NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 141:

  The nurse assesses a postoperative mastectomy client and notes that breath sounds are diminished in both posterior bases. The nurse's action should be to:

  A. Encourage coughing and deep breathing each hour
  B. Obtain arterial blood gases
  C. Increase O2 from 2? L/min
  D. Remove the postoperative dressing to check for bleeding
  A. Encourage coughing and deep breathing each hour

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  (A) Decreased or absent breath sounds are frequently indicators of postoperative atelectasis. (B) Arterial blood gases are not indicated because there is no other information indicating impendingdanger. (C) Increasing O2 rate is not indicated without additional information. (D) Removing the dressing is not indicated without additional information.

• Question 142:

  Parents of young children often need anticipatory guidance from the nurse. Parents may have little knowledge regarding growth and development. Which of the following toys and activities would the nurse suggest as appropriate for a toddler?

  A. Cutting, pasting, string beads, music, dolls
  B. Mobiles, rattle, squeeze toys
  C. Pull-toys, large ball, dolls, sand and water play, music
  D. Simple card games, puzzles, bicycle, television
  C. Pull-toys, large ball, dolls, sand and water play, music

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  (A) These activities are suited for the preschool-age child (3? years old). The activities are not safe for a toddler. (B) Infants (0? year) like these toys. (C) These activities provide the toddler (1? years old) with a variety of physical activities for play. (D) The toddler lacks the physical and cognitive abilities for these activities. The tasks are far better suited for the school-age child.

• Question 143:

  A 45-year-old client diagnosed with major depression is scheduled for electroconvulsive therapy (ECT) in the morning. Which of the following medications are routinely administered either before or during ECT?

  A. Thioridazine (Mellaril), lithium, and benztropine
  B. Atropine, sodium brevitol, and succinylcholine chloride (Anectine)
  C. Sodium, potassium, and magnesium
  D. Carbamazepine (Tegretol), haloperidol, and trihexyphenidyl (Artane)
  B. Atropine, sodium brevitol, and succinylcholine chloride (Anectine)

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  (A) Thioridazine (an antipsychotic drug), lithium (an antimanic drug), and benztropine (an antiparkinsonism agent) are generally administered to treat schizophrenic and bipolar disorders. (B) Atropine (a cholinergic blocker), sodium brevitol (a shortacting anesthetic), and succinylcholine (a neuromuscular blocker) are administered either before or during ECT to coun teract bradycardia and to provide anesthesia and total muscle relaxation. (C) These are electrolyte substances administered to correct fluid and electrolyte imbalances in the body. (D) Carbamazepine (an anticonvulsant), haldoperidol (an antipsychotic), and trihexyphenydyl (an antiparkinsonism agent) are usually administered in psychiatric settings to control problems associated with psychotic behavior.

• Question 144:

  The medication that best penetrates eschar is:

  A. Mafenide acetate (Sulfamylon)
  B. Silver sulfadiazine (Silvadene)
  C. Neomycin sulfate (Neosporin)
  D. Povidone-iodine (Betadine)
  A. Mafenide acetate (Sulfamylon)

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  (A) Mafenide acetate is bacteriostatic against gram-positive and gram-negative organisms and is the agent that best penetrates eschar. (B) Silver sulfadiazine poorly penetrates eschar. (C) Neomycin sulfate does not penetrate eschar. (D) Povidoneiodine does not penetrate eschar.

• Question 145:

  The usual treatment for diabetes insipidus is with IM or SC injection of vasopressin tannate in oil. Nursing care related to the client receiving IM vasopressin tannate would include:

  A. Weigh once a week and report to the physician any weight gain of10 lb.
  B. Limit fluid intake to 500 mL/day.
  C. Store the medication in a refrigerator and allow to stand at room temperature for 30 minutes prior to administration.
  D. Hold the vial under warm water for 10?5 minutes and shake vigorously before drawing medication into the syringe.
  D. Hold the vial under warm water for 10?5 minutes and shake vigorously before drawing medication into the syringe.

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  (A) Weight should be obtained daily. (B) Fluid is not restricted but is given according to urine output. (C) The medication does not have to be stored in a refrigerator. (D) Holding the vial under warm water for 10?5 minutes or rolling between your hands and shaking vigorously before drawing medication into the syringe activates the medication in the oil solution.

• Question 146:

  Which of the following nursing care goals has the highest priority for a child with epiglottitis?

  A. Sleep or lie quietly 10 hr/day.
  B. Consume foods from all four food groups.
  C. Be afebrile throughout her hospital stay.
  D. Participate in play activities 4 hr/day.
  A. Sleep or lie quietly 10 hr/day.

