NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 201:

  The nurse instructs a client on the difference between true labor and false labor. The nurse explains, "In true labor:

  A. Uterine contractions will weaken with walking."
  B. Uterine contractions will strengthen with walking."
  C. The cervix does not dilate."
  D. The fetus does not descend."
  B. Uterine contractions will strengthen with walking."

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  (A) Uterine contractions increase with activity. (B) Walking will increase the strength and regularity of uterine contractions in true labor. (C) Uterine contractions that are strong and regular facilitate cervical dilation. (D) Regular, strong uterine contractions, as in true labor, result in fetal descent.

• Question 202:

  When assessing fetal heart rate status during labor, the monitor displays late decelerations with tachycardia and decreasing variability. What action should the nurse take?

  A. Continue monitoring because this is a normal occurrence.
  B. Turn client on right side.
  C. Decrease IV fluids.
  D. Report to physician or midwife.
  D. Report to physician or midwife.

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  (A) This is not a normal occurrence. Late decelerations need prompt intervention for immediate infant recovery. (B) To increase O2 perfusion to the unborn infant, the mother should be placed on her left side. (C) IV fluids should be increased, not decreased. (D) Immediate action is warranted, such as reporting findings, turning mother on left side, administering O2, discontinuing oxytocin (Pitocin), assessing maternal blood pressure and the labor process, preparing for immediate cesarean delivery, and explaining plan of action to client.

• Question 203:

  In teaching the client about proper umbilical cord care, the nurse recommends that:

  A. Petrolatum be placed around the cord after the sponge bath
  B. A belly binder be applied to prevent umbilical hernia
  C. The area be cleansed at diaper changes with alcohol and inspected for redness or drainage
  D. The cord clamp be left on until the cord stump separates
  C. The area be cleansed at diaper changes with alcohol and inspected for redness or drainage

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  (A) Petrolatum does not allow the cord to dry and will encourage infection. (B) Belly binders do not facilitate drying of the cord and will encourage abdominal relaxation. (C) Frequent applications of alcohol will facilitate drying and discourage infection. (D) The cord clamp can be removed in 24 hours. Leaving it on is cumbersome and could pull on the cord unnecessarily.

• Question 204:

  Early in her ninth month of pregnancy, a client has been diagnosed as having mild preeclampsia. In counseling her about her diet, the nurse must emphasize the importance of:

  A. Decreasing her sodium intake
  B. Decreasing her fluids
  C. Increasing her carbohydrate intake
  D. Eating a moderate to high-protein diet
  D. Eating a moderate to high-protein diet

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  (A) Women with pregnancy-induced hypertension have a reduced plasma volume secondary to venous vessel constriction, not hypovolemia; therefore, sodium restriction is not recommended. It is suggested that these women avoid extremely salty foods. (B) Drinking six to eight glasses of water per day facilitates optimal fluid volume and renal perfusion, but it will not decrease the venous vessel constriction of pregnancy-induced hypertension. (C) Carbohydrate needs increase during pregnancy, specifically during the second and third trimesters, but they have not been linked to pregnancy-induced hypertension. (D) Loss of urinary protein (proteinuria) is associated with increased permeability of the large protein molecules with pregnancy-induced hypertension.Additional dietary protein also helps increase the plasma colloidal osmotic pressure. Diets deficient in protein have been linked to pregnancy-induced hypertension.

• Question 205:

  A client is diagnosed with Mycobacterium tuberculosis. He is placed in respiratory isolation, intubated, and receives mechanical ventilation. When performing suctioning, the nurse should:

  A. Suction for a maximum of 20 seconds
  B. Hyperoxygenate before and after suctioning
  C. Suction for a maximum of 30 seconds
  D. Maintain clean technique during suctioning
  B. Hyperoxygenate before and after suctioning

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  (A) The maximum time for suctioning is 10?5 seconds. (B) Supplemental O2should be administered before and after suctioning to reduce hypoxia. (C) The maximum time for suctioning is 10?5 seconds. (D) Strict sterile technique should be used during suctioning.

