NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 261:

  A client with a spinal cord injury is preparing to return home from the rehabilitation unit.

  Which of the following statements by a family member indicates a need for further teaching regarding autonomic dysreflexia?

  A. "I should raise him to a sitting position."

  B. "I should check for a fecal impaction."

  C. "I should look for a kink in the urinary catheter tubing."

  D. "I should see whether symptoms worsen."

  Correct Answer: D

  If the client develops signs or symptoms of autonomic dysreflexia, they need to be addressed immediately. If the family member is not able to relieve them, a health care provider needs to be notified immediately. The remaining choices are correct; they are all ways to relieve autonomic dysreflexia.

• Question 262:

  Which of the following foods can cause diarrhea when eaten by a client with an ileostomy?

  A. eggs

  B. coffee

  C. fish

  D. garlic

  Correct Answer: B

  Coffee might cause diarrhea in a client with an ileostomy. The other foods might cause odor.

• Question 263:

  Which of the following syndromes associated with incomplete lesions of the spinal cord is a result of damage to one-half of the spinal cord?

  A. Brown-S閝uard syndrome

  B. posterior cord syndrome

  C. central cord syndrome

  D. cauda equina syndrome

  Correct Answer: A

  Brown-S閝uard syndrome is a result of damage to one-half of the spinal cord.

  The other choices are also incomplete lesions of the spinal cord, but they have different defining

  characteristics.

• Question 264:

  Which of the following nursing diagnoses is most appropriate for a client with a new colostomy?

  A. Excess Fluid Volume

  B. Risk for Aspiration

  C. Disturbed Body Image

  D. Urinary Retention

  Correct Answer: C

  Disturbed Body Image is the most appropriate nursing diagnosis for a client with a new colostomy, due to

  the adjustments that need to be made with the physical alteration of a colostomy.

  The other diagnoses are not applicable.

• Question 265:

  Which cultural group has the highest incidence of inflammatory bowel disease (IBD)?

  A. Asians B. Caucasians

  C. Hispanics

  D. African Americans

  Correct Answer: B

  Caucasians have the highest incidence of inflammatory bowel disease (IBD).

• Question 266:

  Which of the following statements indicates adequate dietary understanding in a client with constipation?

  A. "I should decrease my intake of fluids."

  B. "I should decrease my level of activity."

  C. "I should increase my intake of apples."

  D. "I should increase my intake of milk."

  Correct Answer: C

  Apples are a source of high fiber, which decreases constipation. A constipated client needs to increase

  fluids and activity level.

  Milk is not a high-fiber food.

• Question 267:

  Which of the following actions should a nurse take first for a client who has just vomited 300 cc of bright red blood?

  A. Document the vomiting.

  B. Increase the IV fluids.

  C. Get a complete blood count.

  D. Check the blood pressure.

  Correct Answer: D

  The blood pressure should be checked first for a client who has just vomited 300 cc of bright red blood, to

  determine whether the client is hypotensive.

  The other actions can be taken later.

• Question 268:

  For which condition might a client's antidiuretic hormone (ADH) level be increased?

  A. diabetes mellitus

  B. diabetes insipidus

  C. hypothyroidism D. hyperthyroidism

  Correct Answer: B

  ADH level is increased in the client with nephrogenic diabetes insipidus.

• Question 269:

  Which of the following represents a normal serum potassium level?

  A. 1.5 mEq/L

  B. 3.0 mEq/L

  C. 4.0 mEq/L

  D. 6.0 mEq/L

  Correct Answer: C

  Normal serum potassium levels fall in a range of 3.5?.5mEq/L. The other choices listed fall below or above this range.

• Question 270:

  Which of the following is not a function of parathyroid hormone?

  A. moving calcium from bones to the bloodstream

  B. promoting renal tubular reabsorption of phosphorus

  C. promoting renal tubular reabsorption of calcium

  D. enhancing renal production of vitamin D metabolites

  Correct Answer: B

  Parathyroid hormone depresses renal tubular reabsorption of phosphorus. All of the other choices are functions of parathyroid hormone.