NCLEX-PN Flashcard Book

REA'S Interactive

Flashcards®

NCLEX-PN®

National Council Licensure Examination for Practical Nurses

Rebekah Warner, RN, BSN

Research & Education Association

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The information contained herein presents scenarios and other narrative consistent with targeted preparation for the NCLEX-PN Exam. The book's contents are deemed to be accurate and relevant to the cited subject matter at the time of publication. Neither the publisher, Research & Education Association, Inc., northe author(s) is engaged in nor shall be construed as offering legal, nursing or medical advice or assistance or a plan of care. If legal, nursing or medical assistance is required, the services of a competent professional person should be sought.

NCLEX-PN® is a registered trademark of the National Council of State Boards of Nursing, Inc.

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REA's Interactive Flashcards® Book for the NCLEX-PN® (National Council Licensure Examination for Practical Nurses)

Published 2012

Copyright © 2008 by Research & Education Association, Inc. All rights reserved. No part of this book may be reproduced in any form without permission of the publisher.

Printed in the United States of America

Library of Congress Control Number 2007903242

ISBN-13: 978-0-7386-0211-0

ISBN-10: 0-7386-0211-6

REA's Interactive Flashcards•

What they're for. . .

          How to use them. . .

They come in a book, not in a box of hundreds of loose cards.

They are most useful as test time approaches to help you check your test readiness.

They are a good tool for self-study and also for group study.

They can even be used as a competitive game to see who scores best.

They work with any text.

The interactive feature is a unique learning tool. With it, you can write in your own answer to each question which you can then check against the correct answer provided on the flip side of each card.

You will find that the flashcards in a book have several advantages over flashcards in a box.

You don‘t have to cope with hundreds of loose cards. Whenever you want to study, you don’t have to decide beforehand which cards you are likely to need; you don't have to pull them out of a box (and later return them in their proper place). You can just open the book and get going without ado.

A very detailed index will guide you to whatever topics you want to cover.

You can take along REA's flashcard book anywhere, ready for use when you are. You don't need to tote along the box or a bunch of loose cards.

REA's Flashcard books have been carefully put together with REA's customary concern for quality. We believe you will find them an excellent review and study tool.

Larry B. Kling

Chief Editor   

P.S. As you could tell, you could see all the flashcards in the book while you were in the store; they aren't sealed in shrink-wrap.

About Research & Education Association

Founded in 1959, Research & Education Association (REA) is dedicated to publishing the finest and most effective educational materials–including software, study guides, and test preps–for students in middle school, high school, college, graduate school, and beyond.

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Acknowledgments

We would like to thank Larry B. Kling, Vice President, Editorial, for his overall direction; Pam Weston, Vice President, Publishing, for setting the quality standards for production integrity and managing the publication to completion; Diane Goldschmidt, Senior Editor, for project management and preflight editorial review; Christine Saul, Senior Graphic Designer, for designing our cover; and Aquent Publishing Services for typesetting the manuscript.

About the Author

Rebekah Warner is a Registered Nurse (RN) with a Baccalaureate of Science in Nursing (BSN) degree. Upon graduation from the nursing program at Roberts Wesleyan College in Rochester, N.Y., in May 2004, Rebekah and her husband, Robert, moved to central Florida. There, she accepted her first position as an RN in the medical cardiology department of a large local hospital. The cardiology department is considered a critical care floor that consists of a primary population of clients with chronic or acute conditions of the heart.

Rebekah's next position found her at a smaller community hospital in the area, where she is currently employed on the Progressive Care Unit (PCU). The PCU is designed for the care of clients suffering from various critical conditions that are stable enough to be cared for outside of the Intensive Care Unit (ICU).

While in nursing school, Rebekah was inducted into Delta Sigma Tai, the honor society for nurses. She became a member of the American Association of Critical Care Nurses (AACN) in 2005. She is also currently certified in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Cardio-Pulmonary Resuscitation (CPR).

Aside from this work, Rebekah has written review notes for basic college chemistry to be used for students who are preparing to take the College-Level Examination Program's (CLEP) Chemistry examination.

Contents

Questions

Correct Answers

Questions

Q–1

Elderly Mr. Thomas comes into the Urgent Care Clinic. He states, I tripped and fell down the stairs in my house. When the doctor visits the patient, the LPN/LVN describes the injury as exhibiting pain with movement, swollen, and ecchymotic. When Mr. Thomas asks what ecchymotic means, the best response from the nurse would be:

(A) fractured

(B) blanched

(C) edematous

(D) bruised

Your Answer

Q–2

The LPN/LVN observes a nursing assistant applying a client's antiembolism stockings. What is the appropriate routine for these stockings?

(A)The nursing assistant is applying the stockings just after assisting the patient with ROM leg exercises.

(B)The nursing assistant is applying the stockings just before assisting the patient out of bed in the morning.

(C)The nursing assistant is applying the stockings at night as the patient is getting ready to go to sleep.

