NCLEX Exams Practice Questions Set 1

1. A two-year-old is admitted due to suspected intussusception.
Which of the following is associated with intussusception?:
Projectile Vomiting
palpable mass over the flank
¨Ribbonlike¨ stools
¨Currant Jelly¨ Stools
2. Which of the following findings would be expected in the infant
with biliary atresia?
Rapid Weight gain and hepatomegaly
Dark Stools and poor weight gain
Abdominal distention and rapid weight gain
Adbominal distention and poor weight gain
3. The physician has made a diagnosis of “shaken child” syndrome for a 13-month-old who was brought to the emergency room after a reported fall from his highchair. Which finding supports the diagnosis of “shaken child” syndrome?
Fracture of the Clavicle
Periobital Brusing
fracture of the humerus
retinal hemorrhages
4. The nurse is teaching the mother of an infant with galactosemia. Which information should be included in the nurse’s teaching?:
Sources of galactose are essential for growth
Future children will not be affected
Foods containing galactose can gradually be added
Check food and drug labels for the presence of lactose
5. A four-year-old is admitted with acute leukemia. It will be most
important to monitor the child for?
Abdominal pain and anorexia
Petechiae and mucosal ulcers
Fatigue and bruising
Bleeding and pallor

All the absolute best with this quick practice questions! A tip that I often found to be useful is to read through the topic or diagnosis independently regardless of the answer you selected. In so doing, you will learn more about the condition incase you come across it in the clinical area or in the actual licensure exams.

Reference Rinehart et al. 2017

Nursing Licensure Exam Practice

1. What is the purpose of an APGAR score in obstetrics?
2. What does the first ´´A´´ in an APGAR score stand for?
Apnoeic
Activity
Attention
Acyanotic
Appearance

3. Which of these are types of pelvises as discussed in obstetrics and gynaecology?
Android, Gynaecoid, Anthropoid, obstetric
Android, Gynaecoid, Anthropoid, Platypelloid
4. Which of these are types of incomplete breech presentation?
Footing breech, frank breech
Footling breech and kneeing breech
5. Briefly describe the following stages of labour including the activities of each;
-first stage
-second stage
-third stage
-fourth stage

Hospital Acquired Pneumonia

Hospital-acquired pneumonia (HAP) is pneumonia that develops 48 hours or longer after admission to a hospital. HAP is the second most common nosocomial infection.

-Medscape

Nursing Process Case Studies: Epixtasis

A 14 year old male comes into the emergency with complaints of dizziness, headache & bloody vomitus for 1 day. He has been nose bleeding passively for three days & actively for 24hours. The accompanying guardian has had him lean back in an effort to stop the bleeding.

On assessment he has cold clammy skin and is weak looking while being pale with some confusion. Vital signs: BP 94/55, HR: 120b/m, Spo2 94% on room air with a temperature 34.9 degrees celsius having cold clammy skin.

Write a care plan for this patient on Epixtasis. Let us know in the comments section how that goes. Here is a seven column Nursing Process and some tips and ideas on writing Nursing Care Plans.

Classic signs of Hyperglycemia

Symptoms of hyperglycemia due to insulin deficiency:

  • Polyuria – Increased volume and frequency of urination
  • Polydipsia – Thirst is often extreme
  • Nocturia and secondary enuresis in a previously continent child
  • Weight loss – May be dramatic due to breakdown of protein and fat stores
  • Muscle pains and cramps

Epidemiology of Shock in Pediatrics

Pediatric patients have smaller total blood volumes and, therefore, are at risk to lose a proportionately greater percentage of blood on an equivalent-volume basis during exsanguination compared to adults. The kidneys of children younger than 2 years are not mature; they have a blunted ability to concentrate solute. Younger children cannot conserve circulating volume as effectively as older children. Also, the body surface area is increased relative to the weight, allowing for rapid heat loss and early hypothermia, possibly leading to coagulopathy. Read more here.

Tetralogy of Fallot

A two-year-old patient is admitted into the ward with a diagnosis of Tetralogy of Fallot.

  • Draw and label the position of heart defects in tetralogy of Fallot and direction of blood flow.
  • List six clinical manifestations the patient presents.
  • State five actual nursing diagnoses for this patient.

Tetralogy of Fallot consists of four associated defects:

  1. Ventricular septal defect; This involves the membranous septum and the anterior portion of the muscular septum    , and right ventricular hypertrophy.
  2. Dextroposition of the aorta or overriding aorta; The aorta overrides the right ventricle and is in communication with the septal defect
  3. Narrowing of the pulmonary outflow channel; including pulmonic valve stenosis, a decrease in the size of the pulmonary trunk, or both
  4. Hypertrophy of the right ventricle; Due to the raised work required to pump blood through the obstructed pulmonary channels.

Signs and symptoms;

  1. Cyanosis due to right-to-left shunting at the ventricular septal defect.                        The degree of cyanosis is determined by the restriction of blood flow into the pulmonary bed. Right ventricular outflow obstruction causes deoxygenated blood from the right ventricle to shunt across the ventricular septal defect and be ejected into the systemic circulation.
  2. Hypercyanotic attacks (“tet spells”) which often occur the morning during crying, feeding, or defecating. These stressful activities often raise oxygen needs. Crying and defecating may additionally raise pulmonary vascular resistance.
  3. Acutely cyanotic, irritability & diaphoresis which often occur with the tet spells.
  4. Loss of conciousness; Later in the spell, the infant becomes limp and may lose consciousness.

Diagnosis;

  • Harsh systolic ejection murmur on auscultation from turbulent flow across the narrow right ventricular outflow track.
  • Chest radiograph
  • Electrocardiogram & echocardiogram. (echocardiogram PROVIDES the definitive diagnosis)

Management;

  • Total surgical correction is required for all children with tetralogy of Fallot.
  • Placing the infant in the knee-chest position increases systemic vascular resistance, which increases pulmonary blood flow and decreases right-to-left shunting. During a hypercyanotic spell, toddlers and older children may spontaneously assume the squatting position, which functions like the knee-chest position to relieve the spell.

Nursing Management;

  • Ineffective infant feeding pattern
  • Imbalanced nutrition: less than body requirements
  • Activity intolerance
  • Ineffective peripheral tissue perfusion
  • Acute Pain
  • Decreased cardiac output

There are Three simple steps to writing a nursing care plan  for you to use the nursing process in managing this client


References;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651859/

Photo credits; Medline Plus