NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 191:

  The nurse observes a client crying quietly. She has just experienced a spontaneous abortion at nine weeks' gestation. An appropriate response by the nurse would be:

  A. "It must be God's will and probably is for the best."
  B. "This must be a difficult time for you. Would you like to talk about it?"
  C. "I'm sure your other children will be a comfort for you."
  D. "Don't worry, you're still young. If I were you I'd just try again."
  B. "This must be a difficult time for you. Would you like to talk about it?"

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  (A) This response is nontherapeutic because it belittles the client's response and gives a meaningless rationalization. (B) This response acknowledges the client's feelings and demonstrates the therapeutic offering of self by the nurse. (C) This response is nontherapeutic because it does not focus on the client's feelings and offers false reassurance. (D) This response is nontherapeutic because it belittles the client's feelings and offers her advice.

• Question 192:

  A 6-month-old infant has developmental delays. His weight falls below the 5th percentile when plotted on a growth chart. A diagnosis of failure to thrive is made. What behaviors might indicate the possibility of maternal deprivation?

  A. Responsive to touch, wants to be held
  B. Uncomforted by touch, refuses bottle
  C. Maintains eye-to-eye contact
  D. Finicky eater, easily pacified, cuddly
  B. Uncomforted by touch, refuses bottle

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  (A) Normal infant attachment behaviors include responding to touch and wanting to be held. (B) Maternal deprivation behaviors include poor feeding, stiffening and refusal to eat, and inconsistencies in responsiveness. (C) Attachment behavior includes maintaining eye contact. (D) Maternal deprivation behaviors include displeasure with touch and physical contact.

• Question 193:

  Which of the following physician's orders would the nurse question on a client with chronic arterial insufficiency?

  A. Neurovascular checks every 2 hours
  B. Elevate legs on pillows
  C. Arteriogram in the morning
  D. No smoking
  B. Elevate legs on pillows

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  (A) Neurovascular checks are a routine part of assessment with clients having this diagnosis. (B) Elevation of the legs is contraindicated because it reduces blood flow to areas already compromised. (C) Arteriogram is a routine diagnostic order. (D) Smoking is highly correlated with this disorder.

• Question 194:

  In healthcare settings, nurses must be familiar with primary, secondary, and tertiary levels of care. As a nurse in the community, which of the following interventions might be a primary prevention strategy?

  A. Crisis intervention with an intoxicated teenager whose mother just committed suicide
  B. Referring a client who has been on a detoxification unit to a rehabilitation center
  C. Teaching fifth-grade children the harmful effects of substance abuse
  D. Counseling a client with post-traumatic stress disorder
  C. Teaching fifth-grade children the harmful effects of substance abuse

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  (A) The teenager is already coping ineffectively and requires early detection and treatment, which is secondary prevention. (B) The client must be sent to a rehabilitation unit, which requires tertiary prevention. (C) Reducing the incidence of disease through education supports primary prevention. (D) A client with identified symptoms of post-traumatic stress disorder requires intervention by treatment.

• Question 195:

  A 20-year-old male client is being treated for protein deficiency. If he likes all of the following foods, which one would the nurse recommend to increase in the diet?

  A. Cantaloupe
  B. Rice
  C. Chicken
  D. Green beans
  C. Chicken

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  (A) Cantaloupe is a good source of carbohydrates, vitamin C, and vitamin A. (B) Rice contains about 4 g of protein per 200 g. (C) Chicken contains 35 g protein per breast. Chicken is a rich source of vitamin B6 (pyridoxine), which is needed for adequate protein synthesis. As protein intake increases, vitamin B6 intake must also be increased. Vitamin B6 is a coenzyme in amino acid metabolism. (D) Green beans only contain 2 g of protein per cup.

• Question 196:

  A client experiencing delusions states, "I came here because there were people surrounding my house that wanted to take me away and use my body for science." The best response by the nurse would be:

  A. "Describe the people surrounding your house that want to take you away."
  B. "I need more information on why you think others want to use your body for science."
  C. "There were no people surrounding your house, your relatives brought you here, and no one really wants your body for science."
  D. "I know that must be frightening for you; let the staff know when you are having thoughts that trouble you."
  D. "I know that must be frightening for you; let the staff know when you are having thoughts that trouble you."

