NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 251:

  Which of the following ECG changes would be seen as a positive myocardial stress test response?

  A. Hyperacute T wave
  B. Prolongation of the PR interval
  C. ST-segment depression
  D. Pathological Q wave
  C. ST-segment depression

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  (A)

  Hyperacute T waves occur with hyperkalemia. (B) Prolongation of the P R interval occurs with first-degree AV block. (C) Horizontal ST-segment depression of>1 mm during exercise isdefinitely a positive criterion on the exercise ECG test.

  (D)

  Patho-logical Q waves occur with MI.

• Question 252:

  A client's prenatal screening indicated that she has no immunity to rubella. She is now 10 weeks pregnant. The best time to immunize her is:

  A. In the immediate postpartum period
  B. After the first trimester
  C. At 28 weeks' gestation
  D. Within 72 hours postpartum
  A. In the immediate postpartum period

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  (A) The rubella vaccine is made with attenuated virus and is given in the immediate postpartal period to prevent infection during pregnancy and subsequent adverse fetal and neonatal sequelae. Mothers are advised to prevent pregnancy for 3 months following immunization. (B) Rubella infection during the second trimester may result in permanent hearing loss for the fetus. (C) RhoGam is the drug generally administered at 28 weeks' gestation to Rh-negative women. It is contraindicated to administer rubella vaccine during pregnancy. (D) RhoGam is the drug administered within 72 hours postpartum to Rh- negative women to prevent the development of antibodies to fetal cells.

• Question 253:

  A client is started on prednisone 2.5 mg po bid. Which of the following instructions should be included in her discharge teaching specific to this medication?

  A. Increase your oral intake of fluids to at least 4000 mL every day.
  B. Avoid contact with people who have contagious illnesses.
  C. Brush your teeth at least 4 times a day with a firm toothbrush.
  D. Immediately stop taking the prednisone if you feel depressed.
  B. Avoid contact with people who have contagious illnesses.

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  (A) Fluid retention is a side effect of prednisone. The nurse should teach clients to weigh themselves daily and to observe for signs of edema. If these signs of fluid retention occur, they should notify the physician. (B) Prednisone, a glucocorticoid, suppresses the normal immune response making the client more susceptible to infections. (C) An increase in bleeding tendencies is a side effect of prednisone therapy. The nurse should teach clients to use preventive measures (i.e., electric razors and soft toothbrushes). (D) Depression and personality changes are side effects of prednisone therapy. Prednisone should never be discontinued abruptly.

• Question 254:

  A newborn has been delivered with a meningomyelocele. The nursery nurse should position the newborn:

  A. Prone
  B. Supine C. Side lying
  D. Semi-Fowler
  A. Prone

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  (A) The prone position reduces pressure and tension on the sac. Primary nursing goals are to prevent trauma and infection of the sac. (B) The supine position exerts pressure on the sac. (C) Newborns usually cannot maintain side-lying position. (D) The semi- Fowler position exerts pressure on the sac.

• Question 255:

  A client is being discharged with albuterol (Proventil) and beclomethasone dipropionate (Vanceril) to be administered via inhalation three times a day and at bedtime. Client teaching regarding the sequential order in which the drugs should be administered includes:

  A. Glucocorticoid followed by the bronchodilator
  B. Bronchodilator followed by the glucocorticoid
  C. Alternate successive administrations
  D. According to the client's preference
  B. Bronchodilator followed by the glucocorticoid

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  (A) The client would not receive therapeutic effects of the glucocorticoid when it is inhaled through constricted airways. (B) Bronchodilating the airways first allows for the glucocorticoid to be inhaled through open airways and increases the penetration of the steroid for maximum effectiveness of the drug. (C) Inac- Inaccurate use of the inhalers will lead to decreased effectiveness of the treatment. (D) Client teaching regarding the use and effects of inhalers will promote client understanding and compliance.

• Question 256:

  A client is admitted to the psychiatric unit after lavage and stabilization in the emergency room for an overdose of antidepressants. This is her third attempt in 2 years. The highest priority intervention at this time is to:

  A. Assess level of consciousness
  B. Assess suicide potential
  C. Observe for sedation and hypotension
  D. Orient to her room and unit rules
  B. Assess suicide potential

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  (A) The client was stabilized in the ED and consequently would not be sent to the psychiatric unit if comatose. (B) Suicide assessment is always appropriate for clients with a history of previous attempts or depression, because either of these factors places the client at high risk. (C) The admission assessment should include observation for sedation and hypotension, but this is not in priority over suicide assessment. (D) Orientation to room and unit rules is of low priority at this time.

• Question 257:

  A 1000-mL dose of D5W 12 normal saline is to be infused in 8 hours. The drop factor for the tubing is 60 gtt/min. How many drops per minute should the nurse administer?

  A. 75 gtt/min
  B. 100 gtt/min C. 125 gtt/min
  D. 150 gtt/min
  C

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  (A) This answer is a miscalculation. (B) This answer is a miscalculation. (C)125 gtt/min. (D) This answer is a miscalculation.

• Question 258:

  The nurse is planning a reality orientation program for a group of clients with organic brain syndrome at the mental health center. Props that could be used for this program are:

  A. Month-old magazines that are provided by volunteers
  B. Large maps and posters depicting area of current residence
  C. A litter of kittens for the clients to pet
  D. A library of biographical books
  B. Large maps and posters depicting area of current residence

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  (A) This answer is incorrect. Current magazines would be appropriate. (B) This answer is correct. Maps of the state and town and posters that depict current events in the area are appropriate props. (C) This answer is incorrect. Kittens would be appropriate for pet therapy, not reality therapy. (D) This answer is incorrect. Biographies depict a past, not a present, orientation.

• Question 259:

  A registered nurse is trying to determine the appropriate care that she should provide for her obstetrical clients. Which of the following documents is considered the legal standard of practice?

  A. State nursing practice act
  B. AWHONN Standards for the Nursing Care of Women and Newborns
  C. American Nurses' Association Standards of Maternal- Child Health Nursing
  D. International Council of Nurses' Code
  A. State nursing practice act

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  (A) The state nursing practice act determines the standard of care for the professional nurse. (B) AWHONN Standards are published as recommendations and guidelines for maternal-newborn nursing. (C) American Nurses' Association Standards are published as recommendations and guidelines for maternalchild health nursing. (D) The International Council of Nurses' Code emphasizes the nurse's obligations to the client rather than to the physician. It is published as recommendations and guidelines by the international organization for professional nursing.

• Question 260:

  After an infant is delivered by cesarean delivery and placed on the warmer, the RN dries and assesses the infant. At 1 and 5 minutes after birth, the RN does the Apgar scoring of the infant. The RN knows that because this infant was delivered by cesarean section, he is at increased risk for having which one of the following:

  A. Cold stress
  B. Cyanosis
  C. Respiratory distress syndrome
  D. Seizures
  C. Respiratory distress syndrome

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  (A) The infant is placed on the warmer and dried after birth. Cold stress occurs when the infant is not dried and kept warm. (B) The fact that this infant was born by cesarean delivery does not place him at a greater risk for cyanosis than an infant delivered vaginally. Cyanosis occurs when infants cannot oxygenate their blood after the umbilical cord is severed. (C) Infants born by cesarean delivery are at a higher risk for developing respiratory distress syndrome because these infants do not pass through the pelvis, where the chest is compressed and fluid is able to escape from the lungs. (D) Cesarean-delivered infants are not at greater risk for seizures than infants delivered vaginally.