NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 621:

  Which type of practice is most similar to research based practice?

  A. Best practices
  B. Evidence based practice
  C. Benchmark practices
  D. Standard based practice
  B. Evidence based practice

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  Evidence-based practice is an approach to patient care that encourages nurses to use the best available evidence, or research, in combination with the individual patient's circumstances and preferences in clinical practice. Simply stated, evidence based practice is research based practice. Best practices may or may not be based on sound research; benchmarks are similar to best practices and these benchmarks are used so that nurses can compare their outcomes of care to those of others. Standards of care are guidelines for practice; standards of care and standards of practice are published by the American Nurses Association as well as other professional organizations and associations.

• Question 622:

  When a client who is 25 years of age asks the nurse when she should seek fertility counseling, the best response by the nurse is __________.

  A. "Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse."
  B. "Fertility couseling should be sought when you have not been able to conceive after 6-9 months of unprotected intercourse."
  C. "The average time it takes someone your age to conceive is 51/2 months, so if you haven't conceived by then, we can refer you."
  D. "We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year."
  D. "We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year."

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  The guidelines for a fertility workup are to refer after the couple has not conceived after one year of unprotected intercourse. So, Choice "Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse." is technically correct, but it doesn't consider the immediate need for the couple to have some counseling. Choice "We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year." is the best answer because it gives the couple guidance now and the referral at the appropriate time. If the woman is over the age of 35, an earlier referral, at six to nine months of unprotected intercourse, is appropriate. It is true that the average time it takes a 25-year-old woman to conceive is 5.3 months, but that does not address the concern the client is expressing. Choice "We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year." is still the most caring and correct answer. Couples conceive within the first month of unprotected intercourse 20% of the time.

• Question 623:

  Distraction therapy is ___________.

  A. focusing one's attention on stimuli other than pain
  B. cognitive reappraisal
  C. the replacement of positive images of pain with other images
  D. the use of medication and meditation
  A. focusing one's attention on stimuli other than pain

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  Explanation Explanation/Reference:The focus of distraction therapy is on positive stimuli rather than negative input.

• Question 624:

  When a client informs the nurse that he is experiencing hypoglycemia, the nurse provides immediate intervention by providing __________.

  A. one commercially prepared glucose tablet
  B. two hard candies
  C. 4-6 ounces of fruit juice with 1 teaspoon of sugar added
  D. 2-3 teaspoons of honey
  D. 2-3 teaspoons of honey

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  The usual recommendation for treatment of hypoglycemia is 10-15 grams of a fast-acting simple carbohydrate, orally, if the client is conscious and able to swallow (for example, 3-4 commercially prepared glucose tablets or 4-6 oz of fruit juice). It is not necessary to add sugar to juice, even if it is labeled as unsweetened juice because the fruit sugar in juice contains enough simple carbohydrate to raise the blood glucose level. Addition of sugar might result in a sharp rise in blood sugar that could last for several hours.

• Question 625:

  Hormonal agents are used to treat some cancers.

  An example is __________.

  A. thyroxine to treat thyroid cancer.
  B. ACTH to treat adrenal carcinoma.
  C. estrogen antagonists to treat breast cancer.
  D. glucagon to treat pancreatic carcinoma.
  C. estrogen antagonists to treat breast cancer.

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  Estrogen antagonists are used to treat estrogen hormone-dependent cancer, such as breast carcinoma. A wellknown estrogen antagonist used in breast cancer therapy is Tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs, reduces breast cancer recurrence by 30%. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history of the disease. Thyroxine is a natural thyroid hormone. It does not treat thyroid cancer. ACTH is an anterior pituitary hormone that stimulates the adrenal glands to release glucocorticoids; it does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone that stimulates glycogenolysis and gluconeogenesis; it does not treat pancreatic cancer.

• Question 626:

  An Asian family has an elderly member with latestage Alzheimer's disease. The physician has recommended placement in a long-term care facility, but the family refuses. Which of the following is an appropriate response to the family by the nurse?

  A. "You really need to listen to what the physician says."
  B. "You will get too tired to take care of him at home."
  C. "What can I do to assist you to care for him at home?"
  D. "You are too busy to be taking care of an elderly person."
  C. "What can I do to assist you to care for him at home?"

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  Explanation Explanation/Reference:This is the only culturally sensitive statement. Many Asian cultures have a high respect for elders, and members of these cultures might not consider placement in a long-term care facility. This is because they feel it is more respectful for them to care for the family member at home. The nurse might be able to assist the family by determining what community resources are available to assist them.

• Question 627:

  Ten-year-old Jackie is admitted to the hospital with a medical diagnosis of Rheumatic Fever. She relates a history of "a sore throat about a month ago." Bed rest with bathroom privileges is prescribed.

  Which of the following nursing assessments should be given the highest priority when assessing Jackie's condition?

  A. her response to being hospitalized
  B. the presence of a macular rash on her trunk
  C. her cardiac status
  D. the presence of polyarthritis and pain in her joints
  C. her cardiac status

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  Monitoring cardiac status is of the highest priority. Permanent cardiac damage can result from rheumatic fever. The second priority is assessing the client's joints for the presence of polyarthritis and accompanying pain.

• Question 628:

  A nurse is teaching a client about self-administration of Haldol 15 mg po hs. For which side effects must the client seek medical attention?

  A. SOB and fatigue
  B. restlessness and muscle spasms
  C. dry mouth
  D. diarrhea
  B. restlessness and muscle spasms

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  Explanation Explanation/Reference:Muscle spasms and restlessness are side effects of Haldol.

• Question 629:

  Which of the following is the best worded expected outcome?

  A. "The nurse will provide for adequate hydration"
  B. "The nurse will insure that the patient is safe"
  C. "The patient will cough and deep breath every two hours"
  D. "The patient will value health"
  C. "The patient will cough and deep breath every two hours"

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  "The patient will cough and deep breath every two hours" is the best worded expected patient outcome. This outcome or goal is specific, measurable, achievable, realistic, within a specified timeframe, trackable and it should be agreed to by the patient. All expected outcomes are worded in terms of what the patient, not the nurse, will do and it should also be specific and measurable. "The patient will value health" is not measurable.

• Question 630:

  A client who recently lost 50 pounds just received news that she is pregnant.

  A possible nursing diagnosis is __________.

  A. Actual Chronic Low Self-Esteem (related to obesity)
  B. Potential Chronic Low Self-Esteem (related to obesity)
  C. Actual Situational Low Self-Esteem (related to fear of weight regain and pregnancy)
  D. Potential Situational Low Self-Esteem (related to fear of weight regain and pregnancy)
  D. Potential Situational Low Self-Esteem (related to fear of weight regain and pregnancy)

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  Explanation Explanation/Reference:If there are indications of a body image disturbance, the nursing care plan should include body disturbances, related to a functional or physical problem. The disturbance might be an anticipated one ?that is, weight gain and pregnancy. Stressors can include a change in physical appearance, sexuality concerns, or an unrealistic ideal self.