is in a treatment center for aprazolam (Xanax) abuse and continues to manifest moderate levels of anxiety 3 weeks into the rehabilitation program, often requesting medication for 'his nerves.' Included in the client - s plan of care is to identify alternate methods of coping with stress and anxiety other than use of medication. After intervening with assistance in stress reduction techniques, identifying feelings and past coping, the nurse evaluates the outcome as being met if:

A) Client promises that he will not abuse aprazolam after discharge
B) Client demonstrates use of exercise or physical activity to handle nervous energy following conflicts of everyday life
C) Client is able to verbalize effects of substance abuse on the body
D) Client has remained substance free during hospitalization and is discharged

1. Right Answer: A
Explanation: (A) Initial home treatment of croup includes placing the child in an environment of high humidity to liquefy and mobilize secretions. (B) Antihistamines should be avoided because they can cause thickening of secretions. (C) Drooling is a characteristic sign of airway obstruction and the child should be taken directly to the emergency room. (D) Crying increases respiratory distress and hypoxia in the child with croup. The nurse should promote methods that will calm the child.

2. Right Answer: C
Explanation: (A) Clinical manifestations of acute tracheitis include a 23 day history of URI, croupy cough, stridor, purulent secretions, high fever. (B) Clinical manifestations of spasmodic croup include a history of URI, croupy cough, stridor, dyspnea, low-grade fever, and a slow progression. The age group most affected is 3 months to 3 years. (C) Three clinical observations have been found to be predictive of epiglottitis: the presence of drooling, absence of spontaneous cough, and agitation.Epiglottitis has a rapid onset that is accompanied by high fever and dysphagia. (D) Clinical manifestations of acute laryngotracheobronchitis (LTB) include slow onset with a history of URI, low-grade fever, stridor, brassy cough, and irritability.

3. Right Answer: A
Explanation: (A) Cool air will often relieve pruritus without damaging the cast or irritating the skin. (B) The nurse should never force anything under the cast, because the cast may become damaged and skin breakdown may occur. (C) Forcing an object under the cast could lead to cast damage and skin breakdown. The object may become lodged under the cast necessitating cast removal. (D) This technique does not dislodge skin cells. It could damage the cast and cause skin breakdown.

4. Right Answer: C
Explanation: (A) A person in crisis needs support, assistance, and direction from a caregiver rather than just an instruction. (B) A battered person may feel guilt and think that they cause the abusers behavior; however, the abuser has the problem and goes through phases of violence. (C) The nurse should provide support and guidance to the client in crisis by offering alternatives and assist in referrals. (D) Focusing on help from law enforcement may be a very temporary solution, because the victim may be fearful of pressing charges. This answer does not address the crisis of going home.

5. Right Answer: B
Explanation: (A) This client response does not address stress reduction techniques. Verbal response focuses only on the problem. (B) Exercise or physical activity is a common strategy or coping technique used to reduce stress and anxiety. (C) Verbalizing effects of substance abuse on the body may help with insight and break through denial, but it is not a strategy to reduce anxiety. (D)Remaining substance-free does indicate motivation to change lifestyle of substance abuse or dependence, and it is not a stress reduction strategy in itself.

80% DISCOUNT: NCLEX-RN PRACTICE EXAMS