Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 35

1. A mother came to the pediatric clinic with her 17- month-old child. The mother would like to begin toilet training. What should the nurse teach her about implementing toilet training?

A) Take two or three favorite toys with the child.
B) Have a child-sized toilet seat or training potty on hand.
C) Explain to the child she is going to 'void' and 'defecate.'
D) Show disapproval if she does not void or defecate.

2. A mother is unsure about the type of toys for her 17-month-old child. Based on knowledge of growth and development, what toy would the nurse suggest?

A) A pull toy to encourage locomotion
B) A mobile to improve hand-eye coordination
C) A large toy with movable parts to improve pincer grasp
D) Various large colored blocks to teach visual discrimination

3. A 16-year-old student has a long history of bronchial asthma and has experienced several severe asthmatic attacks during the school year. The school nurse is required to administer 0.2 mL of 1/1000 solution of epinephrine SC during an asthma attack. How does the school nurse evaluate the effectiveness of this intervention?

A) Increased pulse rate
B) Increased expectorate of secretions
C) Decreased inspiratory difficulty
D) Increased respiratory rate

4. Respiratory function is altered in a 16-year-old asthmatic. Which of the following is the cause of this alteration?

A) Altered surfactant production
B) Paradoxical movements of the chest wall
C) Increased airway resistance
D) Continuous changes in respiratory rate and depth

5. A mother frantically calls the emergency room (ER) asking what to do about her 3-year-old girl who was found eating pills out of a bottle in the medicine cabinet.The ER nurse tells the mother to:

A) Give the child 15 mL of syrup of ipecac.
B) Give the child 10 mL of syrup of ipecac with a sip of water.
C) Give the child 1 cup of water to induce vomiting.
D) Bring the child to the ER immediately.

1. Right Answer: B
Explanation: (A) Giving her toys will distract her and interfere with toilet training because of inappropriate reinforcement. (B) A child-sized toilet seat or training potty gives a child a feeling of security. (C) She should use words that are age appropriate for the child. (D) Children should be praised for cooperative behavior and/or successful evacuation.

2. Right Answer: A
Explanation: (A) Increased locomotive skills make push-pull toys appropriate for the energetic toddler. (B) Infants progress from reflex activity through simple repetitive behaviors to imitative behavior. Hand-eye coordination forms the foundation of other movements. (C) At age 8 months, infants begin to have pincer grasp. Toys that help infants develop the pincer grasp are recommended for this age group. (D) Various large colored blocks are suggested toys for infants 612 months of age to help visual stimulation.

3. Right Answer: C
Explanation: (A) A side effect of epinephrine is fatal ventricular fibrillation owing to its effects on cardiac stimulation. (B) Medications used to treat asthma are designed to decrease bronchospasm, not to increase expectorate of secretions. (C) Epinephrine decreased inspiratory difficulty by stimulating -, 1, and 2-receptors causing sympathomimetic stimulation (e.g., bronchodilation). (D) The person with asthma fights to inspire sufficient air thus increasing respiratory rate.

4. Right Answer: C
Explanation: (A) Altered surfactant production is found in sudden infant death syndrome. (B) Paradoxical breathing occurs when a negative intrathoracic pressure is transmitted to the abdomen by a weakened, poorly functioning diaphragm. (C) Asthma is characterized by spasm and constriction of the airways resulting in increased resistance to airflow. (D) If the pulmonary tree is obstructed for any reason, inspired air has difficulty overcoming the resistance and getting out. The rate of respiration increases in order to compensate, thus increasing air exchange.

5. Right Answer: D
Explanation: (A) Before giving any emetic, the substance ingested must be known. (B) At least 8 oz of water should be administered along with ipecac syrup to increase volume in the stomach and facilitate vomiting. (C) Water alone will not induce vomiting. An emetic is necessary to facilitate vomiting. (D) Vomiting should never be induced in an unconscious client because of the risk of aspiration.

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