Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 9

1. When administering phenytoin (Dilantin) to a child, the nurse should be aware that a toxic effect of phenytoin therapy is:

A) Stephens-Johnson syndrome
B) Folate deficiency
C) Leukopenic aplastic anemia
D) Granulocytosis and nephrosis

2. A six-month-old infant has been admitted to the emergency room with febrile seizures. In the teaching of the parents, the nurse states that:

A) Sustained temperature elevation over 103F is generally related to febrile seizures
B) Febrile seizures do not usually recur
C) There is little risk of neurological deficit and mental retardation as sequelae to febrile seizures
D) Febrile seizures are associated with diseases of the central nervous system

3. When assessing a child with diabetes insipidus, the nurse should be aware of the cardinal signs of:

A) Anemia and vomiting
B) Polyuria and polydipsia
C) Irritability relieved by feeding formula
D) Hypothermia and azotemia

4. The usual treatment for diabetes insipidus is with IM or SC injection of vasopressin tannate in oil. Nursing care related to the client receiving IM vasopressin tannate would include:

A) Weigh once a week and report to the physician any weight gain of10 lb.
B) Limit fluid intake to 500 mL/day.
C) Store the medication in a refrigerator and allow to stand at room temperature for 30 minutes prior to administration.
D) Hold the vial under warm water for 10 - 15 minutes and shake vigorously before drawing medication into the syringe.

5. A child is admitted to the emergency room with her mother. Her mother states that she has been exposed to chickenpox. During the assessment, the nurse would note a characteristic rash:

A) That is covered with vesicular scabs all in the macular stage
B) That appears profusely on the trunk and sparsely on the extremities
C) That first appears on the neck and spreads downward
D) That appears especially on the cheeks, which gives a'slapped-cheek' appearance

1. Right Answer: A
Explanation: (A) Stephens-Johnson syndrome is a toxic effect of phenytoin. (B) Folate deficiency is a side effect of phenytoin, but not a toxic effect. (C) Leukopenic aplastic anemia is a toxic effect of carbamazepine (Tegretol). (D) Granulocytosis and nephrosis are toxic effects of trimethadione (Tridione).

2. Right Answer: C
Explanation: (A) The temperature elevation related to febrile seizures generally exceeds 101F, and seizures occur during the temperature rise rather than after a prolonged elevation. (B) Febrile seizures may recur and are more likely to do so when the first seizure occurs in the 1st year of life. (C) There is little risk of neurological deficit, mental retardation, or altered behavior secondary to febrile seizures. (D) Febrile seizures are associated with disease of the central nervous system.

3. Right Answer: B
Explanation: (A) Anemia and vomiting are not cardinal signs of diabetes insipidus. (B) Polyuria and polydipsia are the cardinal signs of diabetes insipidus. (C) Irritability relieved by feeding water, not formula, is a common sign, but not the cardinal sign, of diabetes insipidus. (D) Hypothermia and azotemia are signs, but not cardinal signs, of diabetes insipidus.

4. Right Answer: D
Explanation: (A) Weight should be obtained daily. (B) Fluid is not restricted but is given according to urine output. (C) The medication does not have to be stored in a refrigerator. (D) Holding the vial under warm water for 1015 minutes or rolling between your hands and shaking vigorously before drawing medication into the syringe activates the medication in the oil solution.

5. Right Answer: B
Explanation: (A) A rash with vesicular scabs in all stages (macule, papule, vesicle, and crusts). (B) A rash that appears profusely on the trunk and sparsely on the extremities.(C) A rash that first appears on the neck and spreads downward is characteristic of rubeola and rubella. (D) A rash, especially on the cheeks, that gives a'slapped-cheek' appearance is characteristic of roseola.

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