NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 131:

  A new mother experiences strong uterine contractions while breast-feeding her baby. She excitedly rings for the nurse. When the nurse arrives the mother tells her, "Something is wrong. This is like my labor." Which reply by the nurse identifies the physiological response of the client?

  A. "Your breasts are secreting a hormone that enters your bloodstream and causes your abdominal muscles to contract."
  B. "Prolactin increases the blood supply to your uterus, and you are feeling the effects of this blood vessel engorgement."
  C. "The same hormone that is released in response to the baby's sucking, causing milk to flow, also causes the uterus to contract."
  D. "There is probably a small blood clot or placental fragment in your uterus, and your uterus is contracting to expel it."
  C. "The same hormone that is released in response to the baby's sucking, causing milk to flow, also causes the uterus to contract."

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  (A) Mammary growth as well as milk production and maintenance in the breast occur in response to hormones produced primarily by the hypothalamus and the pituitary gland. (B) Prolactin stimulates the alveolar cells of the breast to produce milk. It is important in the initiation of breast-feeding. (C) Oxytocin, which is released by the posterior pituitary, stimulates the let-down reflex by contraction of the myoepithelial cells surrounding the alveoli. In addition, it causes contractions of the uterus and uterine involution. (D) Afterpains may occur with retained placental fragments. A boggy uterus and continued bleeding are other symptoms that occur in response to retained placental fragments.

• Question 132:

  A 30-year-old client has a history of several recent traumatic experiences. She presents at the physician's office with a complaint of blindness. Physical exam and diagnostic testing reveal no organic cause. The nurse recognizes this as:

  A. Delusion
  B. Illusion
  C. Hallucination
  D. Conversion
  D. Conversion

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  (A) The client's blindness is real. Delusion is a false belief. (B) Illusion is the misrepresentation of a real, external sensory experience. (C) Hallucination is a false sensory perception involving any of the senses. (D) Conversion is the expression of intrapsychic conflict through sensory or motor manifestations.

• Question 133:

  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."

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  (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 134:

  An 80-year-old widow is living with her son and daughter- in-law. The home health nurse has been making weekly visits to draw blood for a prothrombin time test. The client is taking 5 mg of coumadin per day. She appears more debilitated, and bruises are noted on her face. Elder abuse is suspected. Which of the following are signs of persons who are at risk for abusing an elderly person?

  A. A family member who is having marital problems and is regularly abusing alcohol
  B. A person with adequate communication and coping skills who is employed by the family
  C. A friend of the family who wants to help but is minimally competent
  D. A lifelong friend of the client who is often confused
  A. A family member who is having marital problems and is regularly abusing alcohol

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  (A) This answer is correct. Two risk factors are identified in this answer. (B) This answer is incorrect. Persons at risk tend to lack communication skills and effective coping patterns. (C) This answer is incorrect. Persons at risk are usually family members or those reluctant to provide care. (D) This answer is incorrect. This individual has a vested interest in providing care.

• Question 135:

  A male client is diagnosed with hypoparathyroidism. He has been on dialysis for several years. He is experiencing symptoms such as numbness of the lips, muscle weakness, carpopedal spasms, and wheezing. Given the client's symptoms, nursing assessment would focus on:

  A. Detection of tetany
  B. Detection of hypocalcemia to prevent seizures
  C. Evidence of depression
  D. Detection of premature cataract formation
  A. Detection of tetany

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  (A) Assessment should focus on detection of tetany, which is the most common symptom of hypoparathyroidism. Left undetected and untreated, tetany resulting from hypocalcemia can progress to seizures. (B) Hypocalcemia is difficult to detect on nursing assessment alone. Abdominal cramping may be an indication of hypocalcemia, but laboratory data are required to confirm diagnosis. (C) Depression can be a symptom of hypoparathyroidism, but it is not definitive. (D) Premature cataract formation can occur, but it also is not specific to parathyroidism and poses no immediate danger to the client.

