NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 361:

  Which of these is not a symptom of Serotonin Syndrome?

  A. fever
  B. tremors
  C. edema
  D. confusion
  C. edema

• Question 362:

  A patient has just been prescribed Minipress to control hypertension.

  The nurse should instruct the patient to be observant of the following __________.

  A. Dizziness and light headed sensations
  B. Weight gain
  C. Sensory changes in the lower extremities
  D. Fatigue
  A. Dizziness and light headed sensations

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  Explanation Explanation/Reference:Hypotension may be result of over correction of a hypertensive condition.

• Question 363:

  One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base.

  The nurse should suspect __________.

  A. cor pulmonale
  B. atelectasis
  C. pulmonary embolus
  D. cardiac tamponade
  B. atelectasis

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  The first three symptoms could be indicative of any of the conditions. The distinguishing symptom is the lack of breath sounds in the lower-right base, which is assessed when a portion of the lung has collapsed.

• Question 364:

  A client has experienced a CVA with right hemiparesis and is ready for discharge from the hospital to a long-term care facility for rehab. To provide optimal continuity of care, the nurse should do all of the following except __________.

  A. document current functional status
  B. have the physician phone a report to the receiving facility
  C. copy appropriate parts of the medical record for transport to the receiving facility
  D. phone a report to the facility
  B. have the physician phone a report to the receiving facility

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  It is the nurse's responsibility to communicate the client's condition and care plan to the receiving facility to support continuity of care. Documentation of the client's baseline functional status is important for the receiving facility to work with in further goal setting. A copy of select portions of the medical record (according to facility policy) is another form of communication and supports continuity. A physician might be asked to be involved if there are specific medical needs or orders that she believe are important, but is generally not involved.

• Question 365:

  A client admitted to the medical nursing unit has classic symptoms of tuberculosis (TB) and tests positive on the purified protein derivative (PPD) skin test. Several months later, the nurse who cared for the client also tests positive on an annual TB skin test for work.

  The most likely course of treatment if the chest X-ray (CXR) is negative is to __________.

  A. repeat a TB skin test in six months
  B. treat the nurse with an anti-infective agent for six months
  C. monitor for signs and symptoms within the next year
  D. follow up in one year at the next annual physical with CXR only
  B. treat the nurse with an anti-infective agent for six months

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  Exposure with a positive TB skin test usually requires six months of prophylactic treatment unless contraindicated. The TB skin test should not be repeated; the results will always be positive. A CXR is usually not required annually in the event that the skin test was positive. TB is a type of pneumonia caused by the acid-fast bacillus, mycobacterium tuberculosis, and is contracted by airborne droplets that enter the lungs and multiply in the pulmonary alveoli. Nursing Assessment: (1) Assessment includes symptom analysis of type and progression of symptoms; color, consistency, and amount of sputum; knowledge of the disease; weight pattern; vital signs; description of any pain; palpable lymph nodes; breath sounds; and activity tolerance. (2) Diagnostic tests: ?CXR (shows dense lesions in the upper lobes, enlarged lymph nodes, and formation of large cavities); ?CBC (presence of leukocytosis); ?Fiberoptic bronchoscopy and bronchial washing (for obtaining culture specimens); ?Tuberculin skin test (positive at 5 to 9 mm for clients with abnormal CXR or HIV; positive at 10 to 15 mm for clients with high-risk factors such as intravenous [IV] drug use; residence in a long-term facility, high-incidence country; positive at 15 mm for all other people); ?Three early-morning sputum collections for acid-fast staining, culture and sensitivity positive for M. tuberculosis. Results can take up to 10 days.

• Question 366:

  A 26-year-old single woman is knocked down and robbed while walking her dog one evening. Three months later, she presents at the crisis clinic, stating that she cannot put this experience out of her mind. She complains of nightmares, extreme fear of being outside or alone, and difficulty eating and sleeping.

  What is the best response by the nurse?

  A. "I will ask the physician to prescribe medication for you."
  B. "That must have been a very difficult and frightening experience. It might be helpful to talk about it."
  C. "In the future, you might walk your dog in a more populated area or hire someone else to take over this task."
  D. "Have you thought of moving to a safer neighborhood?"
  B. "That must have been a very difficult and frightening experience. It might be helpful to talk about it."

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  Choice "That must have been a very difficult and frightening experience. It might be helpful to talk about it." gives the client support and an opportunity to discuss the experience. Choices "I will ask the physician to prescribe medication for you.", "In the future, you might walk your dog in a more populated area or hire someone else to take over this task.", and "Have you thought of moving to a safer neighborhood?" do not validate her experience or permit discussion of her feelings.

• Question 367:

  The LPN is caring for a patient newly diagnosed with HIV.

  Which statement made by the patient regarding antiretroviral therapy (ART) would require correction from the nurse?

  A. "I will need to be on ART indefinitely."
  B. "I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3."
  C. "I can still use ART even though I am Hepatitis C positive."
  D. "If I start ART and use condoms, I'm less likely to transmit HIV to my partner."
  B. "I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3."

• Question 368:

  For which of the following conditions might blood be drawn for uric acid level?

  A. asthma
  B. gout
  C. diverticulitis
  D. meningitis
  B. gout

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  Explanation Explanation/Reference:Uric acid levels are indicated for clients with gout.

• Question 369:

  A preschooler has successfully completed the test item "counts 5 blocks" on the Denver II test.

  This pass is evidence of which of the following developmental concepts?

  A. centration
  B. causality
  C. nonreversibility
  D. conservation
  D. conservation

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  The ability to move five blocks to a piece of paper and state there are five blocks on the paper is evidence that the preschooler has the ability of conservation. This concept refers to the fact that the quantity of something doesn't change just because the shape, contour, and so on has changed. Five blocks are still five blocks, whether they are lying beside the paper, stacked on the paper or moved to the paper. Centration is the ability to concentrate on one feature of a situation while neglecting all other aspects. Causality is based on the sequence of events, one event ordinarily following another. Nonreversibility refers to the inability of preschoolers to reverse their operations. They are only able to think forward, not retrace or reverse their thought processes.

• Question 370:

  A nurse is performing a screening on a patient that has been casted recently on the left lower extremity.

  Which of the following statements should the nurse be most concerned about?

  A. The patient reports, "I didn't keep my extremity elevated like the doctor asked me to."
  B. The patient reports, "I have been having pain in my left calf."
  C. The patient reports, "My left leg has really been itching."
  D. The patient reports, "The arthritis in my wrists is flaring up, when I put weight on my crutches."
  B. The patient reports, "I have been having pain in my left calf."

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  Pain may be indicating neurovascular complication.