NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 1:

  The most important goal in the care plan for a child who was hospitalized with an accidental overdose would be to:

  A. Determine child's activity pattern
  B. Reduce mother's sense of guilt
  C. Instruct parents in use of ipecac
  D. Teach parents appropriate safety precautions
  D. Teach parents appropriate safety precautions

  ---

  explanation:

  (A) This goal is not the most important. (B) There is always some guilt when an accident occurs; however, the priority is to be sure future accidents are prevented. (C) Ipecac is not used for caustic alkali and acid ingestions. (D) Determining the parent's knowledge about safety hazards and teaching appropriate preventive measures are likely to prevent recurrence of accidents.

• Question 2:

  One afternoon 3 weeks into his alcohol treatment program, a client says to the nurse, "It's really not all my fault that I have a drinking problem. Alcoholism runs in my family. Both my grandfather and father were heavy drinkers." The nurse's best response would be:

  A. "That might be a problem. Tell me more about them."
  B. "Risk factors can often be controlled by self-responsibility."
  C. "It sounds like you're intellectualizing your drinking problem."
  D. "Your grandfather and father were both alcoholics?"
  B. "Risk factors can often be controlled by self-responsibility."

  ---

  explanation:

  (A) Focusing is an effective therapeutic strategy. This response, however, allows the client to "defocus" off the topic of learning how to accept responsibility for his behavior and future growth. (B) The nurse can educate the client about both the "genetic risk" for the development of alcoholism and ways to make long-term healthy lifestyle changes. (C) This response is inappropriately confrontational and condescending to the client. (D) Reflection of content can be an effective verbal therapeutic technique. It is used inappropriately here.

• Question 3:

  A 35-year-old client is admitted to the hospital for elective tubal ligation. While the nurse is doing preoperative teaching, the client says, "The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?" The best explanation for the nurse to give the client would be that balanced anesthesia:

  A. Is a type of regional anesthesia
  B. Uses equal amounts of inhalation agents and liquid agents
  C. Does not depress the central nervous system
  D. Is a combination of several anesthetic agents or drugs producing a smooth induction and minimal complications
  D. Is a combination of several anesthetic agents or drugs producing a smooth induction and minimal complications

  ---

  explanation:

  (A) Regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. (B) Varying amounts of anesthetic agents are used when employing balanced anesthesia. Amounts depend on age, weight, condition of the client, and surgical procedure. (C) General anesthesia is a drug-induced depression of the central nervous system that produces loss of consciousness and decreased muscle activity. (D) Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.

• Question 4:

  An 18-month-old child has been playing in the garage. His mother brings him to a nurse's home complaining of his mouth being sore. His lips and mouth are soapy and white, with small ulcerated areas beginning to form. The child begins to vomit. His pulse is rapid and weak. The nurse suspects that the child has:

  A. Inhaled gasoline fumes
  B. Ingested a caustic alkali
  C. Eaten construction chalk
  D. Lead poisoning
  B. Ingested a caustic alkali

  ---

  explanation:

  (A, C, D) These agents would not cause ulcerations on mouthand lips. (B) Strong alkali or acids will cause burns and ulcerationson the mucous membranes.

• Question 5:

  Which of the following should the nurse anticipate receiving as an as-needed order for a postoperative carotid endarterectomy client?

  A. Nifedipine 10 mg SL for B/P 140/90
  B. Furosemide 20 mg/PO for decreased urine output
  C. Magnesium salicylate to decrease inflammation
  D. Nitroglycerin gr 1/150 for chest pain
  A. Nifedipine 10 mg SL for B/P 140/90

  ---

  explanation:

  (A) It is important to maintain a normal to slightly lower pressure to prevent the graft from blowing and excessive pressure to surgical vascular areas. (B, C, D) None of these drugs is related to managing the problem at hand. Also, none of the problems for which these drugs would be indicated is expected with this type of surgery, except if there is a prior history.

