NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 271:

  A 27-year-old primigravida at 32 weeks' gestation has been diagnosed with complete placenta previa. Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:

  A. Dinitrophenylhydrazine
  B. Metachromatic stain
  C. Blood serum phenylalanine test
  D. Lecithin-sphingomyelin ratio
  D. Lecithin-sphingomyelin ratio

  ---

  (A) Dinitrophenylhydrazine is a laboratory test used to detect phenylketonuria, maple syrup urine disease, and Lowe's syndrome. (B) Metachromatic stain is a laboratory test that may be used to diagnose Tay-Sachs and other lipid diseases of the central nervous system. (C) The blood serum phenylalanine test is diagnostic of phenylketonuria and can be used for wide-scale screening. (D) A lecithin-sphingomyelin ratio of at least 2:1 is indicative of fetal lung maturity, and survival of the fetus is likely.

• Question 272:

  A female client comes for her second prenatal visit. The nurse-midwife tells her, "Your blood tests reveal that you do not show immunity to the German measles." Which notation will the nurse include in her plan of care for the client? "Will need . . .

  A. Rh-immune globulin at the next visit"
  B. Rh-immune globulin within 3 days of delivery"
  C. Rubella vaccine at the next visit"
  D. Rubella vaccine after delivery on the day of discharge"
  D. Rubella vaccine after delivery on the day of discharge"

  ---

  (A) Rh immune globulin is given to Rh-negative mothers to prevent the maternal Rh immune response. (B) Rh immune globulin is given to Rh-negative mothers to prevent the maternal Rh immune response. (C) The rubella vaccine is not given during pregnancy because of its teratogenicity. (D) Nonimmune mothers are vaccinated early in the postpartum period to prevent future infection with the rubella virus.

• Question 273:

  The nurse is caring for a client who has had a tracheostomy for 7 years. The client is started on a fullstrength tube feeding at 75 mL/hr. Prior to starting the tube feeding, the nurse confirms placement of the tube in the stomach. The hospital policy states that all tube feeding must be dyed blue. On suctioning, the nurse notices the sputum to be a blue color. This is indicative of which of the following?

  A. The client aspirated tube feeding.
  B. The nurse has placed the suction catheter in the esophagus.
  C. This is a normal finding.
  D. The feeding is infusing into the trachea.
  A. The client aspirated tube feeding.

  ---

  (A) Once the feeding tube placement is confirmed in the stomach, aspiration can occur if the client's stomach becomes too full. When suctioning the trachea, if secretions resemble tube feeding, the client has aspirated the feeding. (B) Because the trachea provides direct access to a client's airway, it would not be possible to place the catheter in the esophagus. (C) Blue-colored sputum is never considered a normal finding and should be reported and documented. (D) The nurse confirmed placement of the feeding tube in the stomach prior to initiating the tube feeding; therefore, it is highly unlikely that the feeding tube would be located in the trachea.

• Question 274:

  When preparing insulin for IV administration, the nurse identifies which kind of insulin to use?

  A. NPH
  B. Human or pork
  C. Regular
  D. Long acting
  C. Regular

  ---

  (A, B, D) Intermediate-acting and long-acting preparations contain materials that increase length of absorption time from the subcutaneous tissues but cause the preparation to be cloudy and unsuitable for IV use. Human insulin must be given SC. (C) Only regular insulin can be given IV.

• Question 275:

  MgSO4 is ordered IV following the established protocol for a client with severe PIH. The anticipated effects of this therapy are anticonvulsant and:

  A. Vasoconstrictive
  B. Vasodilative
  C. Hypertensive
  D. Antiemetic
  B. Vasodilative

  ---

  (A) An anticonvulsant effect is the goal of drug therapy for PIH. However, we would not want to increase the vasoconstriction that is already present. This would make the symptoms more severe. (B) An anticon-vulsant effect and vasodilation are the desired outcomes when administering this drug. (C) An anticonvulsant effect is the goal of drug therapy for PIH; however, hypertensive drugs would increase the blood pressure even more. (D) An anticonvulsant effect is the goal of drug therapy for PIH. MgSO4is not classified as an antiemetic. Antiemetics are not indicated for PIH treatment.

