NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 291:

  Perineal care to a female client by the nurse can be performed ___________.

  A. without gloves, pouring water from a sterile bottle
  B. without gloves, having the client perform all care
  C. with gloves, washing the perineal area from front to back
  D. with gloves, washing the perineal area from back to front
  C. with gloves, washing the perineal area from front to back

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  Explanation Explanation/Reference:Gloves should always be worn, and the perineal area should be washed with a washcloth from front to back. This method prevents E. coli and other bacteria from being swept into the urethra. The procedure should be performed and explained in a private area with all equipment gathered first.

• Question 292:

  The LPN is helping a patient get out of bed to use the restroom. Which of these actions represents proper ergonomic practice?

  A. Aid the patient in sitting/standing by lifting with the legs and keeping the back straight.
  B. Bend over the patient to get a good grip when sitting the patient up.
  C. Lift the patient into a standing position by using your leg and back muscles.
  D. Let the patient use your body to pull up in a sitting, then standing, position.
  A. Aid the patient in sitting/standing by lifting with the legs and keeping the back straight.

• Question 293:

  While walking in the hallway of an acute care unit of the hospital, the nurse overhears the change of shift report.

  The nurse should ___________.

  A. make the charge nurse on the unit aware of the situation so that he or she can take the necessary steps to maintain the confidentiality of the information being reported
  B. disregard the information because it changes quickly on the acute care unit and is outdated within 2-3 hours anyway
  C. return to his or her own unit and not disclose that confidential information has been overheard
  D. ignore the situation
  A. make the charge nurse on the unit aware of the situation so that he or she can take the necessary steps to maintain the confidentiality of the information being reported

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  To protect the confidentiality of the information being reported, the nurse should make the charge nurse on the unit aware of the situation so that the information can be communicated in an appropriate way in privacy.

• Question 294:

  A client is to have an enema to reduce flatus. The enema tube should be inserted __________.

  A. 4 inches
  B. 6 inches
  C. 2 inches
  D. 8 inches
  A. 4 inches

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  Explanation Explanation/Reference:Enema tubing must be passed beyond the internal sphincter. Two inches is not far enough to pass the internal sphincter. Both 6 and 8 inches are too far and might cause trauma to the bowel.

• Question 295:

  A client recently lost a child due to poisoning. The client tells the nurse, "I don't want to make any new friends right now." This is an example of __________ indicator of stress.

  A. emotional behavioral indicator
  B. spiritual indicator
  C. sociocultural indicator
  D. intellectual indicator
  C. sociocultural indicator

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  Explanation Explanation/Reference:Stress can alter a person's relationships with others.

• Question 296:

  A laboring patient is experiencing late decelerations.

  Which position should she be placed in?

  A. lithotomy
  B. semi-Fowler's
  C. left lateral
  D. right lateral
  C. left lateral

• Question 297:

  A person using over-the-counter nasal decongestant drops who reports unrelieved and worsening nasal congestion should be instructed to __________.

  A. switch to a stronger dose of the medication
  B. discontinue the medication for a few weeks
  C. continue taking the same medication, but use it more frequently
  D. use a combination of medications for better relief
  B. discontinue the medication for a few weeks

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  Prolonged use of decongestant drops (3 to 5 days) can lead to rebound congestion, which is relieved by discontinuing the medication for 2 to 3 weeks. Nasal congestion results from dilation of nasal blood vessels due to infection, inflammation, or allergy. With this dilation, there is a transudation of fluid into the tissue spaces, resulting in swelling of the nasal cavity. Nasal decongestants (sympathomimetic amines) stimulate the alphaadrenergic receptors, producing vascular constriction (vasoconstriction) of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion (runny nose). Decongestants can make a client jittery, nervous, or restless. These side effects decrease or disappear as the body adjusts to the drug. When nasal decongestants are used for longer than 5 days, instead of the nasal membranes constricting, vasodilation occurs, causing increased stuffy nose and nasal congestion. The nurse should emphasize the importance of limiting the use of nasal sprays and drops. As with any alpha-adrenergic drug (for example, decongestants), blood pressure and blood glucose levels can increase. These drugs are contraindicated and should only be used with extreme caution for clients with hypertension, cardiac disease, hyperthyroidism, and diabetes mellitus.

• Question 298:

  A 60-year-old widower is hospitalized after complaining of difficulty sleeping, extreme apprehension, shortness of breath, and a sense of impending doom.

  What is the best response by the nurse?

  A. "You have nothing to worry about. You are in a safe place. Try to relax."
  B. "Has anything happened recently or in the past that might have triggered these feelings?"
  C. "We have given you a medication that helps to decrease feelings of anxiety."
  D. "Take some deep breaths and try to calm down."
  B. "Has anything happened recently or in the past that might have triggered these feelings?"

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  Choice "Has anything happened recently or in the past that might have triggered these feelings?" provides support, reassurance, and an opportunity to gain insight into the cause of the anxiety. Choice "You have nothing to worry about. You are in a safe place. Try to relax." dismisses the client's feelings and offers false reassurance. Choices "We have given you a medication that helps to decrease feelings of anxiety." and "Take some deep breaths and try to calm down." do not allow the client to discuss his feelings, which he must do in order to understand and resolve the cause of his anxiety.

• Question 299:

  Which of the following blood pressure parameters indicates PIH? Elevation over a baseline of __________.

  A. 30 mmHg systolic and/or 15 mmHg diastolic
  B. 40 mmHg systolic and/or 20 mmHg diastolic
  C. 10 mmHg systolic and/or 5 mmHg diastolic
  D. 20 mmHg systolic and/or 20 mmHg diastolic
  A. 30 mmHg systolic and/or 15 mmHg diastolic

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  Explanation Explanation/Reference:These are the accepted parameters for mild PIH. Mild preclampsia includes an increase in systolic blood pressure higher than 30 mmHg or an increase in diastolic blood pressure higher than 15 mmHg, noted on two readings taken 6 hours apart (or 140/90).

• Question 300:

  The PN is reinforcing education with a patient being discharged with an Albuterol inhaler. The medication prescription orders the patient to take two puffs from the inhaler every 4-6 hours as needed.

  How long should the PN instruct the patient to wait between taking the first and second puff?

  A. 30 seconds
  B. 1 minute
  C. 1 hour
  D. 15 seconds
  B. 1 minute