NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 331:

  Quality is defined as a combination of all of the following except __________.

  A. conforming to standards
  B. performing at the minimally acceptable level
  C. meeting or exceeding customer requirements
  D. exceeding customer expectations
  B. performing at the minimally acceptable level

  ---

  Compliance or performance at the minimally acceptable level is not considered quality care.

• Question 332:

  A visitor accidentally knocks over a plastic pleural drainage system connected to a client, and it cracks. What should the nurse do first?

  A. Observe the client's response.
  B. Notify the physician.
  C. Change the drainage system.
  D. Observe for leaks.
  C. Change the drainage system.

  ---

  Explanation Explanation/Reference:If a crack is seen in a pleural drainage system, it should be changed immediately. The remaining choices can be performed later.

• Question 333:

  The sexually transmitted disease, sometimes referred to as the silent STD, that is more common than gonorrhea and a leading cause of PID is __________.

  A. genital herpes
  B. trichomoniasis
  C. syphilis
  D. chlamydia
  D. chlamydia

  ---

  Chlamydia is a sexually transmitted genital infection and is manifested in males primarily as urethritis and in females as mucopurulent cervicitis. Clinical manifestations of urethritis are often difficult to distinguish from gonorrhea and include mucopurulent discharges of scant or moderate quantity, urethral itching, and burning on urination. Possible complications or sequelae of male urethral infections include epididymitis, infertility, and Reiter syndrome. In homosexual men, receptive anorectal intercourse might result in chlamydial proctitis. In women, the clinical manifestations might be similar to those of gonorrhea and frequently present as a mucopurulent endocervical discharge, with edema, erythema, and easily induced endocervical bleeding caused by inflammation of the endocervical columnar epithelium. However, up to 70% of sexually active women with chlamydial infections are asymptomatic. Complications and sequelae include salpingitis with subsequent risk of infertility, ectopic pregnancy, or chronic pelvic pain. Asymptomatic chronic infections of the endometrium and fallopian tubes might lead to the same outcome.

• Question 334:

  The LPN is observing a patient using crutches for a leg injury.

  Which of these would indicate that the patient needs to be reinforced on the proper use of crutches?

  A. When going down the stairs, the patient leads with the injured leg.
  B. The patient rests the axilla on the top padding and loosely grips the handles with hands.
  C. The patient has a slight bend in the elbow when using the handles.
  D. The patient places the top padding 1-2 inches below the axilla with a firm grip on the handles.
  B. The patient rests the axilla on the top padding and loosely grips the handles with hands.

• Question 335:

  Select the stage of shock that is accurately paired with its characteristic.

  A. The initial stage of shock: Hyperventilation occurs and the blood pH rises.
  B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises.
  C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.
  D. The refractory stage of shock: Potassium ions leak out, sodium ions build up and metabolic acidosis increases.
  C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.

  ---

  During the progressive stage of shock, histamine is released, fluid and proteins leak into surrounding tissues and the blood thickens. The initial stage of shock is marked with hypoxia and an increase in lactic acid; the compensatory stage of shock is characterized with hyperventilation and rises in the blood pH. The progressive stage of shock is also characterized with the leakage of potassium ions, the buildup of sodium ions and increasingly more severe metabolic acidosis. The refractory, or final, stage of shock becomes irreversible.

• Question 336:

  In teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?

  A. Use a soft toothbrush.
  B. Use dental floss daily.
  C. Hold pressure on any scrapes for 1-2 minutes.
  D. Use a triple-edged razor.
  A. Use a soft toothbrush.

  ---

  A soft toothbrush is less likely to cause the gums to bleed than a stiff one. So many white cells are produced in clients with leukemias that other cell types (like platelets) are crowded out, putting the client at risk for bleeding. To use dental floss daily is incorrect because dental floss is contraindicated; it can make the gums bleed. To hold pressure on any scrapes for 1-2 minutes is incorrect because when clotting is impaired, pressure should be held for 5-10 minutes or longer, until the bleeding stops. To use a triple-edged razor is incorrect because an electric razor should be used to prevent small cuts.

• Question 337:

  What is the reason for a contract between nurse and client?

  A. Contracts state the roles the participants take.
  B. Contracts are indicative of the feeling tone established between participants.
  C. Contracts are binding and prevent either party from ending the relationship prematurely.
  D. Contracts spell out the participation and responsibilities of both parties.
  D. Contracts spell out the participation and responsibilities of both parties.

  ---

  A contract emphasizes that the nurse works with the client, rather than doing something for the client. Working withsuggests that each party is expected to participate and share responsibility for outcomes. Contracts do not,however, stipulate roles or feeling tone, nor is premature termination expressly forbidden.

• Question 338:

  A chemical reaction between drugs prior to their administration or absorption is known as __________.

  A. a drug incompatibility
  B. a side effect
  C. an adverse event
  D. an allergic response
  A. a drug incompatibility

  ---

  This occurs most often when drug solutions are combined before they are given intravenously but can occur with orally administered drugs as well. A side effect, an adverse event and an allergic response are incorrect choices because drugs can cause these events after administration and absorption.

• Question 339:

  Which of the following is most likely to impact the body image of an infant newly diagnosed with Hemophilia?

  A. immobility
  B. altered growth and development
  C. hemarthrosis
  D. altered family processes
  D. altered family processes

  ---

  Altered Family Processes is a potential nursing diagnosis for the family and client with a new diagnosis of Hemophilia. Infants are aware of how their caregivers respond to their needs. Stresses can have an immediate impact on the infant's development of trust and how others relate to them because of their diagnosis. The longterm effects of hemophilia can include problems related to immobility. Altered growth and development could not have developed in a newly diagnosed client. Hemarthrosis is acute bleeding into a joint space that is characteristic of hemophilia. It does not have an immediate effect on the body image of a newly diagnosed hemophiliac.

• Question 340:

  A female patient is about to begin her first chemotherapy treatment. She tells the LPN, "It sounds silly, but I'm just so afraid of how people will react to me once I lose all my hair. I always had such pretty hair... I know, stupid, right?"

  What is the LPN's best response?

  A. "Your hair will grow back right after treatment stops. And for many women, it grows back even thicker and shinier! For now, just focus on getting better."
  B. "Don't worry. The way they make wigs these days, no one will be able to tell! Would you like me to help you pick one out?"
  C. "Most people are pretty understanding about chemo hair loss, but I know it's hard. Have you joined our chemotherapy support group?"
  D. "Many people have a hard time with chemo-related hair loss. Tell me a little more about your concerns."
  D. "Many people have a hard time with chemo-related hair loss. Tell me a little more about your concerns."