Nursing Licensure Exam Questions and Answers 17th Edition
Nursing Licensure Exam Questions and Answers 17th Edition
1. A nurse is monitoring a preterm newborn for respiratory distress syndrome (RDS). Which findings in the newborn would alert the nurse to the possibility of this syndrome?
A. Hypotension and bradycardia
B. Tachypnea and retractions
C. Acrocyanosis and grunting
D. The presence of a barrel chest with acrocyanosis
Answer: B. Tachypnea and retractions
Rationale: The newborn with respiratory distress syndrome may present with cyanosis, tachypnea or apnea, nasal flaring, chest wall retractions, or audible expiratory grunts. Acrocyanosis is the bluish discoloration of the hands and feet, is associated with immature peripheral circulation, and is not uncommon in the first few hours of life. Options 1, 3, and 4 do not indicate clinical signs of respiratory distress syndrome.
Test-Taking Strategy: Use the process of elimination. Recalling that acrocyanosis is a normal sign in a newborn will assist in eliminating options 3 and D. From the remaining options, focusing on the issue of the question, RDS, will direct you to option B. If you had difficulty with this question, review these clinical manifestations of RDS.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Postpartum
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 152.
2. A nurse is caring for a neonate born to a mother who is addicted to drugs. The nurse expects to observe which of the following while caring for the neonate?
A. Sleeps quietly
B. Is easy to console when crying
C. Is lethargic
D. Cries incessantly
Answer: D. Cries incessantly
Rationale: A neonate born to a woman who is addicted to drugs is irritable, may cry incessantly, and may be difficult to console. The neonate would hyperextend and posture rather that cuddle when being held.
Test-Taking Strategy: Use the process of elimination. Eliminate options 1, 2, and 3 because they are similar and indicate a lack of hyperactivity. Review the assessment findings in the neonate born to a drug-addicted mother if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Postpartum
Reference: Lowdermilk, D., & Perry, A. (2004). Maternity & women’s health care (8th ed.). St. Louis: Mosby, p. 1075.
3. A nurse is reviewing the criteria for early discharge of a newborn infant with her mother. Which of the following if noted in the infant would indicate that the criteria for early discharge have not been met?
A. Infant’s vital signs are documented as normal and stable
B. Infant has urinated and passed at least one stool
C. Infant has completed at least two successful feedings
D. Infant has evidence of significant jaundice
Answer: D. Infant has evidence of significant jaundice
Rationale: Criteria for early discharge in the newborn include no evidence of significant jaundice within the first 24 hours after birth. The infant should have urinated and passed at least one stool, completed at least two successful feedings, and have normal vital signs for at least 12 hours.
Test-Taking Strategy: Use the process of elimination, noting the key words have not been met. Note that the only abnormal finding is option 4, which indicates the presence of jaundice. Review early discharge criteria for a newborn if you are unfamiliar with this area.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Maternity/Postpartum
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 235.
4. A nurse has provided instructions to the mother of a male newborn who is not circumcised about measures to clean the penis. Which statement by the mother indicates an understanding of this procedure?
A. “I need to retract the foreskin and clean the penis every time I give my newborn a bath.”
B. “I should gently retract the foreskin as far as it will go on the penis, and then pull the skin back over the penis after cleaning.”
C. “I should retract the foreskin and clean the penis every time I change the diaper.”
D. “I need to avoid pulling back the foreskin to clean the penis because this may cause adhesions.”
Answer: D. “I need to avoid pulling back the foreskin to clean the penis because this may cause adhesions.”
Rationale: In newborn males, prepuce is continuous with the epidermis of the glans and is not retractable. If retraction is forced, adhesions can develop. It is best to allow separation of the foreskin to occur naturally, which usually occurs between 3 years and puberty. Most foreskins are retractable by 3 years of age and should be pushed back gently at this time for cleaning once a week.
Test-Taking Strategy: Use the process of elimination. Note that options 1, 2, and 3 are similar in that they all recommend retracting the foreskin. Option 4 is the option that is different. If you had difficulty with this question, review teaching points related to cleaning the penis in a newborn who is uncircumcised.
Level of Cognitive Ability: Comprehension
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Evaluation
Content Area: Maternity/Postpartum
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 291.
5. A client with a history of spinal cord injury is receiving baclofen (Lioresal) for muscle spasms. The nurse determines that the client is experiencing a side effect of this medication if the client experiences:
A. Photosensitivity
B. Drowsiness
C. Hypertension
D. Muscle pain
Answer: B. Drowsiness
Rationale: Baclofen is a centrally acting skeletal muscle relaxant. Side effects of baclofen (Lioresal) include drowsiness, dizziness, weakness, and nausea. Occasional side effects include headache, paresthesia of the hands and feet, constipation or diarrhea, anorexia, hypotension, confusion, and nasal congestion. Options 1, 3, and 4 are incorrect.
Test-Taking Strategy: Use the process of elimination. Recalling that baclofen is a centrally acting skeletal muscle relaxant will assist in directing you to option B. If you had difficulty with this question, review the side effects related to baclofen.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 200D. Philadelphia: W.B. Saunders, p. 108.
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