NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 211:

  A family by court order undergoes treatment by a family therapist for child abuse. The nurse, who is the child's case manager knows that treatment has been effective when:

  A. The child is removed from the home and placed in foster care
  B. The child's parents identify the ways in which he is different from the rest of the family
  C. The child's father is arrested for child abuse
  D. The child's parents can identify appropriate behaviors for children in his age group
  D. The child's parents can identify appropriate behaviors for children in his age group

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  (A) Removing an abused child from the home and placement in a foster home are not the desired outcome of treatment. (B) Children who are perceived as "different" from the rest of the family are more likely to be abused. (C) Although legal action may be taken against abusive parents, it is not an indicator of an effective treatment program. (D) Identification of age-appropriate behaviors is essential to the role of parents, because misunderstanding children's normal developmental needs often contributes to abuse or neglect.

• Question 212:

  Which behavior by a female client feeding her newborn demonstrates that she needs more teaching related to safety and infant feeding?

  A. She uses the bulb syringe to help clear her baby's nose when milk is regurgitated.
  B. She places her infant on her right side after feeding her.
  C. She props the bottle in the crib to feed her baby,which allows her to write birth announcements and feed her baby at the same time.
  D. She burps her baby by placing her in a sitting position, supporting her head and neck and gently massaging her back.
  C. She props the bottle in the crib to feed her baby,which allows her to write birth announcements and feed her baby at the same time.

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  (A) This practice is the proper use of the bulb syringe to clear the infant's airway in case of regurgitation. (B) Placing the infant on either side or on the stomach prevents aspiration of regurgitated milk. (C) "Bottle propping" is an unsafe practice because it increases the likelihood of aspiration. (D) This practice is one correct way of burping an infant.

• Question 213:

  A 28-year-old multigravida has class II heart disease. At her prenatal visit at 34 weeks' gestation, all of the following observations are made. Which would require intervention?

  A. Weight gain of 2 kg in 4 weeks
  B. Blood pressure of 128/78
  C. Subjective data: shortness of breath after showering
  D. Ankle edema reported present in late afternoon and evenings
  C. Subjective data: shortness of breath after showering

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  (A) This is not an excessive weight gain indicative of fluid retention. (B) The blood pressure is within normal range. (C) Showering should not cause shortness of breath. This could be a sign ofcardiac decompensation. (D) Dependent ankle edema is normal late in the day among pregnant women. Progressive edema would be a dangerous development.

• Question 214:

  A 55-year-old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:

  A. Intake and output measurement
  B. Daily weights
  C. Straining of all urine
  D. Administration of O2 therapy
  C. Straining of all urine

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  (A) Intake and output measurements are important but must be accompanied by straining urine. (B) Daily weights would not provide for identification of calculi. (C) Straining urine provides for assessment of calculi and evaluation of calculi descent through ureters and urethra. (D) O2therapy should not be necessary for renal calculi.

• Question 215:

  A client who has gout is most likely to form which type of renal calculi?

  A. Struvite stones
  B. Staghorn calculi
  C. Uric acid stones
  D. Calcium stones
  C. Uric acid stones

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  (A) The presence of urinary tract infection is a factor in the formation of struvite stones. (B) Staghorn calculi is the other name for struvite stones associated with urinary tract infection. (C) Clients who have gout form uric acid stones. (D) Clients who have increased urinary excretion of calcium form calcium stones.

• Question 216:

  On admission, the client has signs and symptoms of pulmonary edema. The nurse places the client in the most appropriate position for a client in pulmonary edema, which is:

  A. High Fowler
  B. Lying on the left side
  C. Sitting in a chair
  D. Supine with feet elevated
  A. High Fowler

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  (A) High Fowler position decreases venous return to the heart and permits greater lung expansion so that oxygenation is maximized. (B) Lying on the left side may improve perfusion to the left lung but does not promote lung expansion. (C) Sitting in a chair will decrease venous return and promote maximal lung expansion. However, clients with pulmonary edema can deteriorate quickly and require intubation and mechanical ventilation. If a client is sitting in achair when this deterioration happens, it will be difficult to intervene quickly. (D) The supine with feet elevated position increases venous return and will worsen pulmonary edema.

• Question 217:

  Nursing assessment of early evidence of septic shock in children at risk includes:

  A. Fever, tachycardia, and tachypnea
  B. Respiratory distress, cold skin, and pale extremities
  C. Elevated blood pressure, hyperventilation, and thready pulses
  D. Normal pulses, hypotension, and oliguria
  A. Fever, tachycardia, and tachypnea

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  (A) Fever, tachycardia, and tachypnea are the classic early signs of septic shock in children. (B) Respiratory distress, cold skin, and pale extremities are later signs of septic shock. (C) Elevated blood pressure, hyperventilation, and thready pulses are later signs of septic shock. (D) Normal pulses, hypotension, and oliguria are not early signs of septic shock.

• Question 218:

  A 6-year-old girl has been diagnosed with a urinary tract infection secondary to vesicoureteral reflux. Which statement by her mother indicates a need for further teaching?

  A. "I have taught her to wipe from front to back after urinating."
  B. "I make sure she drinks plenty of fluids every day."
  C. "She enjoys wearing nylon panties, but I make her change them everyday."
  D. "She tries to empty her bladder completely after she urinates, like I told her."
  C. "She enjoys wearing nylon panties, but I make her change them everyday."

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  (A) Wiping from front to back is wiping from an area of lesser contamination (urethra) to an area of greater contamination (rectum). (B) Generous fluid intake reduces the concentration of urine. (C) Cotton is a natural, absorbent fabric. Nylon often predisposes the client to urinary tract infections. Dark, warm, moist areas are excellent media for bacterial growth. (D) With vesicoureteral reflux, urine refluxes into the ureter(s) during voiding and then returns to the bladder (residual), which becomes a source for future infection.

• Question 219:

  When a client arrives on the labor and delivery unit, she informs the nurse that she has been having contractions for the last 5 hours. Now the pain is constant and not cyclical as it was earlier. The nurse considers the possibility of uterine rupture. Which of the following symptoms would be consistent with a uterine rupture?

  A. A large gush of clear fluid from the vagina
  B. Systolic hypertension
  C. Abdominal rigidity
  D. Increased fetal movements
  C. Abdominal rigidity

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  (A) This symptom would indicate a rupture of the membranes, which would be expected during labor. There would be no cause for alarm if the fluid were clear. (B) With uterine rupture and the risk of maternal shock secondary to blood loss, the most likely sign would be hypotension indicating hypovolemic shock. (C) In the event of a uterine rupture, an abdominal examination would likely reveal rigidity or tenderness. (D) The most likely finding would be a decrease in fetal movement related to fetal distress due to impaired uteroplacental blood flow. Maintaining the client on her left side would help to maximize uterine blood flow.

• Question 220:

  Assessment of a newborn for Apgar scoring includes observation for:

  A. Pupil response
  B. Respiratory rate
  C. Heart rate
  D. Babinski's reflex
  C. Heart rate

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  (A) Pupil response should be assessed but is not part of Apgar scoring. (B) Respiratory effort is an essential part of Apgar scoring, not respiratory rate. (C) Heart rate is the most critical component of Apgar scoring. (D) Assessment of Babinski's reflex is not a component of Apgar scoring.