NCLEX Practice Questions With Answer and Rationale 34th Edition

NCLEX Practice Questions With Answer and Rationale 34th Edition

1. Penicillin G procaine (Wycillin) 1,000,000 U intramuscularly has been prescribed for the child with a throat infection. The child’s weight is 62 lb. The safe pediatric dosage is greater than 60 lb: 600,000 to 1,200,000 U daily. The nurse determines that:

A. The dosage is too low
B. The dosage is too high
C. The dosage is within the safe range
D. There is not enough information to determine the safe dosage

Answer: C. The dosage is within the safe range

Rationale: The child’s weight is 62 lb, which falls within the safe pediatric dosage range. The dosage is safe.

Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dosage range of the medication. Calculation is not required because the information needed to answer the question is identified in the question. Review information related to pediatric medications if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 235-236.

2. A nurse is checking postoperative orders and planning care for a 110-lb child after spinal fusion. Morphine sulfate 8 mg subcutaneously every 4 hours PRN for pain is ordered. The pediatric drug reference states that the safe dosage is 0.1 to 0.2 mg/kg every 2 to 4 hours. From this information, the nurse determines that:

A. The dosage is too low
B. The dosage is too high
C. The dosage is within the safe range
D. There is not enough information to determine the safe dosage

Answer: C. The dosage is within the safe range

Rationale: Convert pounds to kilograms by dividing by 2.2, because 1 kg = 2.2 lb.
Therefore, 110 lb divided by 2.2 = 50 kg. Then determine the dosage parameters.
Dosage parameters: 0.1 mg/kg x 50 kg = 5 mg --> 0.2 mg/kg x 50 kg = 10 mg
The dosage is safe.

Test-Taking Strategy: The question provides you with a medication order, a child’s weight, and safe dose information. The safe dose is given in milligrams per kilogram and the child’s weight is given in pounds. You should know that the conversion factor is 2.B. Because pounds are smaller than kilograms, you divide the number of pounds by the conversion factor. Calculate the dosage parameters using the safe dose range identified in the question and the child’s weight in kilograms. Review these formulas if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 235-236.

3. A physician’s order reads: tobramycin sulfate (Nebcin) 7.5 mg intramuscularly twice daily. The medication label states: tobramycin sulfate, 10 mg/mL. How many milliliters (mL) will the nurse give to administer one dose?

Answer: 0.75 ml

Rationale: Use the following formula for calculating the appropriate medication dose:
Desired 7.5 mg
_______ = _______ x 1.0 mL = 0.75 mL
Available  10 mg

Test-Taking Strategy: Follow the formula for calculating the correct dose. Recheck your work with a calculator and make sure that the answer makes sense. If you had difficulty with this question, review medication calculation problems.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Fundamental Skills
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 80.

4. A physician’s order reads: theophylline timed-release capsules (Slo-bid) 100 mg orally every 6 hours. The medication label reads: Theophylline timed-release capsules, 50-mg capsules. How many capsules will the nurse give to administer one dose?

Answer: 2 Capsules

Rationale: Use the following formula for calculating the appropriate medication dose:
Desired 100 mg
_______ = _______ x 1 Capsule = 2 Capsules
Available  50 mg

Test-Taking Strategy: Follow the formula for calculating the correct dose. Recheck your work with a calculator and make sure that the answer makes sense. If you had difficulty with this question, review medication calculation problems.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Fundamental Skills
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 80.

5. A nurse is assigned to care for a client who has experienced uterine rupture. The nurse plans care knowing that which of the following is the priority concern in caring for the client?

A. Fear
B. Acute pain
C. Impaired gas exchange
D. Grieving

Answer: C. Impaired gas exchange

Rationale: The priority should always deal with airway. Although options A, B, and D are also appropriate concerns for this client, they are not the priority and assume a lesser priority than impaired gas exchange.

Test-Taking Strategy: Note the key word priority. Use the ABCs—airway, breathing, and circulation. This will direct you to option C. Review care to the client with uterine rupture if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Delegating/Prioritizing
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 698.

Source : NCLEX example quiz and answer

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