NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 941:

  When a client describes their family as having multiple wives, all of whom are sisters, married to one man, the nurse documents the family structure as?

  A. polyandry

  B. soronal

  C. nonsororal D. sororate

  Correct Answer: B

  The practice of polygamy refers to having multiple wives or husbands.

  When there are multiple wives who are sisters, the polygamy is designated as soronal.

  When the wives are not sisters it is nonsororal.

  Polyandry refers to multiple husbands and is rare. Some cultures practice a polygamy designated as

  sororate.

  Sororate polygamy specifies that a husband must marry his wife's sister if she dies. These marriages are

  successive rather than concurrent.

• Question 942:

  The teaching plan for gay or lesbian parents who want to disclose their homosexuality to their children should include all of the following instructions except __________.

  A. disclose the information before the child knows or suspects

  B. be comfortable with your sexual preference first

  C. have the discussion in a quiet place where interruptions are unlikely

  D. explain how your relationship with the child changes because of the discussion

  Correct Answer: D

  Children of gay and lesbian parents should be reassured that their relationship with their parent will not change because of the discussion. Choices "disclose the information before the child knows or suspects", "be comfortable with your sexual preference first" and "have the discussion in a quiet place where interruptions are unlikely" are all important aspects of the disclosure. As children grow, they might have additional questions. Preschool children might not understand the absence of a father or mother. Schoolage children might be troubled that their family isn't like their friends' families. Adolescents might become reluctant to discuss it or accept it even though they expressed acceptance at an earlier age. In general the earlier children are informed, the easier it is for them to accept and assimilate the information. Nurses need to be nonjudgmental and learn how to express and accept these differences so that they can keep the nurse-child-family relationship intact.

• Question 943:

  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."

  Correct Answer: A

  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 944:

  If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?

  A. retrograde ejaculation

  B. decreased plasma testosterone

  C. hypertrophy of testicles

  D. state of euphoria

  Correct Answer: B

  Untreated chronic renal failure causes decreased testosterone levels, atrophy of testicles, and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure. It is a complication of transurethral resection of the prostate. In chronic renal failure, the testicles atrophy; they do not hypertrophy. Chronic renal failure produces a state of depression, not euphoria.

• Question 945:

  When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?

  A. hysterosalpingography

  B. semen analysis

  C. endometrial biopsy

  D. transvaginal ultrasound

  Correct Answer: B

  Because semen analysis is the least invasive of the tests listed and because in 35% of the cases the

  infertility is related to a male factor, semen analysis should be one of the first diagnostic tests performed.

  Hysterosalpingography fills the uterus and fallopian tubes with a radiopaque substance that can be seen

  with an X ray. It demonstrates tubal patency or any distortion of the uterine cavity.

  Endometrial biopsy provides information about the effects of progesterone after ovulation and the

  endometrial receptivity.

  Transvaginal ultrasound is mostly used in the treatment of infertility. For diagnosis it allows the

  endocrinologist to evaluate the developing follicle, assess oocyte maturity, and diagnose luteal phase

  defects. Hysterosalpingography, endometrial biopsy and transvaginal ultrasound are more invasive,

  require greater expertise to evaluate and treat, and are more costly.

  If the semen analysis is normal, the couple can expect to progress through these tests as well.

• Question 946:

  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."

  Correct Answer: D

  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 947:

  Which of the following home-care strategies is most likely to negatively impact the body image of a client with Cushing's syndrome?

  A. providing safety measures to prevent falls

  B. taking medications as prescribed

  C. wearing a medical ID indicating Cushing's syndrome

  D. having regular health assessments

  Correct Answer: C

  All of the strategies listed are included in home care for the client with Cushing's syndrome. Choice "wearing a medical ID indicating Cushing's syndrome" is the best answer because wearing a medical ID is a visible sign that something is wrong and a constant reminder to the client that he or she has a loss of body function. Choice "providing safety measures to prevent falls" might enhance body image because it prevents falls that could cause further injury and debilitation. Taking medications as prescribed should enhance body image because it decreases the symptoms present. Having regular health assessments indicates an enhanced body image because it signals the desire to take care of the body and keep it at its best.

• Question 948:

  Which of the following infant behaviors demonstrates the concept of object permanence?

  A. The infant cries when his mother leaves the room.

  B. The infant looks at the floor to find a toy that he was playing with and dropped.

  C. The infant picks up another toy after the one he was playing with rolls under the couch.

  D. The infant participates in a game of patty-cake.

  Correct Answer: B

  Object permanence occurs when the infant learns that something/someone still exists even though they might not be able to see it/them. This develops between 9 and 10 months of age. If the infant cries when his mother leaves the room, it might be because he believes she is no longer in the house when he can't see her. If an infant picks up another toy after the one he is playing with rolls under the couch and the infant fails to look for it, he believes the toy that rolled under the couch no longer exists. Patty-cake is a game infants engage in but, it has nothing to do with object permanence. An infant game that does show object permanence is peek-a-boo. In this game, an infant continues to hunt for a hidden face because he believes it is still there.

• Question 949:

  The parents of a 2-year-old child ask the nurse how they can teach their child to quit taking toys away from other children.

  Which of the following statements by the nurse offers the parents the best explanation of their child's behavior?

  A. "Your child is egocentric. Egocentricity is normal for 2-year-old children. He believes other children want him to have their toys."

  B. "Your child is showing negativity. He doesn't want other children to have the toys he wants."

  C. "Your child is demonstrating magical thinking. He believes he can make the other children want him to play with their toys."

  D. "Your child is engaging in domestic imitation. He is doing what he has seen other children do."

  Correct Answer: A

  Two-year-old children are very egocentric. They believe everything and everyone is concerned about them. They believe other children want them to have their toys. This is different than believing they can make other children want them to have all the toys, as in magical thinking, which normally occurs in preschool-age children. Toddlers are very negative, but this is expressed by refusal of requests made to them. Domestic imitation does occur in preschool-age children, but it refers to the imitation of household chores and roles performed by adults, not the imitation of other children.

• Question 950:

  The teaching plan for a postpartum client who is about to be discharged should include which of the following instructions?

  A. "It is normal for your breasts to be tender. You should call the physician if you also have redness and fatigue."

  B. "Because your baby was delivered vaginally, you might have to urinate more frequently."

  C. "It is normal to run a low-grade temperature for a few days. If it is higher than 100?F, call your physician."

  D. "Be sure to call your physician if your vaginal discharge becomes bright red."

  Correct Answer: D

  The vaginal discharge after birth is called lochia, and it changes from red (rubra) to serosa (clear) on the third postpartum day. If it returns to red or contains clots, it could signal impending hemorrhage or infection and the physician should be notified. It is not normal for the breasts to be tender. If the breasts become engorged, they might be tender and the mother might need to be given additional instructions on breast care. Tenderness, redness, and fatigue are clinical manifestations of mastitis and should be reported to the physician. A woman should void in normal patterns and frequency after birth. Increased frequency is a sign of a urinary tract infection and should be reported to the physician. By the time of discharge, the woman's temperature should be normal. Elevations should be reported to the physician.