NCLEX NCLEX-PN Online Practice Questions and Exam Preparation

NCLEX NCLEX-PN Online Questions & Answers

• Question 951:

  The advanced directive in a client's chart is dated August 12, 1998.The client's daughter produces a Power of Attorney for Health Care, dated 2003, which contains different care direction(s).

  The nurse is supposed to ___________.

  A. follow the 1998 version because it's part of the legal chart
  B. follow the 1998 version because the physician's code order is based on it
  C. follow the 2003 version, place it in the chart, and communicate the update appropriately
  D. follow neither until clarified by the unit manager
  C. follow the 2003 version, place it in the chart, and communicate the update appropriately

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  The document dated 2003 supersedes the previous version and should be used as a basis for care direction. Choices "follow the 1998 version because it's part of the legal chart" and "follow the 1998 version because the physician's code order is based on it" are incorrect because the 1998 version is now outdated. Choice "follow neither until clarified by the unit manager" is incorrect because the nurse can be held negligent for not responding to the 2003 document as directed.

• Question 952:

  When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?

  A. family history of stroke
  B. ovaries removed before age 45
  C. frequent hot flashes and/or night sweats
  D. unexplained vaginal bleeding
  D. unexplained vaginal bleeding

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  Unexplained vaginal bleeding is a contraindication for hormone replacement therapy. Family history of stroke is not a contraindication for hormone replacement therapy. If the woman herself had a history of stroke or other blood-clotting events, hormone therapy could be contraindicated. Frequent hot flashes and/or night sweats can be relieved by hormone replacement therapy.

• Question 953:

  Which of the following indicates a hazard for a client on oxygen therapy?

  A. A No Smoking sign is on the door.
  B. The client is wearing a synthetic gown.
  C. Electrical equipment is grounded.
  D. Matches are removed.
  B. The client is wearing a synthetic gown.

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  Explanation Explanation/Reference:A synthetic gown might generate sparks of static electricity, which can be a fire hazard, particularly in the presence of oxygen. The client on oxygen therapy should wear a cotton gown. The remaining options are appropriate safety measures.

• Question 954:

  A nurse has just started on the 7PM surgical unit shift.

  Which of the following patients should the nurse check on first?

  A. A 75-year-old female who is scheduled for an EGD in 10 hours.
  B. A 34-year-old male who is complaining of low back pain following back surgery and has an onset of urinary incontinence in the last hour.
  C. A 21-year-old male who had a lower extremity BKA yesterday, following a MVA and has phantom pain.
  D. A 27-year-old female who has received 1.5 units of RBC's. via transfusion the previous day.
  B. A 34-year-old male who is complaining of low back pain following back surgery and has an onset of urinary incontinence in the last hour.

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  Explanation Explanation/Reference:The new onset of urinary incontinence may require additional medical assessment, and the physician needs to be notified.

• Question 955:

  Which is the best way to position a client's neck for palpation of the thyroid?

  A. flexed toward the side being examined
  B. hyperextended directly backward
  C. flexed away from the side being examined
  D. flexed directly forward
  A. flexed toward the side being examined

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  Flexed toward the side being examined.

• Question 956:

  Client room environments should include __________.

  A. a made bed, fresh water, thermostat regulation, and clean floors in all occupied client areas
  B. a made bed, comfort and safety, a clutter-free area, hygiene articles nearby
  C. accident prevention, comfort, a room (including furniture) that has been cleaned with chloroseptic wash, a bed that is made every other day
  D. odor control (by spraying the room with deodorizers), closet storage of all client objects, a clean room. (Gloves should be worn when cleaning.)
  B. a made bed, comfort and safety, a clutter-free area, hygiene articles nearby

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  Explanation Explanation/Reference:Preparing a client's room environment should include making the client's bed, ensuring comfort and safety at all times, keeping the area free of clutter, and keeping the client's hygiene articles nearby. All procedures should be explained before they are performed, and the client should assist with personal arrangement of articles.

• Question 957:

  A patient placed under neutropenic precautions asks you how she can prevent infection. Which advice would be most appropriate?

  A. Only brush teeth once a day or every other day.
  B. Wash hands when finished cleaning up after pets.
  C. Only use pads for menstrual periods.
  D. Do not let visitors within 10 feet.
  C. Only use pads for menstrual periods.

• Question 958:

  The nurse provides a postoperative client with an analgesic medication and darkens the room before the client goes to sleep for the night. The nurse's actions __________.

  A. help the client's circadian rhythm
  B. stimulate hormonal changes in the brain
  C. decrease stimuli from the cerebral cortex
  D. alert the hypothalamus in the brain
  C. decrease stimuli from the cerebral cortex

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  Explanation Explanation/Reference:Reduction of environmental stimuli (particularly light and noise) from the cerebral cortex (which can be an area of arousal) facilitates sleep. Sleep occurs when there is a decreased input into this area.

• Question 959:

  A 55-year-old female asks a nurse the following, "Which mineral/vitamin is the most important to prevent progression of osteoporosis." The nurse should state __________.

  A. Potassium
  B. Magnesium
  C. Calcium
  D. Vitamin B12
  C. Calcium

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  Explanation Explanation/Reference:Calcium is the most recognized osteoporosis treatment.

• Question 960:

  When a client who is having trouble conceiving says to the nurse, "I have started taking ginseng," the best response by the nurse is ___________.

  A. "No studies show that ginseng is effective for infertility."
  B. "Some studies show that ginseng enhances in vitro sperm motility."
  C. "Why don't you try acupuncture instead. Many studies have shown it to be effective for infertility."
  D. "It's probably not going to hurt you, but it's also probably not going to help. Let's look at some other alternatives."
  B. "Some studies show that ginseng enhances in vitro sperm motility."

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  Some studies have shown that ginseng and astragalus have enhanced in vitro sperm motility. Ginseng has long been used in traditional Chinese medicine to enhance male fertility. So, Choice "Some studies show that ginseng enhances in vitro sperm motility." is correct and directly addresses the client's comments. Many times couples struggling with infertility turn to alternative therapies in desperation. They can be very expensive, and some are harmful. Ginseng should not interfere with any of the traditional fertility treatments and might help the couple feel empowered that they are also doing something on their own. Choice "No studies show that ginseng is effective for infertility." is not true. Choice "Why don't you try acupuncture instead. Many studies have shown it to be effective for infertility." introduces another alternative therapy. It is true that acupuncture is a traditional Chinese medical therapy and has been shown in several clinical studies to be effective in treating infertility in both women and men. The best response by the nurse should address the therapy the client states she is using. Choice "It's probably not going to hurt you, but it's also probably not going to help. Let's look at some other alternatives." dismisses the client's attempts to work through her issues and contribute to the solution. One concern is always that more traditional therapies might be ignored, and time might be lost to alternative therapies. But this response causes the client to perceive the nurse as unsupportive and inhibits further discussion and disclosure.