NCLEX-RN EXAM PACK SET 9 75
QUESTIONS & ANSWERS UPDATED EXAM
|QUESTIONS WITH CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |A+
GRADED
1. 1. Question
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Which roommate would be most suitable for the 6-year-old
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male with a fractured femur in Russell’s traction?
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o A. 16-year-old female with scoliosis
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o B. 12-year-old male with a fractured femur
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o C. 10-year-old male with sarcoma
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o D. 6-year-old male with osteomyelitis
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Correct Answer: B. 12-year-old male with a fractured
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femur
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The 6-year-old should have a roommate as close to the same age
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as possible, so the 12-year-old is the best match. A bed is
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Vavailable and the patient gets assigned. There are certain
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Vconstraints—sex, semi-private versus private, isolation issues,
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Vacuity, telemetry and specialty needs. All need to be taken into
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Vaccount to ensure that each patient goes to the right place
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Vandreceives the proper care. But good capacity management
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Vdemands that bed assignment be carefully considered and
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Vexecuted.
o Option A: The client is too old and is female. Bed
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assignment simply provides the proper location
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basedon specific patient attributes like sex,
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isolation, telemetry, acuity, and specialty needs.
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o Option C: The 10-year-old with sarcoma has cancer V V V V V V V
and will be treated with chemotherapy that makes
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him immune suppressed. Bed managers aim at
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finding an assignment of patients to rooms that
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strikes a balancebetween patients’ preferences and
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comfort on the one V V V V
, hand, and patients’ clinical conditions and the
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resulting required room facilities on the other.
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o Option D: The 6-year-old with osteomyelitis is
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infectious. Rooms and beds belong to the critical
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assets of just any hospital. They account for a
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considerable part of a hospital’s infrastructure, and
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alarge amount of financial resources are invested in
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equipping them with medical apparatus to facilitate
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patient care. Furthermore, they also represent the
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place where most patients will spend a large part of
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their stay, as they recover from surgery, wait for
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examinations to take place, etc.
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• 2. Question
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A client with osteoarthritis has a prescription for celebrex
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(Celecoxib). Which instruction should be included in the
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discharge teaching?
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o A. Take the medication with milk.
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o B. Report chest pain.
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o C. Remain upright after taking for 30 minutes.
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o D. Allow 6 weeks for optimal effects.
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Correct Answer: B. Report chest pain.
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Cox II inhibitors have been associated with heart attacks and
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strokes. Any changes in cardiac status or signs of a stroke should
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be reported immediately, along with any changes in bowel or
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bladder habits because bleeding has been linked to use of Cox II
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inhibitors. Like all NSAIDs, celecoxib carries an FDA boxed
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warning for cardiovascular risk, including the increased risk of
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heart attacks and strokes. As a selective COX-2 inhibitor,
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celecoxib also faces scrutiny for increased cardiovascular risk,
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since another selective COX-2 inhibitor, rofecoxib, was
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withdrawnfrom production in 2004 due to cardiovascular risk
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concerns.
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o Options A: The medication can be taken with water.
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Celecoxib is a medication that is taken orally and
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comes in 50, 100, 200, and 400 mg doses. In rare
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cases, celecoxib can also be added to customized
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, compounds for topical administration with or without V V V V V V
the use of iontophoresis or other topical delivery
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mechanisms. It is not available via any other route
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ofadministration.
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o Option C: The client may remain upright but not
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necessarily for 30 minutes. Symptoms of celecoxib
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overdose would likely be similar to overdoses of
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other NSAIDs, which include lethargy, drowsiness,
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nausea, vomiting, and epigastric pain. Activated
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charcoal may be administered for overdose
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treatment at the discretion of emergency medical
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providers if the patient presents within 4 hours of
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known or suspectedingestion of significant amounts
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of celecoxib.
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o Option D: Allow 6 weeks for optimal effect. In V V V V V V V V
theinpatient setting, as mentioned above,
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celecoxib is increasingly being used as part of
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pre-operative andpost-operative multimodal pain
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management algorithms. Research has shown in
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several small randomized trials that administering
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celecoxib peri- operatively for elective procedures
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such as total hiparthroplasties, total knee
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arthroplasties, and other procedures with some
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success in reducing pain and improving
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• 3. Question V
A client with a fractured tibia has a plaster-of-Paris cast applied to
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immobilize the fracture. Which action by the nurse indicates an
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Vunderstanding of a plaster-of-Paris cast? The nurse:
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o A. Handles the cast with the fingertips
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o B. Petals the cast
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o C. Dries the cast with a hair dryer
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o D. Allows 24 hours before bearing weight
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Correct Answer: D. Allows 24 hours before bearing
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weightA plaster-of-Paris cast takes 24 hours to dry, and the
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client shouldnot bear weight for 24 hours. After the process of
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applying the casting material is completed, the material will
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start to dry in
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, about 10 to 15 minutes. The temperature of the skin might rise
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as the plaster is drying because of a chemical reaction that
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occurs. When plaster is used, it can take from 1 to 2 days for
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thecast to harden completely.
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o Option A: The cast should be handled with the V V V V V V V V
palms,not the fingertips. Use the palm of hand to
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apply, hold,or move cast and support on pillows after
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application. Uneven plaster is irritating to the skin
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and may result in abrasions. V V V V V
o Option B: Petaling a cast is covering the end of the V V V V V V V V V V
cast with cast batting or a sock, to prevent skin
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irritation and flaking of the skin under the cast. Trim
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excess plaster from edges of the cast as soon as
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casting is completed; prevents skin breakdown caused
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by prolonged moisture trapped under the cast.
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o Option C: The client should be told not to dry the V V V V V V V V V V
castwith a hair dryer because this causes hot spots
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and could burn the client. This also causes unequal
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drying. Promote cast drying by removing bed linen,
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exposing it to circulating air; pressure can cause
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ulcerations, necrosis, or nerve palsies. Pad (petal) the
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edges of the cast with waterproof tape; provides an
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effective barrierto cast flaking and moisture. Helps
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prevent the breakdown of cast material at the edges
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and reduce skin irritation and excoriation.
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• 4. Question V
The teenager with a fiberglass cast asks the nurse if it will be
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okay to allow his friends to autograph his cast. Which
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response would be best?
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o A. "It will be alright for your friends to
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V autographthe cast." V V
o B. "Because the cast is made of plaster, autographing
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can weaken the cast."
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o C. "If they don’t use chalk to autograph, it is okay."
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o D. "Autographing or writing on the cast in any form
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V willharm the cast." V V V
