NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 121:

  Which of the following nursing actions is most effective when evaluating a kinetic family drawing?

  A. telling the child to draw their family doing something
  B. offering specific suggestions of what to include in the drawing
  C. discouraging the child from talking about the drawing
  D. noting the omission of any family members
  D. noting the omission of any family members

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  There are several guidelines for evaluating kinetic family drawings, including Choice "noting the omission of any family members". Effective nursing actions include asking the child to explain what each family member is doing, encouraging him or her to tell as much as possible about the drawing, noting physical intimacy or distance, noting placement of family members in the drawing, noting facial expressions of family members and noting if they are facing each other or turned away. Choice "telling the child to draw their family doing something" is initial instruction, not evaluation. Only general encouragement should be given to avoid suggesting themes to the child.

• Question 122:

  Which of the following statements by an adult child of a client with late-stage Alzheimer's disease indicates a need for further teaching by the nurse?

  A. "I should provide a regular schedule for toileting."
  B. "I should talk to my father less because he can't communicate."
  C. "I should give my father oral care after every meal and bedtime."
  D. "I should assist my father with eating and drinking."
  B. "I should talk to my father less because he can't communicate."

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  Explanation Explanation/Reference:Even though an Alzheimer's client might not be able to talk or communicate his needs, the family should still communicate through talking and touching. The other statements are correct and indicate adequate understanding.

• Question 123:

  A nurse is instructing a person who had a left CVA and right lower extremity hemiparesis to use a quad cane. Which of the following is the most appropriate gait sequence?

  A. Place the cane in the patient's left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.
  B. Place the cane in the patient's left upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence.
  C. Place the cane in the patient's right upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.
  D. Place the cane in the patient's right upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence.
  A. Place the cane in the patient's left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.

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  Explanation Explanation/Reference:The cane should be placed in the patient's strong upper extremity, and left arm/right foot go together, for normal gait.

• Question 124:

  When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?

  A. hysterosalpingography
  B. semen analysis
  C. endometrial biopsy
  D. transvaginal ultrasound
  B. semen analysis

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  Because semen analysis is the least invasive of the tests listed and because in 35% of the cases the infertility is related to a male factor, semen analysis should be one of the first diagnostic tests performed. Hysterosalpingography fills the uterus and fallopian tubes with a radiopaque substance that can be seen with an X ray. It demonstrates tubal patency or any distortion of the uterine cavity. Endometrial biopsy provides information about the effects of progesterone after ovulation and the endometrial receptivity. Transvaginal ultrasound is mostly used in the treatment of infertility. For diagnosis it allows the endocrinologist to evaluate the developing follicle, assess oocyte maturity, and diagnose luteal phase defects. Hysterosalpingography, endometrial biopsy and transvaginal ultrasound are more invasive, require greater expertise to evaluate and treat, and are more costly. If the semen analysis is normal, the couple can expect to progress through these tests as well.

• Question 125:

  A successful resolution of the nursing diagnosis Negative Self-Concept (related to unrealistic self-expectations) is when the client can __________.

  A. report a positive self-concept
  B. identify negative thoughts
  C. recognize positive thoughts
  D. give one positive cue with each negative cue
  A. report a positive self-concept

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  The problem statement is Negative Self Concept. A successful resolution of the problem is when the client can report a positive self-concept. When the nurse determines how the client perceives himself, effort should be directed to reinforce self-worth and promote a positive self-concept, including helping a client to identify areas of strength. Assisting the client to evaluate himself and make behavior changes is a nursing intervention.

• Question 126:

  What are the implications for a client with renal insufficiency who wants to start a low-carbohydrate (CHO) diet?

  A. As long as the client eats a minimum of 30g of CHO/day, there should be no problem.
  B. The client's clinical condition is a contraindication to starting a low CHO diet.
  C. Calcium supplements should be utilized to prevent the development of osteoporosis while on a low CHO diet.
  D. As long as the client eats foods that are high biologic protein sources, a low CHO diet can be followed.
  B. The client's clinical condition is a contraindication to starting a low CHO diet.

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  A client with renal insufficiency should not start a low CHO diet because it could result in an increased renal solute load. Clients who have renal disease (renal failure, endstage renal disease [ESRD], dialysis, and transplant) or liver disease (liver failure, hepatic encephalopathy, cirrhosis, transplant, and hepatitis) require some form of protein control in dietary patterns to prevent complications from an inability to handle protein solute load. Proteins used in the diet must be of high biologic value, and protein intake is usually weight based, starting at 0.8 g/kg of dry weight, depending on the client's underlying clinical condition. Protein levels may be increased as necessary to account for metabolic response to dialysis and regeneration of liver tissue (1.5?.0 g/kg/day). A minimum level of CHOs are needed in the diet (50?00 g/day) to spare protein. Vitamin and mineral supplements might be indicated with clients who have liver failure. The dietician is instrumental in calculating specific nutrient requirements for these clients and reviewing fluid intake and output, medication profile, and daily weight to monitor client outcomes in conjunction with dialysis technicians and nurses.

• Question 127:

  Which disease decreases the metabolic rate?

  A. Cancer
  B. Hypothyroidism
  C. Chronic obstructive pulmonary disease
  D. Cardiac failure
  B. Hypothyroidism

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  Explanation Explanation/Reference:Hypothyroidism causes a decreased metabolic demand, so fewer calories are required. Cancer, chronic obstructive pulmonary disease, or cardiac failure all increase the metabolic demands and the need for added calories.

• Question 128:

  Vaccines provide what type of immunity?

  A. active
  B. passive
  C. transplacental
  D. active and passive
  A. active

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  Explanation Explanation/Reference:Vaccines provide active immunity. Passive immunity comes from antibodies produced in another human or host. Transplacental immunity comes from passive immunity transferred from mother to infant.

• Question 129:

  In a disaster situation, the nurse assessing a diabetic client on insulin assesses for all of the following except __________.

  A. diabetic signs and symptoms
  B. nutritional status
  C. bleeding problems
  D. availability of insulin
  C. bleeding problems

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  Explanation Explanation/Reference:Bleeding problems are not characteristic of diabetes. All the other options are appropriate areas of assessment.

• Question 130:

  The nurse observes bilateral bruises on the arms of an elderly client in a long-term care facility. Which of the following questions should the nurse ask this client?

  A. "How did you get those bruises?"
  B. "Did someone grab you by your arms?"
  C. "Do you fall often?"
  D. "What did you bump against?"
  B. "Did someone grab you by your arms?"

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  Explanation Explanation/Reference:Using a direct approach is best when asking about suspected abuse. Clients are reluctant to report abuse because of shame and fear of reprisal.