NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 171:

  A child is admitted to the emergency room with her mother. Her mother states that she has been exposed to chickenpox. During the assessment, the nurse would note a characteristic rash:

  A. That is covered with vesicular scabs all in the macular stage
  B. That appears profusely on the trunk and sparsely on the extremities
  C. That first appears on the neck and spreads downward
  D. That appears especially on the cheeks, which gives a "slapped-cheek" appearance
  B. That appears profusely on the trunk and sparsely on the extremities

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  (A) A rash with vesicular scabs in all stages (macule, papule, vesicle, and crusts). (B) A rash that appears profusely on the trunk and sparsely on the extremities. (C) A rash that first appears on the neck and spreads downward is characteristic of rubeola and rubella. (D) A rash, especially on the cheeks, that gives a "slapped-cheek" appearance is characteristic of roseola.

• Question 172:

  In discussing the plan of care for a child with chronic nephrosis with the mother, the nurse identifies that the purpose of weighing the child is to:

  A. Measure adequacy of nutritional management
  B. Check the accuracy of the fluid intake record
  C. Impress the child with the importance of eating well
  D. Determine changes in the amount of edema
  D. Determine changes in the amount of edema

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  (A) Weighing a child with nephrosis is to assess for edema, not nutrition. (B, C) This is not the purpose for weighing the child. (D) Weight and measurement are the primary ways of evaluating edema and fluid shifts.

• Question 173:

  An 11-year-old boy has received a partial-thickness burn to both legs. He presents to the emergency room approximately 15 minutes after the accident in excruciating pain with charred clothing to both legs. What is the first nursing action?

  A. Apply ice packs to both legs.
  B. Begin débridement by removing all charred clothing from wound.
  C. Apply Silvadene cream (silver sulfadiazine).
  D. Immerse both legs in cool water.
  D. Immerse both legs in cool water.

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  (A)

  Ice creates a dramatic temperature change in the tissue, which can cause further thermal injury. (B) Charred clothing should not be removed from wound first. This creates further tissue damage. Débridement is not the first nursing action.

  (C)

  Applying silver sulfadiazine cream first insulates heat in injured tissue and increases potential for infection. (D) Emergency care of a thermal burn is immersing both legs in cool water. Cool water permits gradual temperature change and prevents further thermal damage.

• Question 174:

  A 29-year-old client delivered her fifth child by the Lamaze method and developed a postpartal hemorrhage in the recovery room. What are the initial symptoms of shock that she may experience?

  A. Marked elevation in blood pressure, respirations, and pulse
  B. Decreased systolic pressure, cold skin, and anuria
  C. Rapid pulse; narrowed pulse pressure; cool, moist skin
  D. No urinary output, tachycardia, and restlessness
  C. Rapid pulse; narrowed pulse pressure; cool, moist skin

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  (A) Early shock does not exhibit the symptom of marked elevation in blood pressure. A narrowing of the pulse pressure is indicative of early shock. (B) Anuria is a clinical finding in late shock. (C) All of these clinical findings are congruent with early shock. (D) Absence of urinary output is a clinical finding in the late phase of shock.

• Question 175:

  A 9-month-old infant is being examined in the general pediatric clinic for a routine well-child checkup. His immunizations are up to date, and his mother reports that he has had no significant illnesses or injuries. Which of the following signs would lead the nurse to believe that he has had a cerebral injury?

  A. Hyperextension of the neck with evidence of pain on flexion
  B. Holding the head to one side and pointing the chin toward the other side
  C. Holding the head erect and in the midline when in a vertical position
  D. Significant head lag when raised to a sitting position
  D. Significant head lag when raised to a sitting position

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  (A) This position is indicative of a possible meningeal irritation or infection such as meningitis. (B) This position is seen most frequently in infants who have had an injury to the sternocleidomastoid muscle. (C) Most infants aged 4 months and older are able to maintain this position. (D) Infants older than 6 months of age should not have significant head lag. This is a sign of cerebral injury and should be referred for further evaluation.

• Question 176:

  Loss of appetite for a child with leukemia is a major recurrent problem. The plan of care should be designed to:

  A. Reinforce attempts to eat
  B. Help the child gain weight
  C. Increase his appetite
  D. Make mealtimes pleasant
  A. Reinforce attempts to eat

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  (A)

  Ignoring refusals to eat and rewarding eating attempts are the most successful means of increasing intake. (B) This goal is not specific enough or related to the loss of appetite. (C) This goal is not possible at this time based on his illness.