• Question 206:

  The physician prescribes a medical regimen of isoniazid, rifampin, and vitamin B6 for a tuberculosis client. The nurse instructs the client that B6 is given because it:

  A. Increases activity of isoniazid
  B. Increases activity of rifampin
  C. Improves nutritional status
  D. Reduces peripheral neuropathy
  D. Reduces peripheral neuropathy

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  (A) Vitamin B6does not enhance the activity of isoniazid. (B) Vitamin B6does not enhance the activity of rifampin. (C) A vitamin alone does not improve nutritional status. (D) Isoniazid leads to Vitamin B6deficiency, which is manifested as peripheral neuropathy.

• Question 207:

  A schizophrenic client has made sexual overtures toward her physician on numerous occasions. During lunch, the client tells the nurse, "My doctor is in love with me and wants to marry me." This client is using which of the following defense mechanisms?

  A. Displacement
  B. Projection
  C. Reaction formation
  D. Suppression
  B. Projection

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  (A) Displacement involves transferring feelings to a more acceptable object. (B) Projection involves attributing one's thoughts or feelings to another person. (C) Reaction formation involves transforming an unacceptable impulse into the opposite behavior. (D) Suppression involves the intentional exclusion of unpleasant thoughts or experiences.

• Question 208:

  A client has received digoxin 0.25 mg po daily for 2 weeks. Which of the following digoxin levels indicates toxicity?

  A. 0.5 ng/mL
  B. 1.0 ng/mL
  C. 2.0 ng/mL
  D. 3.0 ng/mL
  D. 3.0 ng/mL

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  (A) 0.5 ng/mL of digoxin is a subtherapeutic level, not a toxic one. (B) 1.0 ng/mL is a therapeutic level. (C) 2.0 ng/mL is a therapeutic level. (D) Digoxin's therapeutic level is 0.8?.0 ng/mL. Digoxin's toxic level is>;2.0 ng/mL.

• Question 209:

  A client presented herself to the mental health center, describing the following symptoms: a weight loss of 20 lb in the past 2 months, difficulty concentrating, repeated absences from work due to "fatigue," and not wanting to get dressed in the morning. She leaves her recorded message on her telephone and has lost interest in answering the phone or doorbell. The nurse's assessment of her behavior would most likely be:

  A. Deep depression
  B. Psychotic depression
  C. Severe anxiety
  D. Severe depression
  D. Severe depression

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  (A) A client in deep depression would have been brought to the mental health center and would not be physically able to seek help for herself. (B) She is not manifesting psychotic symptoms in her behaviors. (C) The client's symptoms are more indicative of depression than anxiety. (D) Although the client was able to bring herself to the mental health center, the extent of her weight loss and the interference of symptoms with activities of daily living indicate that she is severely depressed.

• Question 210:

  A male client was diagnosed 6 months ago with amyotrophic lateral sclerosis (ALS). The progression of the disease has been aggressive. He is unable to maintain his personal hygiene without assistance. Ambulation is most difficult, requiring him to use a wheelchair and rely on assistance for mobility. He recently has become severely dysphasic. Nursing interventions for dysphasia would be aimed toward prevention of:

  A. Loss of ability to speak and communicate effectively
  B. Aspiration and weight loss
  C. Secondary infection resulting from poor oral hygiene
  D. Drooling
  B. Aspiration and weight loss

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  (A) Loss of ability to speak is not dysphasia. Although the client may have difficulty communicating, alternative measures can be developed to enhance communication. This goal, while important, is of a lesser priority. (B) Dysphasia is difficulty swallowing, which could result in aspiration of food and inability to eat, causing weight loss. (C) A secondary infection could result from poor oral hygiene, which could enhance the client's inability to eat, but this goal is of a lesser priority. (D) Drooling normally occurs in clients with amyotrophic lateral sclerosis and may require suctioning. Drooling, while aggravating for the client, does not pose an immediate danger.