• Question 136:

  The nurse observes that a client has difficulty chewing and swallowing her food. A nursing response designed to reduce this problem would include:

  A. Ordering a full liquid diet for her
  B. Ordering five small meals for her
  C. Ordering a mechanical soft diet for her
  D. Ordering a puréed diet for her
  C. Ordering a mechanical soft diet for her

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  (A) Full liquids would be difficult to swallow if the muscle control of the swallowing act is affected; this is a probable reason for her difficulties, given her medical diagnosis of multiple sclerosis. (B) Five small meals would do little if anything to decrease her swallowing difficulties, other than assure that she tires less easily. (C) A mechanical soft diet should be easier to chew and swallow, because foods would be more evenly consistent. (D) A pureed diet would cause her to regress more than might be needed; the mechanical soft diet should be tried first.

• Question 137:

  The nurse notes hyperventilation in a client with a thermal injury. She recognizes that this may be a reaction to which of the following medications if applied in large amounts?

  A. Neosporin sulfate
  B. Mafenide acetate
  C. Silver sulfadiazine
  D. Povidone-iodine
  B. Mafenide acetate

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  (A) The side effects of neomycin sulfate include rash, urticaria, nephrotoxicity, and ototoxicity. (B) The side effects of mafenide acetate include bone marrow suppression, hemolytic anemia, eosinophilia, and metabolic acidosis. The hyperventilation is a compensatory response to the metabolic acidosis. (C) The side effects of silver sulfadiazine include rash, itching, leukopenia, and decreased renal function. (D) The primary side effect of povidone- iodine is decreased renal function.

• Question 138:

  A 35-weeks-pregnant client is undergoing a nonstress test (NST). During the 20-minute examination, the nurse notes three fetal movements accompanied by accelerations of the fetal heart rate, each 15 bpm, lasting 15 seconds. The nurse interprets this test to be:

  A. Nonreactive
  B. Reactive
  C. Positive
  D. Negative
  B. Reactive

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  (A) In a nonreactive NST, the criteria for reactivity are not met. (B) A reactive NST shows at least two accelerations of FHR with fetal movements, each 15 bpm, lasting 15 seconds or more, over 20 minutes. (C, D) This term is used to interpret a contraction stress test (CST), or oxytocin challenge test, not an NST.

• Question 139:

  A 10-year-old has been diagnosed with acute poststreptococcal glomerulonephritis. The clinical findings were proteinuria, moderately elevated blood pressure, and periorbital edema. Which dietary plan is most appropriate for this client?

  A. Low-protein diet
  B. Low-sodium diet
  C. Increased fluid intake
  D. High-cholesterol diet
  B. Low-sodium diet

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  (A) A high-protein diet is usually indicated because protein is excreted in urine. Protein restriction is usually prescribed with severe azotemia. (B) The kidneys usually enlarge in these children, and sodium and water are retained. (C) Fluid restriction may be ordered to help reduce edema; however, monitoring for dehydration is indicated. (D) A high- cholesterol diet would not be indicated for any child, especially one with elevated blood pressure.

• Question 140:

  A 58-year-old client on a general surgery unit is scheduled for transurethral resection of the prostate (TURP) in 2 hours. The nurse explains to the client that this procedure means:

  A. Removal of the prostate tissue by way of a lower abdominal midline incision through the bladder and into the prostate gland
  B. Removal of prostate tissue by a resectoscope that is inserted through the penile urethra
  C. Removal of the prostate tissue by an open surgical approach through an incision between the ischial tuberosities, the scrotum, and the rectum
  D. Removal of prostate tissue by an open surgical approach through a low horizontal incision, bypassing the bladder, to the prostate gland
  B. Removal of prostate tissue by a resectoscope that is inserted through the penile urethra

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  (A) This describes a suprapubic (transvesical) prostatectomy procedure. (B) This is the correct description of a TURP procedure. (C) This describes a perineal prostatectomy procedure. (D) This describes a retropubic (extravesical) prostatectomy procedure.