  (D)

  This goal is helpful, but alone will not address his loss of appetite.

• Question 177:

  A gravida 2 para 1 client delivered a full-term newborn 12 hours ago. The nurse finds her uterus to be boggy, high, and deviated to the right. The most appropriate nursing action is to:

  A. Notify the physician
  B. Place the client on a pad count
  C. Massage the uterus and re-evaluate in 30 minutes
  D. Have the client void and then re-evaluate the fundus
  D. Have the client void and then re-evaluate the fundus

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  (A) The nurse should initiate actions to remove the most frequent cause of uterine displacement, which involves emptying the bladder. Notifying the physician is an inappropriate nursing action. (B) The pad count gives an estimate of blood loss, which is likely to increase with a boggy uterus; but this action does not remove the most frequent cause of uterine displacement, which is a full bladder. (C) Massage may firm the uterus temporarily, but if a full bladder is not emptied, the uterus will remain displaced and is likely to relax again. (D) The most common cause of uterine displacement is a full bladder.

• Question 178:

  A 68-year-old man was recently diagnosed with endstage renal disease. He has not yet begun dialysis but is experiencing severe anemia with associated symptoms of dyspnea on exertion and chest pain. Which statement best describes the management of anemia in renal failure?

  A. Hematocrit levels usually remain slightly below normalin clients with renal failure.
  B. Transfusion is often begun as early as possible to prevent complications of anemia such as dyspnea and angina.
  C. Anemia in renal failure is frequently caused by low serum iron and ferritin and corrected by oral iron and ferritin replacement therapy.
  D. The renal secretion of erythropoiesis is decreased. The bone marrow requires erythropoietin to mature red blood cells.
  D. The renal secretion of erythropoiesis is decreased. The bone marrow requires erythropoietin to mature red blood cells.

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  (A) Clients in renal failure typically have very low hematocrits, often in the range of 16?2%. (B) Transfusion is avoided unless the client exhibits acute symptoms such as dyspnea, chest pain, tachycardia, and extreme fatigue. When the client is given a transfusion, the bone marrow adjusts by producing less red blood cells. (C) Anemia in renal failure is caused primarily by decreased erythropoietin. Low serum iron and ferritin may aggravate the anemia and require treatment. (D) Decreased secretion of erythropoietin by the kidney is the primary cause of anemia. The bone marrow requires this hormone to mature red blood cells. Treatment is with replacement therapy.

• Question 179:

  As a postoperative cholecystectomy client completes tomorrow's dinner menu, the nurse knows that one of the following meal choices will best provide the essential vitamin(s) necessary for proper tissue healing?

  A. Liver, white rice, spinach, tossed salad, custard pudding
  B. Fish fillet, carrots, mashed potatoes, butterscotch pudding
  C. Roast chicken, gelatin with sliced fruit
  D. Chicken breast fillet in tomato sauce, potatoes, mustard greens, orange and strawberry slices
  D. Chicken breast fillet in tomato sauce, potatoes, mustard greens, orange and strawberry slices

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  (A) This meal choice provides more of the vitamins A, D, and K than of vitamin C. (B) This meal choice provides more of the vitamins A, B12, and D than of vitamin C. (C) This meal choice provides more of the vitamins A, B1 (thiamine), niacin, and microminerals than of vitamin C. (D) This meal choice provides foods rich in vitamin C, which are essential in tissue healing.

• Question 180:

  Following a vaginal delivery, the postpartum nurse should observe for:

  A. Dystocia, kraurosis
  B. Chadwick's sign
  C. Fatigue, hemorrhoids
  D. Hemorrhage and infection
  D. Hemorrhage and infection

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  (A) Dystocia is difficult labor. The delivery has occurred. Kraurosis is atrophy and dryness of skin and any mucous membrane (vulva). (B) Chadwick's sign is a bluish color of vaginal mucosa suggestive of pregnancy. (C) Fatigue is a common symptom in the postpartal period. Hemorrhoids may occur with pregnancy. (D) Hemorrhage and infection are potential complications of vaginal delivery. Hemorrhage may result from retained placental fragments or soft uterus. Infection may occur from the introduction of organisms into the uterus during the delivery.