NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 831:

  The best nursing diagnosis for a client with newly diagnosed Diabetes Mellitus is __________.

  A. Impaired Skin Integrity
  B. Knowledge Deficit: New Diabetes Diagnosis
  C. Alteration in Nutrition: More than Body Requirements
  D. Fluid Volume Deficit
  B. Knowledge Deficit: New Diabetes Diagnosis

  ---

  Newly diagnosed diabetics need to learn about their disease, medications, glucose testing, possibly insulin injections, foot care, sick-day plans, and so forth. Impaired Skin Integrity and Fluid Volume Deficit are diagnoses to prevent, but no evidence suggests that they exist at this point. Diabetics might have more or less nutrition than body requirements ?type II is likely to be more, but type I is likely to be less.

• Question 832:

  When a client wishes to improve her appearance by removing excess skin from her face and neck, the nurse should provide teaching regarding which of the following procedures?

  A. dermabrasion
  B. rhinoplasty
  C. blepharoplasty
  D. rhytidectomy
  D. rhytidectomy

  ---

  Rhytidectomy is the procedure for removing excess skin from the face and neck. It is commonly called a face-lift. Dermabrasion involves the spraying of a chemical to cause light freezing of the skin, which is then abraded with sandpaper or a revolving wire brush. It is used to remove facial scars, severe acne, and pigment from tattoos. Rhinoplasty is performed to improve the appearance of the nose and involves reshaping the nasal skeleton and overlying skin. Blepharoplasty is the procedure that removes loose and protruding fat from the upper and lower eyelids.

• Question 833:

  Client self-determination is the primary focus of __________.

  A. malpractice insurance.
  B. nursing's advocacy for clients.
  C. confidentiality.
  D. health care.
  B. nursing's advocacy for clients.

  ---

  Explanation Explanation/Reference:Advocacy for clients by nurses is the primary focus of the client's right to autonomy and self-determination. Confidentiality involves the maintenance of the privacy of the client and information regarding him or her. Malpractice insurance is a type of insurance for professionals.

• Question 834:

  Serum Vancomycin levels are taken to measure __________.

  A. renal function
  B. therapeutic range
  C. trough levels
  D. antibiotic resistance
  B. therapeutic range

  ---

  Explanation Explanation/Reference:Vancomycin levels are monitored to ensure therapeutic effects by peak level. Trough level is that level of wash out or lowest level of drug just prior to the next dose. The blood is taken approximately 2 hours after an IV infusion. Renal function is measured by creatinine and BUN or creatinine clearance and resistance by sensitivity.

• Question 835:

  Which technique or method is used to determine whether or not the patient has an irregular pulse?

  A. Apical pulse
  B. Inspection
  C. Auscultation
  D. Percussion
  C. Auscultation

  ---

  Auscultation is listening to the sounds of the body, particularly the apical pulse for rate and irregularity, using a stethoscope. Inspection is the purposeful and systematic visual inspection and examination of the client. The palpation technique employs the nurse's sense of touch. Percussion is performed by striking the client's body in order to determine what sounds and vibrations their body will produce.

• Question 836:

  A client was involved in a motor vehicle accident in which the seat belt was not worn. The client is exhibiting crepitus, decreased breath sounds on the left, complains of shortness of breath, and has a respiratory rate of 34/min.

  Which of the following assessment findings should concern the nurse the most?

  A. temperature of 102?F and a productive cough
  B. arterial blood gases (ABGs) with a PaO2 of 92 and PaCO2 of 40 mmHg
  C. trachea deviating to the right
  D. barrel-chested appearance
  C. trachea deviating to the right

  ---

  A mediastinal shift is indicative of a tension pneumothorax along with the other symptoms in the question. Because the individual was involved in an MVA, assessment is targeted at acute traumatic injuries to the lungs, heart, or chest wall rather than other conditions indicated in the other choices. Temperature of 102?F and a productive cough is common with pneumonia. Arterial blood gases (ABGs) with a PaO2 of 92 and PaCO2 of 40 mmHg is not alarming. Barrel-chested appearance is typical of someone with chronic obstructive pulmonary disease (COPD). A tension pneumothorax is a dangerous complication and a medical emergency where entering air cannot escape by the same route and pressure within the pleural cavity increases, resulting in complete collapse of the lung. A mediastinal shift to the unaffected side and a downward displacement of the diaphragm can be observed.

• Question 837:

  The nurse can promote relief of muscle pain, spasms, and tension by __________.

  A. having the client continue his activities as usual
  B. immobilizing the client
  C. applying heat, cold, pressure, or vibration to the painful area
  D. giving as much pain medication as needed to ease the muscle
  C. applying heat, cold, pressure, or vibration to the painful area

  ---

  Explanation Explanation/Reference:Superficial heat and cold, massage, pressure, or vibration can be applied to alleviate pain associated with muscle tension, pain, or spasms.

• Question 838:

  A nurse working with a cardiac patient notes the use of an ethical principle during her care of the patient.

  Which of these is the best example of an ethical principle in nursing?

  A. Beneficence, as the nurse promoted the patient to be respected and involved in his or her care.
  B. Veracity, as the nurse followed through with any promises made to the patient during his or her care.
  C. Nonmaleficence, as the nurse did not cause harm to the patient.
  D. Fidelity, as the nurse maintained honesty with the patient during any education and care.
  C. Nonmaleficence, as the nurse did not cause harm to the patient.

• Question 839:

  When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except __________.

  A. Hypoglycemia in diabetic women.
  B. The possible return of monthly menses when taking combination hormones.
  C. Increased risk of gallbladder disease.
  D. Increased risk of breast, cervical, and ovarian cancer with long-term use.
  A. Hypoglycemia in diabetic women.

  ---

  When taking estrogen, there is an increased risk of diabetes or hyperglycemia due to lowered glucose tolerance. It is true that monthly menses might return when taking combination hormones. The progestin is responsible for this. There is also a risk of gallbladder disease. It is also true that there is an increased risk of breast, cervical, and ovarian cancer with long-term hormone replacement therapy.

• Question 840:

  A syringe pump is a type of electronic infusion pump used to infuse fluids or medications directly from a syringe.

  This device is commonly used for __________.

  A. solutions administered in obstetrics
  B. dilute antibiotics
  C. large volumes of IV solution
  D. the neonatal and pediatric populations
  D. the neonatal and pediatric populations

  ---

  Small volumes of medication or fluids are delivered and sometimes at slow rates to neonates and pediatric clients. The syringe pump allows precise infusion of small volumes. Solutions administered in obstetrics is incorrect because a syringe pump can be used in almost any setting, but is not generally for adult clients. Dilute antibiotics and large volumes of IV solution are incorrect because large volumes of fluids are not administered with a syringe pump.