NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 1:

  A client was admitted to the hospital after falling in her home. At the time of admission, her blood alcohol level was 0.27 mg%. Her family indicates that she has been drinking a fifth of vodka a day for the past 9 months. She had her last drink 30 minutes prior to admission. Alcohol withdrawal symptoms would most likely be exhibited by her:

  A. Two to 4 hours after the last drink
  B. Six to 8 hours after the last drink
  C. Immediately on admission
  D. Twenty-four hours after the last drink
  B. Six to 8 hours after the last drink

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  (A) This answer is incorrect. Alcohol withdrawal usually begins approximately 6? hours after the last drink. (B) This answer is correct. It takes approximately 6? hours for metabolism of alcohol. (C) This answer is incorrect. The alcohol is still in the system, as indicated by the high blood alcohol level. (D) This answer is incorrect. Symptoms of alcohol withdrawal usually begin within 6? hours of the last drink.

• Question 2:

  A client tells the nurse that he has been hearing voices that tell him to kill his girlfriend because she is a spy. He further states that he is having difficulty not obeying the voices because, if he does not, his house will be burned down. The highest priority nursing diagnosis for him at this time is:

  A. Sensory-perceptual alteration: auditory command hallucinations
  B. Alteration in thought processes: paranoid delusions
  C. Potential for violence directed at others
  D. Impaired verbal communication: loose associations
  C. Potential for violence directed at others

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  (A) Although the client is having command hallucinations, this is second in priority to real or potential violence, which can be a threat to life itself. (B) Although the client is experiencing delusions, this is also a lower priority than his potential or actual loss of control. (C) Whether real or potential, violence directed at self or others is always high priority. (D) There is no evidence of loosening of associations.

• Question 3:

  A 55-year-old woman entered the emergency room by ambulance. Her primary complaint is chest pain. She is receiving O2 via nasal cannula at 2 L/min for dyspnea. Which of the following findings in the client's nursing assessment demand immediate nursing action?

  A. Associated symptoms of indigestion and nausea
  B. Restlessness and apprehensiveness
  C. Inability to tolerate assessment session with the admitting nurse
  D. History of hypertension treated with pharmacological therapy
  B. Restlessness and apprehensiveness

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  (A) Indigestion or nausea may accompany angina or myocardial infarction, but they do not indicate imminent danger for the client. (B) Restlessness and apprehensiveness require immediate nursing action because they are indicative of very low oxygenation of body tissues and are frequently the first indication of impending cardiac or respiratory arrest. (C) It is common for the cardiac client to experience fatigue and inability to physically tolerate long assessment sessions. (D) A history of hypertension requires no immediate nursing intervention. In the situation described, the blood pressure is not given and therefore cannot be assumed to be elevated.

• Question 4:

  When a client with pancreatitis is discharged, the nurse needs to teach him how to prevent another occurrence of acute pancreatitis. Which of the following statements would indicate he has an understanding of his disease?

  A. "I will not eat any raw or uncooked vegetables."
  B. "I will limit my alcohol to one cocktail per day."
  C. "I will look into attending Alcoholics Anonymous meetings."
  D. "I will report any changes in bowel movements to my doctor."
  C. "I will look into attending Alcoholics Anonymous meetings."

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  (A) Raw or uncooked vegetables are all right to eat postdischarge. (B) This client must avoid any alcohol intake. (C) The client displays awareness of the need to avoid alcohol. (D) This action would be pertinent only if fatty stools associated with chronic hepatitis were the problem.

• Question 5:

  The physician decides to prescribe both a short-acting insulin and an intermediate-acting insulin for a newly diagnosed 8-year-old diabetic client. An example of a short-acting insulin is:

  A. Novolin Regular
  B. Humulin NPH
  C. Lente Beef
  D. Protamine zinc insulin
  A. Novolin Regular

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  (A) Novolin is a short-acting insulin. (B, C) NPH and Lente are intermediate-acting insulins. (D) Protamine zinc insulin is a long-acting insulin preparation.

• Question 6:

  The parents of a 2-year-old child are ready to begin toilet training activities with him. His parents feel he is ready to train because he is now 2 years old. What would the nurse identify as readiness in this child?

  A. Patience by the child when wearing soiled diapers
  B. Communicating the urge to defecate or urinate
  C. The child awakening wet from his naps
  D. The age at which the child's siblings were trained
  B. Communicating the urge to defecate or urinate

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  (A) Children experience impatience with soiled diapers when readiness for training is apparent. They often desire to be changed immediately. (B) A child must be able to use verbal or nonverbal skills to communicate needs. (C) A readiness indicator would be awaking dry from naps. (D) The age at which a sibling was toilet trained has no implications for training this child.

• Question 7:

  The nurse notes scattered crackles in both lungs and 1+ pitting edema when assessing a cardiac client. The physician is notified and orders furosemide (Lasix) 80 mg IV push stat. Which of the following diagnostic studies is monitored to assess for a major complication of this therapy?

  A. Serum electrolytes
  B. Arterial blood gases
  C. Complete blood count
  D. 12-Lead ECG
  A. Serum electrolytes

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  (A)

  Furosemide, a potassium-depleting diuretic, inhibits the reabsorption of sodium and chloride from the loop of Henle and the distal renal tubules. Serum electrolytes are monitored for hypokalemia. (B) Severe acid-base imbalances influence the movement of potassium into and out of the cells, but arterial blood gases to not measure the serum potassium level. (C) Furosemide is a potassium-depleting diuretic. A complete blood count does not reflect potassium levels.

  (D)

  Abnormalities in potassium (both hyperkalemia and hypokalemia) are reflected in ECG changes, but these changes do not occur until the abnormality is severe.

• Question 8:

  The nurse is caring for a client with pancreatitis. Which of the following IV medications would the nurse expect the physician to prescribe for control of pain in this client?

  A. Morphine sulfate
  B. Kerolac tromethamine (Toradol)
  C. Promethazine (Phenergan)
  D. Meperidine (Demerol)
  D. Meperidine (Demerol)

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  (A) Morphine sulfate is contraindicated in clients with pancreatitis because it may cause spasms of the sphincter of Oddi and increase pancreatic pain. (B) Ketorolac tromethamine is currently not approved by the Food and Drug Administration for IV use. (C) Promethazine is a medication that has no analgesic properties. (D) Meperidine is the drug of choice for clients with pancreatitis. It will not cause spasms at the sphincter of Oddi, which can lead to increased pancreatic pain.

• Question 9:

  A young boy tells the nurse, "I don't like my Dad to kiss or hug my Mom. I love my Mom and want to marry her." The nurse recognizes this stage of growth and development as:

  A. Electra complex
  B. Oedipus complex
  C. Superego
  D. Ego
  B. Oedipus complex

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  (A) The Electra complex is the erotic attachment of the female child to the father. (B) The Oedipus complex is characterized by jealousy toward the parent of the same sex and erotic attachment to the parent of the opposite sex. (C) The superego as described by Freud is the part of personality that is associated with internalized parental and societal control. (D) The ego as described by Freud is the part of personality that is associated with reality assessment.

• Question 10:

  An elective saline abortion has been performed on a 3- week primigravida. Following the procedure, the nurse should be alert for which early side effect?

  A. Water satiety
  B. Thirst
  C. Edema
  D. Diabetes insipidus
  B. Thirst

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  (A) If the client is experiencing water satiety, there is no more desire for water. (B) Absorption of saline into circulation rather than into amniotic sac increases serum sodium and desire for water. (C) Edema can be a late side effect caused by water intoxication. (D) Diabetes insipidus occurs as a result of deficient antidiuretic hormone.