(D)The nursing assistant is applying the stockings after observing the color and temperature of the skin.

Your Answer

Correct Answers

A–1

(D) Ecchymosis describes a discoloration of the skin, usually black and blue in color. Ecchymosis is another word for a bruise. This is caused by blood dispersing into the skin after rupture of small blood vessels. A fractured ankle would have to be diagnosed most likely by x-ray, not nursing assessment. Blanched skin refers to skin that is pale. Edema is accumulation of fluid in the tissue or swelling.

A–2

(B) The correct and best time for application of anti-embolism stockings is in the morning, before the client gets out of bed or after the legs have been elevated for an amount of time. The client's lower extremities should be in a non-dependent position during application to prevent trapping venous blood. Antiembolism stockings are usually worn continuously and should only be removed for the nurse to assess the skin.

Questions

Q–3

Mr. Stone is a 32-year-old who recently underwent ORIF (open reduction, internal fixation) surgery for a fractured femur. Over the past few hours the client has started to call the nurse frequently. Mr. Stone has also become more irritable and restless. The best nursing response to this behavior would be:

(A)Encourage the patient to use relaxation techniques to aid with pain management.

(B)Notify the doctor of the patient's behavior.

(C)Ask the patient if there is something on his mind that he'd like to talk about.

(D)Check on and interact with the client frequently until he is calm, and then increase the intervals as he starts to develop trust in the staff.

Your Answer

In 2004, there were approximately 1,200 state-approved programs at technical schools, vocational schools, high schools, colleges, and universities that provided practical or vocational nurse training. (U.S. Bureau of Labor Statistics)

Correct Answers

A–3

(B) Subtle personality changes, restlessness, irritability, or confusion in a patient who has recently sustained a fracture are indications of possible fat emboli that have migrated to the lungs. The physician should be immediately notified of any of these changes to allow for further and immediate testing and evaluation. Encouraging relaxation, therapeutic communication, and methods to improve trust are interventions that do not deal with the dangerous condition that the symptoms suggest.

Questions

Q–4

Mr. Godfry, a warehouse worker, presented to the Emergency Department with an acute onset of severe lower back pain, muscle spasms, and radiation of pain into the buttocks and leg. The physician suspects that Mr. Godfry has a herniated lumbar intervertebral disk. During assessment, the nurse asks Mr. Godfry to describe the characteristics of the pain. Which of the following is an aggravating factor of the condition suspected by the physician?

(A)Sneezing

(B)Chewing

(C)Talking

(D)Bed rest

Your Answer

According to the standards for licensed practical/vocational nurse practice, as set forth by NAPNES, competency "implies knowledge, understanding, and skills that transcend specific tasks and is guided by a commitment to ethical/legal principles." (www.napnes.org)

Correct Answers

A–4

(A) Pain associated with a herniated intervertebral disk is aggravated by actions that increase intraspinal pressure, such as bending, lifting, or straining. Sneezing or coughing involves an amount of straining. The movement associated with chewing and talking does not usually affect this condition. Although bed rest can aggravate symptoms of other conditions, it is usually a relieving factor for herniated disk pain.

Questions

Q–5

The LPN/LVN is assessing a client's halo traction to ensure it is applied appropriately. Which of the following observations indicates proper use of this device?

(A)The client states his pain is bearable.

(B)The client is able to wiggle his toes comfortably.

(C)The client is not able to turn his head from side to side.

(D)There is a finger-width space between the client's skin and the traction device.

Your Answer

Of the practical or vocational nursing jobs held, approximately 27% are in hospitals and 25% are in nursing care facilities. The other 48% of employed LPNs or LVNs work in a variety of settings, such as physicians' offices, community facilities, educational services, and government agencies. (U.S. Bureau of Labor Statistics)

Correct Answers

A–5

(C) Halo traction is used to keep the neck neutrally aligned and immobilized. The best confirmation that the halo traction is applied properly is that the client is unable to turn his head from side to side. Traction does not control pain. The patient should be medicated for pain as appropriate. Traction fits each person differently. Although it should fit in a way that avoids compromising the patient's skin integrity, there is no rule for the distance between the device and the skin or body part.

Questions

Q–6

Mrs. Fischner, a 55-year-old client, presents to her physician that she has stiffness and pain in her joints that never seems to go away. After laboratory tests, the physician diagnoses rheumatoid arthritis. The results of which laboratory test most likely led to the physician's diagnosis?

(A)Serum creatinine

(B)Erythrocyte sedimentation rate (ESR)

(C)International normalized ratio (INR)

(D)Fasting lipid panel

Your Answer

Q–7

Mrs. Fischner's physician diagnosed that she has rheumatoid arthritis. With this condition, the client's chief complaint is persistent joint pain and stiffness. Pain and stiffness associated with rheumatoid arthritis is most often first noticed in the joints of which of the following?

