NCLEX PN Questions 67th Edition 2019 / 2020 - NCLEX Exam NCLEX PN Questions 67th Edition 2019 / 2020 - NCLEX Exam

NCLEX PN Questions 67th Edition 2019 / 2020

NCLEX PN Questions 67th Edition 2019 / 2020


NCLEX PN Questions 67th Edition 2019 / 2020


1. A client has an order to receive purified protein derivative (PPD) 0.1 mL intradermally (Mantoux test). The nurse prepares to administer the PPD and obtains a tuberculin syringe with a 26-gauge, ⅝-inch needle, knowing that the needle will be inserted:

A. Almost parallel to the skin with bevel side up
B. At a 45-degree angle with bevel side down
C. Almost parallel to the skin with bevel side down
D. At a 30-degree angle with bevel side down

Answer: A. Almost parallel to the skin with bevel side up

Rationale: A Mantoux test is administered by giving 0.1 mL of purified protein derivative (PPD) intradermally. This involves drawing the medication into a tuberculin syringe with a 25- to 27-gauge, ⅝-inch needle. The injection is given by inserting the needle as close as possible to a parallel position with the skin and with the needle bevel facing up. This results in formation of a wheal when administered correctly.

Test-Taking Strategy: Use the process of elimination, remembering that the bevel side is up during the administration of PPD. This will assist in directing you to the correct option. Also note that options 2, 3, and 4 are similar in that they indicate administration with the bevel side down. Review the procedure for administering this test if you had difficulty with this question.

Level of Cognitive Ability: Comprehension

Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Adult Health/Respiratory
Reference: Chernecky, C., & Berger, B. (2004). Laboratory tests and diagnostic procedures (4th ed.). Philadelphia: W.B. Saunders, p. 766.



2. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse suggest to include in the client teaching plan regarding this medication?

A. It is necessary to take the medication before meals.
B. It is necessary to return to the clinic weekly for serum drug levels.
C. It is not necessary to call the physician if a skin rash occurs.
D. It is not necessary to restrict alcohol intake with this medication.

Answer: B. It is necessary to return to the clinic weekly for serum drug levels.

Rationale: Cycloserine is an antitubercular medication that requires weekly serum drug level determinations to monitor for the potential of neurotoxicity. Serum drug levels less than 30 mg/mL reduce the incidence of neurotoxicity. The medication needs to be taken after meals to prevent gastrointestinal irritation. The client needs to be instructed to notify the physician if a skin rash or early signs of central nervous system toxicity are noted. Alcohol needs to be avoided because it increases the risk of seizure activity.

Test-Taking Strategy: Use the process of elimination and general medication guidelines to eliminate options 3 and D. From this point, knowing that the medication level needs to be monitored will assist you in selecting the correct option. If you had difficulty with this question, review this medication.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Adult Health/Respiratory
References: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 947.
McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, p. 1054.



3. A nurse is assisting in providing a class to new mothers on newborn care. In teaching umbilical cord care, the nurse makes which suggestion to the new mothers?

A. If triple dye has been applied to the cord, it is not necessary to do anything else to it.
B. Apply alcohol to the cord ensuring that all areas around the cord are cleaned two to three times a day.
C. Gently apply alcohol to the cord, being careful not to move the cord because it will cause the newborn pain.
D. All that is necessary is to wash the cord with antibacterial soap, allowing it to air-dry one time a day.

Answer: B. Apply alcohol to the cord ensuring that all areas around the cord are cleaned two to three times a day.

Rationale: The cord and base should be cleaned with alcohol two to three times per day. The steps are to lift the cord, wipe around the cord starting at the top and wiping around it, clean the base of the cord, and fold the diaper below the umbilical cord to allow the cord to air-dry. Continuation of cord care is necessary until the cord falls off within 7 to 14 days. The baby does not feel pain in this area. Water and soap are not necessary; in fact the cord should be kept from getting wet.

Test-Taking Strategy: Use the process of elimination. Recalling that alcohol is used to cleanse the cord will assist in eliminating options 1 and D. From the remaining options, recall that this procedure is not painful. Review the principles related to cord care if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Content Area: Maternity/Postpartum
Reference: Leifer, G. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, pp. 154, 156.



4. A nurse’s assignment is to visit a new mother at home who was recently discharged from the hospital. What finding would the nurse expect to note in a healthy breast-feeding mother and newborn?

A. A mother breast-feeding with the newborn in a tummy-to-tummy position every 3 to 4 hours without signs of cracked nipples; the baby demonstrates bursts of sucking followed by a pause and swallow
B. A mother breast-feeding the newborn with the newborn’s head turned toward her breast, with the body flat in her arms; mother with sore nipples and newborn with a suck blister, and wetting three to four diapers a day
C. A mother complaining of breast engorgement, breast-feeding every 6 to 8 hours, with the newborn demonstrating difficulty in latching on to the breast
D. A mother with cracked nipples feeding the newborn with a supplemental bottle

Answer: A. A mother breast-feeding with the newborn in a tummy-to-tummy position every 3 to 4 hours without signs of cracked nipples; the baby demonstrates bursts of sucking followed by a pause and swallow

Rationale: The baby should be positioned completely facing the mother with head, neck, and spine aligned. Poor positioning increases the number of attempts for latching on. Options 2, 3, and 4 all identify complications (sore nipples, breast engorgement, cracked nipples).

Test-Taking Strategy: Use the process of elimination and focus on the issue, normal findings. Option 2 is incorrect because it demonstrates improper positioning. Options 3 and 4 are the result of improper positioning. Additionally, options 2, 3, and 4 all identify complications (sore nipples, breast engorgement, cracked nipples). Option 1 is the only option that identifies a normal expectation. Review breast-feeding techniques if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Postpartum
Reference: Leifer, G. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, p. 180.



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