NCLEX-RN Exam Pack Set 9 (75
Questions & Answers Updated
2022)
1. 1. Question
Which roommate would be most suitable for the 6-year-old male
with a fractured femur in Russell’s traction?
o A. 16-year-old female with scoliosis
o B. 12-year-old male with a fractured femur
o C. 10-year-old male with sarcoma
o D. 6-year-old male with osteomyelitis
Correct Answer: B. 12-year-old male with a fractured
femur
The 6-year-old should have a roommate as close to the same age
as possible, so the 12-year-old is the best match. A bed is
available and the patient gets assigned. There are certain
constraints—sex, semi-private versus private, isolation issues,
acuity, telemetry and specialty needs. All need to be taken into
account to ensure that each patient goes to the right place and
receives the proper care. But good capacity management
demands that bed assignment be carefully considered and
executed.
o Option A: The client is too old and is female. Bed
assignment simply provides the proper location based
on specific patient attributes like sex, isolation,
telemetry, acuity, and specialty needs.
o Option C: The 10-year-old with sarcoma has cancer
and will be treated with chemotherapy that makes him
immune suppressed. Bed managers aim at finding an
assignment of patients to rooms that strikes a balance
between patients’ preferences and comfort on the one
, hand, and patients’ clinical conditions and the
resulting required room facilities on the other.
o Option D: The 6-year-old with osteomyelitis is
infectious. Rooms and beds belong to the critical
assets of just any hospital. They account for a
considerable part of a hospital’s infrastructure, and a
large amount of financial resources are invested in
equipping them with medical apparatus to facilitate
patient care. Furthermore, they also represent the
place where most patients will spend a large part of
their stay, as they recover from surgery, wait for
examinations to take place, etc.
2. Question
A client with osteoarthritis has a prescription for celebrex
(Celecoxib). Which instruction should be included in the discharge
teaching?
o A. Take the medication with milk.
o B. Report chest pain.
o C. Remain upright after taking for 30 minutes.
o D. Allow 6 weeks for optimal effects.
Correct Answer: B. Report chest pain.
Cox II inhibitors have been associated with heart attacks and
strokes. Any changes in cardiac status or signs of a stroke should
be reported immediately, along with any changes in bowel or
bladder habits because bleeding has been linked to use of Cox II
inhibitors. Like all NSAIDs, celecoxib carries an FDA boxed
warning for cardiovascular risk, including the increased risk of
heart attacks and strokes. As a selective COX-2 inhibitor,
celecoxib also faces scrutiny for increased cardiovascular risk,
since another selective COX-2 inhibitor, rofecoxib, was withdrawn
from production in 2004 due to cardiovascular risk concerns.
o Options A: The medication can be taken with water.
Celecoxib is a medication that is taken orally and
comes in 50, 100, 200, and 400 mg doses. In rare
cases, celecoxib can also be added to customized
, compounds for topical administration with or without
the use of iontophoresis or other topical delivery
mechanisms. It is not available via any other route of
administration.
o Option C: The client may remain upright but not
necessarily for 30 minutes. Symptoms of celecoxib
overdose would likely be similar to overdoses of other
NSAIDs, which include lethargy, drowsiness, nausea,
vomiting, and epigastric pain. Activated charcoal may
be administered for overdose treatment at the
discretion of emergency medical providers if the
patient presents within 4 hours of known or suspected
ingestion of significant amounts of celecoxib.
o Option D: Allow 6 weeks for optimal effect. In the
inpatient setting, as mentioned above, celecoxib is
increasingly being used as part of pre-operative and
post-operative multimodal pain management
algorithms. Research has shown in several small
randomized trials that administering celecoxib peri-
operatively for elective procedures such as total hip
arthroplasties, total knee arthroplasties, and other
procedures with some success in reducing pain and
improving functionality such as early ambulation.
3. Question
A client with a fractured tibia has a plaster-of-Paris cast applied to
immobilize the fracture. Which action by the nurse indicates an
understanding of a plaster-of-Paris cast? The nurse:
o A. Handles the cast with the fingertips
o B. Petals the cast
o C. Dries the cast with a hair dryer
o D. Allows 24 hours before bearing weight
Correct Answer: D. Allows 24 hours before bearing weight
A plaster-of-Paris cast takes 24 hours to dry, and the client should
not bear weight for 24 hours. After the process of applying the
casting material is completed, the material will start to dry in
, about 10 to 15 minutes. The temperature of the skin might rise
as the plaster is drying because of a chemical reaction that
occurs. When plaster is used, it can take from 1 to 2 days for the
cast to harden completely.
o Option A: The cast should be handled with the palms,
not the fingertips. Use the palm of hand to apply, hold,
or move cast and support on pillows after application.
Uneven plaster is irritating to the skin and may result
in abrasions.
o Option B: Petaling a cast is covering the end of the
cast with cast batting or a sock, to prevent skin
irritation and flaking of the skin under the cast. Trim
excess plaster from edges of the cast as soon as
casting is completed; prevents skin breakdown caused
by prolonged moisture trapped under the cast.
o Option C: The client should be told not to dry the cast
with a hair dryer because this causes hot spots and
could burn the client. This also causes unequal drying.
Promote cast drying by removing bed linen, exposing
it to circulating air; pressure can cause ulcerations,
necrosis, or nerve palsies. Pad (petal) the edges of the
cast with waterproof tape; provides an effective barrier
to cast flaking and moisture. Helps prevent the
breakdown of cast material at the edges and reduce
skin irritation and excoriation.
4. Question
The teenager with a fiberglass cast asks the nurse if it will be
okay to allow his friends to autograph his cast. Which response
would be best?
o A. "It will be alright for your friends to autograph
the cast."
o B. "Because the cast is made of plaster, autographing
can weaken the cast."
o C. "If they don’t use chalk to autograph, it is okay."
o D. "Autographing or writing on the cast in any form will
harm the cast."
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