NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 731:

  A hospital discharge planning nurse is making arrangements for a client who has an epidural catheter for continuous infusion of opioids to be placed in a long-term care facility. The family prefers a facility in its neighborhood to facilitate visiting. The neighborhood facility has never cared for a client with this type of need.

  What is the most appropriate action by the discharge planning nurse?

  A. Ask the physician for an extension of hospitalization until the epidural catheter is discontinued to allow for placement at the neighborhood facility.
  B. Arrange for immediate in-services for the long-term care facility staff on pain management using epidural catheters.
  C. Explain the situation to the client and family and seek another long-term care facility for discharge from the hospital.
  D. Encourage the family to hire private duty nurses skilled in epidural catheter pain management to allow the client to be transferred to the neighborhood facility.
  C. Explain the situation to the client and family and seek another long-term care facility for discharge from the hospital.

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  Explanation Explanation/Reference:Safety demands that a client be transferred to a facility that can deliver care equal to the hospital.

• Question 732:

  A community health nurse is asked to organize a health promotion project that plans to provide glucose screening.

  This activity is most beneficial within what realm?

  A. testing that is performed by volunteers at a local department store and is open to the public
  B. at a professional health fair activity available for selected persons who have been screened as being at risk
  C. mass-marketing vouchers for free fingersticks at a local drug store, where the pharmacist makes recommendations on the findings
  D. testing that is performed by a nurse professional, who immediately provides education regarding the findings
  B. at a professional health fair activity available for selected persons who have been screened as being at risk

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  Public glucose screening has been found to be an ineffective way to screen for diabetes unless based on health risk screening for those persons identified to be at risk or displaying symptoms.

• Question 733:

  When planning care of a client who has a been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that __________.

  A. amphetamines increase energy by increasing dopamine levels at neural synapses
  B. amphetamines have a low risk of tolerance or addiction
  C. amphetamines produce a 10-20-second rush followed by a 2-4-hour high
  D. addiction to barbiturates and amphetamines is rare because they have opposite effects
  A. amphetamines increase energy by increasing dopamine levels at neural synapses

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  Amphetamines cause the release of norepinephrine and dopamine from storage vesicles into the synapse. The increased catecholamines at the receptors causes increased stimulation. Clear patterns of tolerance and withdrawal have not been described. Prolonged or excessive use of amphetamines can lead to psychosis. People use amphetamines for the feelings of euphoria, relief from fatigue, energy, and alertness. Overdose can cause seizures, cardiac arrhythmias, hypertension, and hyperthermia. When abstaining, the client might experience fatigue, depression, and irritability lasting for several weeks. Drug cravings are common and might lead to relapse.

• Question 734:

  When cleaning a PEG tube, which of these tasks should not be performed?

  A. Talcum powder is applied to the tube site.
  B. Mild soap is used to clean around the tube site.
  C. The skin around the tube site is thoroughly dried with a clean towel.
  D. Crusty drainage is gently removed from the site.
  A. Talcum powder is applied to the tube site.

• Question 735:

  Rh negative maternal blood indicates __________.

  A. an incompatibility in the blood between the mother and fetus
  B. that antibodies in the mother's blood are attacking her baby's blood
  C. the mother will require a blood transfusion at the time of delivery
  D. the mother does not have a specific marker on her red blood cells
  D. the mother does not have a specific marker on her red blood cells

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  The mother's red blood cells lacking a specific marker indicate that she is Rh negative. However, incompatibility only occurs if the baby is Rh positive and the mother is Rh negative. This is typically not a problem with a first pregnancy, but in a subsequent pregnancy, the incompatibility can cause the antibodies created during the first pregnancy to attack the new fetus' red blood cells. A blood transfusion would have no effect on this problem.

• Question 736:

  During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes.

  What is the next most likely site of metastasis?

  A. brain
  B. bone
  C. liver
  D. mediastinum
  C. liver

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  Colon tumors tend to spread through the lymphatics and portal vein to the liver. Although metastasis to the other sites listed is possible, the liver is most likely the first to be affected.

• Question 737:

  A client receiving drug therapy with furosemide and digitalis requires careful observation and care.

  In planning care for this client, the nurse should recognize that __________ electrolyte imbalances is most likely to occur.

  A. hyperkalemia
  B. hypernatremia
  C. hypokalemia
  D. hypomagnesemia
  C. hypokalemia

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  Explanation Explanation/Reference:Diuretics such as furosemide might deplete serum potassium. Additionally, the action of digitalis might be potentiated by hypokalemia. These drugs are not associated with hyperkalemia. Diuretic therapy could cause hyponatremia, not hypernatremia. Hypomagnesemia is generally associated with poor nutrition, alcoholism, and excessive GI or renal losses.

• Question 738:

  A nurse is assessing a patient that has undergone a recent CABG. The nurse notices a mole with irregular edges with a bluish color. The nurse should __________.

  A. recommend a dermatological consult to the MD
  B. note the location of the mole and contact the physician via the telephone
  C. note the location of the mole and follow-up with the attending physician via the medical record and phone call
  D. remove the mole with a sharp's debridement technique, following charge nurse approval
  C. note the location of the mole and follow-up with the attending physician via the medical record and phone call

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  Explanation Explanation/Reference:Contacting the attending physician via the medical record is appropriate due to the possibility of melanoma.

• Question 739:

  A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?

  A. turning out the room light and closing the door
  B. tiring the child during the evening with play exercises
  C. identifying the child's home bedtime rituals and following them
  D. encouraging visitation by friends during the evening
  C. identifying the child's home bedtime rituals and following them

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  Explanation Explanation/Reference:Preschool-age children require bedtime rituals that should be followed in the hospital if possible. Turning out the room light and closing the door increases a child's fear. Tiring the child during the evening with play exercises and encouraging visitation by friends during the evening do not promote sleep.

• Question 740:

  A night shift nurse has a patient who is confused and withdrawing from alcohol. He is currently in 4 point restraints after attempting to attack one of the nurses.

  What is the most appropriate action for the nurse to take during his shift?

  A. Release the leg restraints to give the patient a break and see if combative behavior has gotten better.
  B. Have the attending physician discontinue the restraints to give the patient a chance to behave more appropriately.
  C. Assess the patient's skin integrity around the restraints hourly.
  D. Ensure the physician has renewed the order for restraints, as this should be done every 12 hours.
  C. Assess the patient's skin integrity around the restraints hourly.