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  (A) Of these four goals, maintenance of a calm, quiet atmosphere to reduce anxiety and to allow for rest is the most important. (B) Although nutrition is important, the child needs fluids to maintain fluid and electrolyte balance more than solid foods. In addition, the child may not be able to swallow solid foods owing to epiglottic swelling. (C) This goal is unrealistic because fever is a common symptom of the infection associated with epiglottitis. (D) If overexerted, the child will need more O2 and energy than available, and these requirements may exacerbate the condition.

• Question 147:

  A female client has just died. Her family is requesting that all nursing staff leave the room. The family's religious leader has arrived and is ready to conduct a ceremony for the deceased in the room, requesting that only family members be present. The nurse assigned to the client should perform the appropriate nursing action, which might include:

  A. Inform the family that it is the hospital's policy not to conduct religious ceremonies in client rooms.
  B. Refuse to leave the room because the client's body is entrusted in the nurse's care until it can be brought to the morgue.
  C. Tell the family that they may conduct their ceremony in the client's room; however, the nurse must attend.
  D. Respect the client's family's wishes.
  D. Respect the client's family's wishes.

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  (A) It is rare that a hospital has a specific policy addressing this particular issue. If the statement is true, the nurse should show evidence of the policy to the family and suggest alternatives, such as the hospital chapel. (B) Refusal to leave the room demonstrates a lack of understanding related to the family's need to grieve in their own manner. (C) The nurse should leave the room and allow the family privacy in their grief. (D) The family's wish to conduct a religious ceremony in the client's room is part of the grief process. The request is based on specific cultural and religious differences dictating social customs.

• Question 148:

  A baby who was diagnosed with pyloric stenosis has continued to have projectile vomiting. With prolonged vomiting, the infant is prone to:

  A. Respiratory acidosis
  B. Respiratory alkalosis
  C. Metabolic acidosis
  D. Metabolic alkalosis
  D. Metabolic alkalosis

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  (A) Respiratory acidosis is the result of problematic ventilation. Plasma pH decreases, while plasma PCO2 and plasma HCO3 increase. (B) Respiratory alkalosis results from increased respiratory rate and depth. Plasma pH increases, while plasma PCO2 and plasma HCO3 decrease. (C) Metabolic acidosis occurs when there is strong acid gain in the body. Plasma pH, PCO2, and HCO3 decrease. (D) Increased risk for metabolic alkalosis is due to a loss of hydrogen ions; depletion of potassium, sodium, and chloride when vomiting occurs. Plasma pH and plasma PCO2 increase; plasma HCO3 may decrease and then increase to compensate.

• Question 149:

  A client with a diagnosis of C-4 injury has been stabilized and is ready for discharge. Because this client is at risk for autonomic dysreflexia, he and his family should be instructed to assess for and report:

  A. Dizziness and tachypnea
  B. Circumoral pallor and lightheadedness
  C. Headache and facial flushing
  D. Pallor and itching of the face and neck
  C. Headache and facial flushing

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  (A) Tachypnea is not a symptom. (B) Circumoral pallor is not a symptom. (C) Autonomic dysreflexia is an uninhibited and exaggerated reflex of the autonomic nervous system to stimulation, which results in vasoconstriction and elevated blood pressure. (D) Pallor and itching are not symptoms.

• Question 150:

  A 23-year-old college student seeks medical attention at the college infirmary for complaints of severe fatigue. Her skin is pale, and she reports exertional dyspnea. She is admitted to the hospital with possible aplastic anemia. Laboratory values reflect anemia, and the client is prepared for a bone marrow biopsy. She refuses to sign the biopsy consent and states, "Can't you just get the doctor to give me a transfusion and let me go. This weekend begins spring break, and I have plans to go to Florida." At this time the nurse's greatest concern is that:

  A. The client may contract an infection as a result of being exposed to large crowds at spring break
  B. The client does not grasp the full impact of her illness
  C. The client may require transfusion before leaving for spring break
  D. The causative agent be identified and treatment begun
  B. The client does not grasp the full impact of her illness

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  (A) The client could contract an infection, but at this point it is not the most pertinent issue. (B) The client's statement indicates that she does not grasp the full impact of her illness. Further client education must be given, along with allowing her to express her feelings regarding her illness. (C) The client may require a transfusion, but this is a temporary measure because the causative agent has not been identified. Her feelings regarding her illness must be addressed in order for care to continue. (D) A bone marrow is done first to make a definitive diagnosis; then treatment may begin.