NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 541:

  A 35-year-old Latin-American client wishes to lose weight to reduce her chances of developing heart disease and diabetes. The client states, "I do not know how to make my diet work with the kind of foods that my family eats."

  What should the nurse do first to help the client determine a suitable diet for disease prevention?

  A. Provide her with copies of the approved dietary guidelines for the American Diabetic Association and the American Heart Association.
  B. Ask the client to provide a list of the types of foods she eats to determine how to best meet her needs.
  C. Provide a high-protein diet plan for the client.
  D. Provide the client with information related to risk factors for heart disease and diabetes.
  B. Ask the client to provide a list of the types of foods she eats to determine how to best meet her needs.

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  Assessment is the first step. Assessing what the client eats helps the nurse determine a plan for dietary recommendations based on the ADA and AHA guidelines. Providing the client with a copy of the guidelines is important but is not the first priority. Based on the client's wish to reduce her chances of heart disease and diabetes, a high-protein diet plan might not be appropriate. Providing information to the client related to risk factors for heart disease and diabetes is important but is not the first step.

• Question 542:

  Which of the following is an inappropriate item to include in planning care for a severely neutropenic client?

  A. Transfuse netrophils (granulocytes) to prevent infection.
  B. Exclude raw vegetables from the diet.
  C. Avoid administering rectal suppositories.
  D. Prohibit vases of fresh flowers and plants in the client's room.
  A. Transfuse netrophils (granulocytes) to prevent infection.

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  Granulocyte transfusion is not indicated to prevent infection. Produced in the bone marrow, granulocytes normally comprise 70% of all WBCs. They are subdivided into three types based on staining properties: neutrophils, eosinophils, and basophils. They can be beneficial in a selected population of infected, severely granulocytopenic clients (less than 500 mm3) who do not respond to antibiotic therapy and who are expected to experience prolonged suppression of granulocyte production.

• Question 543:

  A man reports his wife is constantly cleaning. The activity has interfered with the family life. Friends have stopped visiting because she makes them uncomfortable. He states he has awakened in the middle of the night and found her cleaning. The nurse should consult with the couple and recommend the husband help with therapy by ___________.

  A. telling his wife to stop cleaning whenever he notices her actions.
  B. making a baseline record of the time the wife spends cleaning.
  C. decreasing the stimuli in the home.
  D. helping his wife with the cleaning.
  C. decreasing the stimuli in the home.

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  Explanation Explanation/Reference:His wife is exhibiting obsessive-compulsive behavior. Because this is an anxiety disorder, it is desirable to maintain an environment that is calm and as stress free as possible. Attempting to stop or focusing on the behavior can increase the wife's anxiety and therefore the repetitive behavior.

• Question 544:

  Which quality assurance or performance improvement technique is used to identify underlying process flaws?

  A. Small group process
  B. Root cause analysis
  C. People at fault process
  D. Cause and effect
  B. Root cause analysis

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  Root cause analysis is a quality assurance or performance improvement technique that is used to identify the underlying, root causes of a problem. Root cause analysis focuses on process flaws and NOT on people who have erred or made a mistake. A cause and effect diagram may be used for root cause analysis but it, in itself, is not a quality assurance or performance improvement technique. Although small groups participate in quality assurance or performance improvement activities, small groups are not a quality assurance or performance improvement technique.

• Question 545:

  When caring for a Native-American family, which of the following the nurse needs to consider?

  A. The family consists solely of the parents and children.
  B. Native Americans tend to be future oriented.
  C. Some Native Americans use herbs and psychologic treatment of illnesses.
  D. Health care is usually prescribed by a medicine man (shaman).
  C. Some Native Americans use herbs and psychologic treatment of illnesses.

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  Symbols of health or traditions might include certain ritualistic items that are used to maintain, protect, or restore physical, mental, or spiritual health.

• Question 546:

  The nurse is assessing an 18-month-old.

  Which of these statements made by the parent or caregiver would require follow-up?

  A. I'm worried that my child is not using two-word phrases yet.
  B. I'm letting my child use a spoon to eat.
  C. My child has recently taken a few steps but does not seem stable when standing.
  D. My child seems to have developed separation anxiety when I leave.
  C. My child has recently taken a few steps but does not seem stable when standing.

• Question 547:

  Which of these actions would be least appropriate when the PN is caring for a patient with an active Digoxin IV order?

  A. Administer over at least 5 minutes.
  B. Monitor respirations during administration.
  C. Monitor EKG rhythm throughout administration.
  D. Monitor the patient's pulse for a minute prior to administration.
  B. Monitor respirations during administration.

• Question 548:

  A client comes to the clinic for assessment of his physical status and guidelines for starting a weight-reduction diet. The client's weight is 216 pounds and his height is 66 inches.

  The nurse identifies the BMI (body mass index) as __________.

  A. within normal limits, so a weight-reduction diet is unnecessary
  B. lower than normal, so education about nutrient-dense foods is needed
  C. indicating obesity because the BMI is 35
  D. indicating overweight status because the BMI is 27
  C. indicating obesity because the BMI is 35

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  Obesity is defined by a BMI of 30 or more with no co-morbid conditions. It is calculated by utilizing a chart or nomogram that plots height and weight. This client's BMI is 35, indicating obesity. Goals of diet therapy are aimed at decreasing weight and increasing activity to healthy levels based on a client's BMI, activity status, and energy requirements.

• Question 549:

  You are caring for a patient who has no cognitive functioning but only basic human functions such opening the eyes and the sleep ?wake cycle.

  What level of consciousness does this patient have?

  A. Obtunded
  B. A persistent vegetative state
  C. Locked in syndrome
  D. Brain death
  B. A persistent vegetative state

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  A persistent vegetative state leaves the client with no cognitive functioning but only basic functions such as a sleep ?wake cycle and eye opening. Locked in syndrome is characterized with retained cognitive functioning but absent motor functioning. This patient is able to communicate with eye movements and they are typically aware of their surroundings. Brain death is defined as the state where there is a known irreversible cause of the coma, a complete loss of all brainstem reflexes, complete unresponsiveness to eternal stimuli and the absence of respiratory function with the presence of hypercapnea. Obtunded patients respond slowly to stimulation.

• Question 550:

  You are caring for a 78-year-old woman who is wondering why she was diagnosed with glaucoma.

  Although she has several risk factors, which of these is not one of them?

  A. Mexican-American heritage
  B. blood pressure reading of 143/89
  C. age
  D. 20/80 vision
  D. 20/80 vision