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  (A) Focusing on the delusional content does not reinforce reality. (B) Pursuing details or more information on the delusion reinforces the false belief and further distances the client from reality. (C) Challenging the client's delusional system may force the client to defend it, and you cannot change the delusion through logic. (D) Focusing on the feeling can reinforce reality and discourage the false belief. Seeking out staff when thoughts are troublesome can help to decrease anxiety.

• Question 197:

  A 9-week-old female infant has a diagnosis of bilateral cleft lip and cleft palate. She has been admitted to the pediatric unit after surgical repair of the cleft lip. Which of the following nursing interventions would be appropriate during the first 24 hours?

  A. Position on side or abdomen.
  B. Maintain elbow restraints in place unless she is being directly supervised.
  C. Clean suture line every shift.
  D. Offer pacifier when she cries.
  B. Maintain elbow restraints in place unless she is being directly supervised.

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  (A) Placing the infant on her abdomen may allow for injury to the suture line. (B) Elbow restraints prevent the infant from touching the suture line and yet leaves hands free. (C) The suture line is cleaned as often as every hour to prevent crusting and scarring. (D) Sucking of a bottle or pacifier places pressure on the suture line and may delay healing and cause scarring.

• Question 198:

  One week ago, a 21-year-old client with a diagnosis of bipolar disorder was started on lithium 300 mg po qid. A lithium level is ordered. The client's level is 1.3 mEq/L. The nurse recognizes that this level is considered to be:

  A. Within therapeutic range
  B. Below therapeutic range
  C. Above therapeutic range
  D. At a level of toxic poisoning
  A. Within therapeutic range

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  (A) This answer is correct. The therapeutic range is 1.0?.5 mEq/L in the acute phase. Maintenance control levels are 0.6?.2 mEq/L. (B, C) This answer is incorrect. A level of 1.3 mEq/L is within therapeutic range. (D) This answer is incorrect. Toxic poisoning is usually at the 2.0 level or higher.

• Question 199:

  A 60-year-old male client was hospitalized 3 days ago with the diagnosis of acute anterior wall myocardial infarction. Today he has been complaining of increasing weakness and shortness of breath. Crackles in both lung bases are audible on auscultation. He is developing:

  A. An extension of his myocardial infarction
  B. Pneumonia
  C. Pulmonary edema
  D. Pulmonary emboli
  C. Pulmonary edema

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  (A) Extensions of his myocardial infarction would be chest pain unrelieved with nitroglycerin, cardiac enzyme elevations, and electrocardiographic changes. (B) Persons with pneumonia may complain of weakness and shortness of breath and have crackles in their lung bases. However, they would also have sputum production and leukocytosis. (C) Persons who have had myocardial infarctions (especially anterior wall) are at risk of developing left ventricular heart failure, which is a major cause of pulmonary edema. Pulmonary edema is manifest by shortness of breath, weakness, and crackles on auscultation of the lung fields. (D) Pulmonary emboli may be accompanied by shortness of breath, weakness, and crackles. However, the pulmonary hypertension that accompanies pulmonary emboli results in signs of increased systemic venous pressure as well.

• Question 200:

  A 24-year-old male client is admitted with a diagnosis of sickle cell anemia. The nurse discusses his disease with him and emphasizes the following information:

  A. He should monitor his sputum, stools, and urine for signs of bleeding.
  B. His daily diet should include a large amount of fluid.
  C. He should not be concerned about having to fly on a commuter airplane on a weekly basis.
  D. He should not worry about having children because this disease is passed on only by female carriers.
  B. His daily diet should include a large amount of fluid.

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  (A) Bleeding is not a symptom of sickle cell anemia or sickle cell crisis. (B) Decreased blood viscosity leads to sickling of red blood cells. Increased fluid intake maintains adequate circulating blood volume and decreases the chance of sickling. (C) Hypoxia leads to sickling of cells. Flying in nonpressurized planes places the client in a situation of low O2 tension, which can lead to sickling. (D) Male and female clients with sickle cell disease can pass the trait on to their offspring. Therefore, this client should receive genetic counseling prior to having children.