NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 631:

  Which of the following is not a function of parathyroid hormone?

  A. moving calcium from bones to the bloodstream
  B. promoting renal tubular reabsorption of phosphorus
  C. promoting renal tubular reabsorption of calcium
  D. enhancing renal production of vitamin D metabolites
  B. promoting renal tubular reabsorption of phosphorus

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  Parathyroid hormone depresses renal tubular reabsorption of phosphorus. All of the other choices are functions of parathyroid hormone.

• Question 632:

  The LPN is caring for a patient who will be undergoing electroconvulsive therapy (ECT).

  Which of the following requires additional intervention prior to the procedure?

  A. The patient has been NPO for 8 hours.
  B. Pre-therapy medication has been administered as ordered.
  C. The patient's intravenous line has been removed.
  D. The patient has removed his or her jewelry.
  C. The patient's intravenous line has been removed.

• Question 633:

  Narrow therapeutic index medications __________.

  A. are drug formulations with limited pharmacokinetic variability.
  B. have limited value and require no monitoring of blood levels.
  C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood.
  D. have limited potency and side effects.
  C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood.

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  The therapeutic index is the ratio between the median lethal dose and median effective dose of a drug. It provides a general indication of the margin of safety of a drug. Choice "are drug formulations with limited pharmacokinetic variability." is incorrect because pharmacokinetics is the process of adsorption, distribution, metabolism, and elimination. Choice "have limited value and require no monitoring of blood levels." is incorrect because narrow therapeutic index drugs require close monitoring since there is often little difference between the desired drug effect and toxicity. Choice "have limited potency and side effects." is incorrect because narrow therapeutic index drugs have the potential for severe toxic effects with only slight increases in the dose or slight decreases in elimination.

• Question 634:

  The nurse uses prioritization to determine all the following except __________.

  A. time allotment for certain tasks
  B. appropriate interventions
  C. treatment procedures
  D. the need for client education
  C. treatment procedures

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  Explanation Explanation/Reference:Treatment procedures are standards of care as defined by the facility or nursing unit. If a treatment is indicated, the nurse is obligated to follow the established procedure to be compliant with practice standards. Established priorities contribute to the determination of time management, appropriate interventions, and the need for client education as a potential intervention.

• Question 635:

  The PN is caring for an American-Indian male. While explaining an upcoming procedure, the patient stares at the floor.

  Which of these is the most accurate assumption concerning this patient behavior?

  A. The patient is being respectful of the nurse.
  B. The patient needs a nurse of a different gender to explain the procedure.
  C. The patient is showing that they do not consent to the procedure.
  D. The patient is not paying attention.
  A. The patient is being respectful of the nurse.

• Question 636:

  Social support systems include of the following except __________.

  A. call-in help lines
  B. emotional assistance provided by others
  C. community support groups
  D. use of coping skills and verbalization for anger management
  D. use of coping skills and verbalization for anger management

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  Explanation Explanation/Reference:Use of coping skills and verbalization for anger management are personal strategies, not examples of social support systems. Choices "call-in help lines", "emotional assistance provided by others" and "community support groups" are all social support systems.

• Question 637:

  A woman seeks assistance because she recently remembered childhood sexual abuse.

  The nurse should include which of the following goals for this client?

  A. prosecuting the perpetrator
  B. managing symptoms of anxiety and fear
  C. determining if the memories are real
  D. collaborating the client's story
  B. managing symptoms of anxiety and fear

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  At least 10% of victims of childhood sexual abuse have periods of complete amnesia about the abuse, followed by delayed recall. Controversial evidence suggests that people who have recovered memories have had part of those memories reconstructed by therapists. The nurse's role is not to determine if the memories are real, but to help the client deal with the stress caused by the remembered abuse.

• Question 638:

  A client receives a cervical intracavitary radium implant as part of her therapy.

  A common side effect of a cervical implant is ___________.

  A. creamy, pink-tinged vaginal drainage
  B. stomatitis
  C. constipation
  D. xerostomia
  A. creamy, pink-tinged vaginal drainage

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  Creamy, pink-tinged vaginal drainage persists for 1 to 2 months after removal of a cervical implant. Diarrhea, not constipation, is usually a side effect of cervical implants. Stomatitis and xerostomia are local side effects of radiation to the mouth.

• Question 639:

  When an elder client asks the nurse whether he will be capable of sexual activity in old age, the best response by the nurse is __________.

  A. "Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes."
  B. "If you haven't been sexually active throughout your life, you will not be able to participate in sexual activity in old age."
  C. "When intercourse isn't possible, many of your sexual needs can be met through intimacy and touch."
  D. "You might find it takes longer for you to achieve an erection, but you can maintain it for a longer time."
  A. "Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes."

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  To provide the best response, the nurse must identify what the elder is asking. Concern is being expressed about whether elders can engage in sexual activity. The most therapeutic response by the nurse is Choice "Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes.". In this choice, the nurse acknowledges that elders can physically engage in sexual activity and have no psychological barriers to the same. All of the other choices contain facts but are not the best initial response. Choice "Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes." opens the conversation for the expression of further concerns about sexual issues. Choice "If you haven't been sexually active throughout your life, you will not be able to participate in sexual activity in old age." is true; past sexual function is predictive of sexual function in elder adults. An elder adult must have been sexually active as a younger adult to engage in intercourse in old age. This does not mean, however, that the elder adult cannot experience sexual intimacy in other ways. The need for intimacy is especially important for elder adults. If they have lost meaningful relationships or are having difficulty with intercourse, they might be able to experience intimacy through touch. As males age, they find it takes longer to achieve an erection, but that when it's achieved, the erection lasts longer. In addition, elder males require direct stimulation to achieve an erection.

• Question 640:

  Which of the following statements, if made by the parents of a newborn, does not indicate a need for further teaching about cord care?

  A. "I should put alcohol on my baby's cord 3-4 times a day."
  B. "I should put the baby's diaper on so that it covers the cord."
  C. "I should call the physician if the cord becomes dark."
  D. "I should wash my hands before and after I take care of the cord."
  D. "I should wash my hands before and after I take care of the cord."

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  Parents should be taught to wash their hands before and after providing cord care. This prevents transferring pathogens to and from the cord. Folding the diaper below the cord exposes the cord to air and allows for drying. It also prevents wet or soiled diapers from coming into contact with the cord. Current recommendations include cleaning the area around the cord 3-4 times a day with a cotton swab but do not include putting alcohol or other antimicrobials on the cord. It is normal for the cord to turn dark as it dries.