• Question 6:

  A measurable outcome criterion in the nursing care of an adolescent with anorexia nervosa would be:

  A. Accepting her present body image
  B. Verbalizing realistic feelings about her body
  C. Having an improved perception of her body image
  D. Exhibiting increased self-esteem
  B. Verbalizing realistic feelings about her body

  ---

  explanation:

  (A) This outcome criterion is inadequate because the term "accepts" is not directly measurable. (B) This outcome criterion is directly measurable because specific goal-related verbalizations can be heard and verified by the nurse. (C) "Improved perception of body image" is not directly measurable and is therefore open to many interpretations. (D) Although long-term goals for the anorexic client should focus on increased self-esteem, this outcome criterion (as stated) does not include specific indicators or behaviors for which to observe.

• Question 7:

  A client is scheduled for a magnetic resonance imaging (MRI) to locate a cerebral lesion. It is important for the nurse to find out if he has a(n):

  A. Allergy to seafood
  B. History of seizures
  C. Movable metal implant
  D. Pin or screw in any bone
  C. Movable metal implant

  ---

  explanation:

  (A) Iodine is not used as a contrast medium for MRI. It is important to inquire about allergy to seafood if the client is to have an arteriogram or enhanced computer tomography. (B) MRI is safe if seizures are under control. It is more important to inquire about movable metal implants. (C) Clients with movable metal implants such as shrapnel or aneurysm clips or clients with permanent pacemakers or implanted pumps can be traumatized during an MRI. (D) Nonmovable metal prostheses or hardware will not cause trauma during an MRI.

• Question 8:

  Following a gastric resection, a 70-year-old client is admitted to the postanesthesia care unit. He was extubated prior to leaving the suite. On arrival at the postanesthesia care unit, the nurse should:

  A. Check airway, feeling for amount of air exchange noting rate, depth, and quality of respirations
  B. Obtain pulse and blood pressure readings noting rate and quality of pulse
  C. Reassure the client that his surgery is over and that he is in the recovery room
  D. Review physician's orders, administering medications as ordered
  A. Check airway, feeling for amount of air exchange noting rate, depth, and quality of respirations

  ---

  explanation:

  (A) Adequate air exchange and tissue oxygenation depend on competent respiratory function. Checking the airway is the nurse's priority action. (B) Obtaining the vital signs is an important action, but it is secondary to airway management. (C) Reorienting a client to time, place, and person after surgery is important, but it is secondary to airway and vital signs. (D) Airway management takes precedence over physician's orders unless they specifically relate to airway management.

• Question 9:

  Diabetes mellitus is a disorder that affects 3.1 out of every 1000 children younger than 20 years old. It is characterized by an absence of, or marked decrease in, circulating insulin. When teaching a newly diagnosed diabetes client, the nurse includes information on the functions of insulin:

  A. Transport of glucose into body cells and storage of glycogen in the liver
  B. Glycogenolysis and facilitation of glucose use for energy
  C. Glycogenolysis and catabolism
  D. Catabolism and hyperglycemia
  A. Transport of glucose into body cells and storage of glycogen in the liver

  ---

  explanation:

  (A) Lack of insulin causes glycogenolysis, catabolism, and hyperglycemia. (B) Insulin promotes the conversion of glucose to glycogen for storage and regulates the rate at which carbohydrates are used by cells for energy. (C) Insulin is anabolic in nature. (D) Glucose stimulates protein synthesis within the tissue and inhibits the breakdown of protein into amino acids.

• Question 10:

  A client with cirrhosis of the liver becomes comatose and is started on neomycin 300 mg q6h via nasogastric tube. The rationale for this therapy is to:

  A. Prevent systemic infection
  B. Promote diuresis
  C. Decrease ammonia formation
  D. Acidify the small bowel
  C. Decrease ammonia formation

  ---

  explanation:

  (A) Neomycin is an antibiotic, but this is not the Rationale for administering it to a client in hepatic coma. (B) Diuretics and salt-free albumin are used to promote diuresis in clients with cirrhosis of the liver. (C) Neomycin destroys the bacteria in the intestines. It is the bacteria in the bowel that break down protein into ammonia. (D) Lactulose is administered to create an acid environment in the bowel. Ammonia leaves the blood and migrates to this acidic environment where it is

  trapped and excreted.