(A)Hands

(B)Arms

(C)Legs

(D)Neck

Your Answer

Correct Answers

A–6

(B) Erythrocyte sedimentation rate (ESR) is the best diagnostic indicator of rheumatoid arthritis. ESR is a nonspecific test that indicates the presence of an inflammatory disease when elevated. Rheumatoid arthritis is one of a number of disease processes that will elevate this serum level. Serum creatinine is used to evaluate kidney function. International normalized ratio (INR) tests the effectiveness of anticoagulation therapy, usually with the drug Warfarin (Coumadin). A fasting lipid panel measures the cholesterol and lipid levels and ratios that are present in the blood when the levels are not affected by recent food ingestion.

A–7

(A) Clients with rheumatoid arthritis usually experience discomfort in the proximal finger joints of the hands before any other joints of the body. Although rheumatoid arthritis can eventually spread to any or every joint, the symptoms of rheumatoid arthritis usually are noticed in the finger and hand joints prior to the joints of the arms, legs, and neck.

Questions

Q–8

The physician prescribes the following for a patient with rheumatoid arthritis: aspirin 5 g po daily. The pharmacy informs the LPN/LVN that the dosage strength of aspirin per tablet is 5 grains. How many tablets should be distributed for this patient in each 24-hour period?

(A)5

(B)10

(C)15

(D)20

Your Answer

With median annual earnings of $41,550, LPNs and LVNs working in employment services are among the highest paid in the field. (U.S. Bureau of Labor Statistics)

Correct Answers

A–8

(C) One gram (g) contains approximately 15 grains. Therefore, 5 grams contain 75 grains (5 × 15 = 75). Solve for x tablets using the following ratio method:

Therefore, the correct answer is (C).

Questions

Q–9

Mrs. Wilkins, a 60-year-old client with advanced diabetic neuropathy is two days post-op from a right-above-the-knee amputation. During assessment, the LPN/LVN asks the client if she is experiencing any pain. Mrs. Wilkins replies, I‘ve been afraid to mention it. I know my right foot isn’t there anymore, but I feel it aching. Which of the following is the most accurate explanation for this sensation?

(A)You may feel pain in the tissues near the incision site, which is known as referred pain.

(B)You may be experiencing a psychosomatic pain response as a result of the loss you are experiencing.

(C)You may be experiencing intractable pain, which can be controlled well with the appropriate narcotics.

(D)You may be experiencing a sensation called ‘phantom pain’ from the site of the amputation.

Your Answer

Since 1941, the National Association for Practical Nurse Education and Service (NAPNES) has set the standards for licensed practical/vocational nurse practice, which provided the foundation for safe and competent care. (www.napnes.org)

Correct Answers

A–9

(D) Phantom pain is a real sensation that some people feel after loss of a limb or other body part. This can be felt differently by different individuals. Many have described it as burning, cramping, or itching. Some people sense that the limb is still there. Referred pain is the sensation of pain localized in an area distant from the actual injury or area of pathology. Psychosomatic pain or illness is a discomfort or array of symptoms caused by mental processes or emotional responses as opposed to physiological causes. Intractable pain is an often unexplainable, severe, and unrelenting pain. Combined therapies are usually necessary to treat intractable pain.

Questions

Q–10

Mrs. Wilkins is in her second post-op day with a right-above-the-knee amputation. She asks the nurse why her stump must be rewrapped every day with an elastic bandage. Which of the following is the most accurate reason for this procedure?

(A)The bandage absorbs drainage and blood from the incision site.

(B)The bandage helps shape the stump and shrinks the stump size.

(C)The bandage prevents dehiscence of the incision caused by movement.

(D)The bandage helps increase circulation to the incision site.

Your Answer

Q–11

A client has just returned to the hospital room from a liver biopsy. Which of the following is a complication that the LPN/LVN should be aware could occur within the first few hours following this procedure?

(A)Hemorrhage

(B)Infection

(C)Tension pneumothorax

(D)Anaphylaxis

Your Answer

Correct Answers

A–10

(B) The site of a new amputation will develop a large amount of edema. Stump wrapping with an elastic bandage shrinks and shapes the stump for prosthesis construction. Therefore, answer (B) is correct. The prosthesis will not be sized and constructed until the stump is cone shaped and the size is no longer changing. Gauze bandages are used to absorb blood and drainage. Dehiscence is the separation of the edges or reopening of a closed incision. With appropriate suturing, normal movement should not cause dehiscence. Antiembolism stockings are used to aid circulation in uncompromised limbs.

A–11

(A) The most common complication following a liver biopsy is bleeding, which can lead to severe hemorrhage. This is because of the vascular nature of the liver and the possibility for escape of blood through the needle insertion site. The correct answer is answer (A). Infection could occur at the puncture site, but this complication occurs gradually, not within a few hours. A tension pneumothorax occurs when air enters the pleural cavity and becomes trapped after the lung has been punctured or lacerated. This would induce immediate symptoms during the biopsy and would not develop over the hours following the procedure. Anaphylaxis is a severe allergic response. This should not occur with a liver biopsy.

Questions

Q–12

Mrs.