V4 EXAM 1
NCLEX PN V4 EXAM 1 QUESTIONS & ANSWERS WITH RATIONALE 2023/2024 UPDATE
1. A client with AIDS asks the nurse why he can’t have a pitcher of water at his bedside so he can drink whenever he likes. The nurse should tell the client that:
A. It would be best for him to drink tap wa...
1. A client with AIDS asks the nurse why he can’t have a pitcher of water
at his bedside so he can drink whenever he likes. The nurse should tell the
client that:
A. It would be best for him to drink tap water.
B. He should drink less water and more juice.
C. Leaving a glass of water makes it easier to calculate his intake.
D. He shouldn’t drink water that has been sitting longer than 15 minutes.
Answer D: The client with AIDS should not drink water that has been sitting
longer than 15 minutes because of bacterial contamination. Answer A is
incorrect because tap water is not better for the client. Answer B is incorrect
because juices should not replace water intake. Answer C is not an accurate
statement; therefore, it is incorrect.
2. The mother of a male child with cystic fibrosis tells the nurse that
she hopes her son’s children won’t have the disease. The nurse is
aware that:
A. There is a 25% chance that his children would have cystic fibrosis.
B. Most of the males with cystic fibrosis are sterile.
C. There is a 50% chance that his children would be carriers.
D. Most males with cystic fibrosis are capable of having children,
so genetic counseling is advised.
Answer B: Approximately 99% of males with cystic fibrosis are sterile
because of obstruction of the vas deferens. Answers A, C, and D are incorrect
because most males with cystic fibrosis are incapable of reproduction.
3. An infant is hospitalized for treatment of botulism. Which
factor is associated with botulism in the infant?
A. The infant sucks on his fingers and toes.
,B. The mother sweetens the infant’s cereal with honey.
,C. The infant was switched to soy-based formula.
D. The infant’s older sibling has an aquarium.
Answer B: Infants under the age of 2 years should not be fed honey because
of the danger of infection with Clostridium botulinum. Answers A, C, and D
have no relationship to the situation; therefore, they are incorrect.
4. A nurse is assessing a client hospitalized with peptic ulcer disease.
Which finding should be reported to the charge nurse immediately?
A. BP 82/60, pulse 120
B. Pulse 68, respirations 24
C. BP 110/88, pulse 56
D. Pulse 82, respirations 16
Answer A: Decreased blood pressure and increased pulse rate are signs
of bleeding. Answers B, C, and D are within normal limits; therefore, they
are incorrect.
5. The nurse is teaching the client with AIDS regarding proper food
preparation. Which statement indicates that the client needs
further teaching?
A. “I should avoid adding pepper to food after it is cooked.”
B. “I can still have an occasional medium-rare steak.”
C. “Eating cheese and yogurt won’t help prevent AIDS-related diarrhea.”
D. “I should eat fruits and vegetables that can be peeled.”
Answer B: Undercooked meat is a source of toxoplasmosis cysts.
Toxoplasmosis is a major cause of encephalitis in clients with AIDS.
Answers A, C, and D are accurate statements reflecting the client’s
understanding of the nurse’s teaching; therefore, they are incorrect.
6. A client taking Laniazid (isoniazid) asks the nurse how long she must
take the medication before her sputum cultures will return to normal. The
nurse recognizes that the client should have a negative sputum culture
within:
A. 2 weeks
B. 6 weeks
C. 2 months
D. 3 months
, Answer D: The client taking isoniazid should have a negative sputum culture
within 3 months. Answers A, B, and C are incorrect because there has not
been sufficient time for the medication to be effective.
7. Which person is at greatest risk for developing Lyme’s disease?
A. Computer technician
B. Middle-school teacher
C. Dog trainer
D. Forestry worker
Answer D: Lyme’s disease is transmitted by ticks found on deer and mice in
wooded areas. Answers A and B have little risk for the disease. Dog trainers
are exposed to dog ticks that carry Rocky Mountain Spotted Fever but not
Lyme’s disease; therefore, answer C is incorrect.
8. Following eruption of the primary teeth, the mother can
promote chewing by giving the toddler:
A. Pieces of hot dog
B. Celery sticks
C. Melba toast
D. Grapes
Answer C: Melba toast promotes chewing and is easily managed by the
toddler. Pieces of hot dog, celery sticks, and grapes are unsuitable for the
toddler because of the risk of aspiration.
9. A client scheduled for an exploratory laparotomy tells the nurse that
she takes kava-kava (piper methysticum) for sleep. The nurse should
notify the doctor because kava-kava:
A. Increases the effects of anesthesia and post-operative analgesia
B. Eliminates the need for antimicrobial therapy following surgery
C. Increases urinary output, so a urinary catheter will be needed postoperatively
D. Depresses the immune system, so infection is more of a problem
Answer A: Kava-kava increases the effects of central nervous system
depressants. Answers B, C, and D are not related to the use of kava-kava;
therefore, they are incorrect.
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