NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 181:

  An episiotomy is __________.

  A. a surgical incision of the perineum to prevent tearing during delivery
  B. releasing the red plug from the cervix just before crowning occurs
  C. an incision in the abdomen with which the baby can be delivered through
  D. the severance of the umbilical cord between mother and child
  A. a surgical incision of the perineum to prevent tearing during delivery

  ---

  An episiotomy is a surgical incision of the perineum and the posterior vaginal wall to quickly enlarge the opening for the baby to pass through; this incision prevents tearing during a vaginal delivery. The releasing of the red plug is known as the bloody show. The baby delivered through an incision in the abdomen is a Caesarian delivery. Umbilical severance or cutting and clamping of the cord both apply to the procedure of separating mother and child after childbirth.

• Question 182:

  A pregnant client has congenital heart disease.

  The nurse should expect to see which alterations in this client's diet during pregnancy?

  A. reduced calories and reduced fat
  B. caffeine and sodium restrictions
  C. decreased protein and increased complex carbohydrates
  D. fluid restriction and reduced calories
  B. caffeine and sodium restrictions

  ---

  Explanation Explanation/Reference:Caffeine might increase heart rate that is already stressed due to pregnancy. Sodium can cause fluid retention. Both might need to be restricted. The other choices are incorrect because calories, fat, and protein are not usually decreased due to the risk of nutrient deficiencies.

• Question 183:

  The nurse is caring for a dying client who has persistently requested that the nurse "help her to die and be in peace."

  According to the Code of Ethics for Nurses, the nurse should __________.

  A. Ask the client whether she has signed the advance directives document.
  B. Tell the client that he or she will ask another nurse to care for her.
  C. Instruct the client that only a physician can legally assist a suicide.
  D. Try to make the client as comfortable as possible, but refuse to assist in death.
  D. Try to make the client as comfortable as possible, but refuse to assist in death.

  ---

  Try to make the client as comfortable as possible but refuse to assist in death. One of the competencies necessary for nurses to have in giving high quality care to clients/families during the end of life care is: apply legal and ethical principles in the analysis of complex issues and end-of-life care, recognizing the influence of personal values, profession codes, and client preferences.

• Question 184:

  The hydraulic lift (Hoyer lift) is __________.

  A. used for all clients who've had orthopedic surgery
  B. used for all clients who are not able to stand and for extremity obese clients
  C. used for all clients, both old and young, in a hospital setting
  D. not an assistive device for special needs
  B. used for all clients who are not able to stand and for extremity obese clients

  ---

  Explanation Explanation/Reference:The hydraulic lift is used for safe transfer when a client is not able to stand or is too heavy for the health care workers to lift safely.

• Question 185:

  The nurse observes a staff member not following the plan of care for a client with an antisocial personality disorder.

  The nurse should __________.

  A. confront the staff member immediately and say, "You know that is not the treatment plan"
  B. write an incident report to create a paper trail of the staff member's failure to follow the planned program
  C. ask the staff member to talk in private, and reinforce how antisocial clients try to divide staff
  D. bring up the incident during the weekly conference so that this staff member is not assigned to work with antisocial persons again
  C. ask the staff member to talk in private, and reinforce how antisocial clients try to divide staff

  ---

  It is essential that the treatment program be followed exactly for clients with antisocial personality disorder because they are very manipulative and attempt to divide staff. However, confronting the staff member in front of the client enhances the division of staff. Talking with the staff member in private allows the person to develop skills to work with this client population.

• Question 186:

  The presence of which hormone in the urine is specifically indicative of pregnancy?

  A. estrogen
  B. progesterone
  C. testosterone
  D. human chorionic gonadotropin
  D. human chorionic gonadotropin

  ---

  Human chorionic gonadotropin is found in the urine during pregnancy and specifically indicates pregnancy. The other hormones do not.

• Question 187:

  After securing the client's safety from a faulty electric bed, which action should the nurse take?

  A. Discuss the matter with the client's significant others.
  B. Document the incident in the client's record in detail.
  C. Notify the physician.
  D. Prepare an incident report.
  D. Prepare an incident report.

  ---

  After the situation is safe for the client, the nurse should record the occurrence on an incident form according to the agency protocol.

• Question 188:

  The power a nurse exerts when he or she works to accomplish goals and effect change in an agency or in policy is considered __________ type of power.

  A. political
  B. personal
  C. positional
  D. professional
  A. political

  ---

  Political power results from one's ability to work within systems, agencies, or through policy to affect change. Personal power is based on one's charisma and self-confidence and is often found in informal leadership situations. Positional power is based on designated authority in a legitimized position within which the power is exercised. Professional power is based on one's professional skills and abilities resulting from one's recognized expertise in an area of practice.

• Question 189:

  An 8-year-old Asian child is being examined during a school screening. The nurse notices small bruises on the anterior and posterior ribs. The nurse should ask the child ___________.

  A. if the family practices coining.
  B. who hit him.
  C. if the child has fallen.
  D. how long the abuse has been occurring.
  A. if the family practices coining.

  ---

  Explanation Explanation/Reference:The nurse must be aware of cultural practices that resemble child abuse. These practices include coining, cupping, and fallen fontanella. Coining and cupping are thought to draw infections from the body. Coining involves rubbing a heated coin on the chest and torso and might cause bruising. Cupping uses heated glasses that can produce erythematous and ecchymotic rounded lesions or linear streaks on the body from the suction. Fallen fontanella involves turning a child upside down to correct a depressed fontanelle; it can cause vomiting, diarrhea, and dehydration in infants. Retinal hemorrhages can also occur, and sometimes Shaken-Baby Syndrome is erroneously diagnosed.

• Question 190:

  What happens if folic acid is given to treat anemia without determining its underlying cause?

  A. Erythropoiesis is inhibited.
  B. Excessive levels of folic acid might accumulate, causing toxicity.
  C. The symptoms of pernicious anemia might be masked, delaying treatment.
  D. Intrinsic factor is destroyed.
  C. The symptoms of pernicious anemia might be masked, delaying treatment.

  ---

  Folic acid should not be used if pernicious anemia is suspected because it does not protect the client from CNS changes common to this type of anemia. Folic acid is usually given with Vitamin B12. Both are part of the Vitamin B complex and are essential for cell growth and division. Folic acid is sometimes used as a rescue drug for cells exposed to some toxic chemotherapeutic agents. The nature of the anemia must be confirmed to ensure that the proper drug regimen is being used.