• Question 276:

  After a 10-year-old child with insulin-dependent diabetes mellitus receives her dinner tray, she tells the nurse that she hates broccoli and wants some corn on the cob. The nurse's appropriate response is:

  A. "No vegetable exchanges are allowed."
  B. "Corn and other starchy vegetables are considered to be bread exchanges."
  C. "Yes, you may exchange any vegetable for any other vegetable."
  D. "Yes, but only one-half ear is allowed."
  B. "Corn and other starchy vegetables are considered to be bread exchanges."

  ---

  (A)

  Sites for injection need to be rotated, including abdominal sites, to enhance insulin absorption. (B) The pinch technique is the most effective method for obtaining skin tightness to allow easy entrance of the needle to subcutaneous tissues.

  (C)

  Massaging the site of injectionfacilitates absorption of the insulin. (D) Changing the needle will break the sterility of the system. It has become acceptable practice to reuse disposable needles and syringes for 3? days.

• Question 277:

  A 10-year-old boy has been diagnosed with Legg-Calv?Perthes disease. Which of the client's responses would indicate compliance during initial therapy?

  A. Drinking large amounts of milk
  B. Not bearing weight on affected extremity
  C. Walking short distances 3 times/day
  D. Putting self on weight reduction diet
  B. Not bearing weight on affected extremity

  ---

  (A) This condition causes aseptic necrosis of the head of the femur in the acetabulum. Drinking large quantities of milk at this time cannot hasten recovery. (B) The aim of treatment is to keep the head of the femur in the acetabulum. Non瓀 eight-bearing is essential. Activity causes microfractures of the epiphysis. (C) In addition to non瓀eight- bearing, clients are often placed on bedrest, which helps to reduce inflammation. Later, active motion is encouraged. (D) Weight is not generally an issue with this disease. Slipped femoral capital epiphysis, which is most frequently observed in obese pubescent children, usually requires a weight reduction diet.

• Question 278:

  Goal setting for a client with Meniere's disease should include which of the following?

  A. Frequent ambulation
  B. Prevention of a fall injury
  C. Consumption of three meals per day
  D. Prevention of infection
  B. Prevention of a fall injury

  ---

  (A) Although not contraindicated, initially ambulation may be difficult because of vertigo and is recommended only with assistance. (B) Vertigo resulting in balance problems is one of the most common manifestations of Meniere's disease. (C) Adequate nutrition is important, but the emphasis in Meniere's disease is not the number of meals per day but a decrease in intake of sodium. (D) Infection is not an anticipated problem.

• Question 279:

  The nurse needs to be aware that the most common early complication of a myocardial infarction is:

  A. Diabetes mellitus
  B. Anaphylactic shock
  C. Cardiac hypertrophy
  D. Cardiac dysrhythmia
  D. Cardiac dysrhythmia

  ---

  (A) Diabetes mellitus is not a common complication of myocardial infarction. (B) Anaphylactic shock is an allergic reaction. (C) Cardiac hypertrophy is a late potential complication. It is a common complication of congestive heart failure. (D) Myocardial infarction causes tissue damage, which may interrupt electrical impulses. Myocardial irritability results from lack of oxygenated tissue.

• Question 280:

  When teaching a class of nursing students, the nurse asks why the embryonic period (weeks 4?) of pregnancy is so critical.

  A. Duplication of genetic information takes place.
  B. Organogenesis occurs.
  C. Subcutaneous fat builds up steadily.
  D. Kidneys begin to secrete urine.
  B. Organogenesis occurs.

  ---

  (A) Duplication of genetic material occurs during the preembryonic period (weeks 1?) following conception. The exact duplication of genetic material is essential for cell differentiation, growth, and biological maintenance of the organism. (B) Weeks 4?, known as the embryonic period, are the time organogenesis occurs and pose the greatest potential for major congenital malformations. All major internal and external organs and systems are formed. (C) Subcutaneous fat does not develop until the latter weeks of gestation. (D) Kidneys begin to secrete urine during the 13th?6th week.