NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 301:

  In evaluating the laboratory results of a client with severe pressure ulcers, the nurse finds that her albumin level is low. A decrease in serum albumin would contribute to the formation of pressure ulcers because: A. The proteins needed for tissue repair are diminished.

  B. The iron stores needed for tissue repair are inadequate.
  C. A decreased serum albumin level indicates kidney disease.
  D. A decreased serum albumin causes fluid movement into the blood vessels, causing dehydration.
  A

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  (A) Serum albumin levels indicate the adequacy of protein stores available for tissue repair. (B) Serum albumin does not measure iron stores. (C) Serum albumin levels do not measure kidney function. (D) A decreased serum albumin level would cause fluid movement out of blood vessels, not into them.

• Question 302:

  A 25-year-old outpatient presents with a diagnosis of compulsive personality disorder. His coworkers become annoyed with his rigid, perfectionistic manner and preoccupation with trivial details and schedules. A nursing intervention appropriate for this client would include:

  A. Encouraging him to engage in recreational activities
  B. Avoiding discussion of his annoying behavior
  C. Encouraging the client to set a time schedule and deadlines for himself
  D. Contracting with him for the amount of time he will spend on the compulsive behaviors
  D. Contracting with him for the amount of time he will spend on the compulsive behaviors

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  (A) This answer is incorrect. The client will work hard at the activity instead of enjoying it. (B) This answer is incorrect. The nurse should allow the client to discuss these thoughts, within limits, not to avoid discussing them. (C) This answer is incorrect. The compulsive client tends to control time to excess. It should not be encouraged. (D) This answer is correct. A contract with the client regarding the amount of time that will be spent discussing the compulsive activities is appropriate. Time allotted should be gradually decreased.

• Question 303:

  The following medications were noted on review of the client's home medication profile. Which of the medications would most likely potentiate or elevate serum digoxin levels?

  A. KCl
  B. Thyroid agents
  C. Quinidine
  D. Theophylline
  C. Quinidine

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  (A) Hypokalemia can cause digoxin toxicity. Administration of KCl would prevent this. (B) Thyroid agents decrease digoxin levels. (C) Quinidine increases digoxin levels dramatically. (D) Theophylline is not noted to have an effect on digoxin levels.

• Question 304:

  A 37-year-old client has been taking antipsychotic medication for the past 10 days. The nurse observes her walking with a shuffling gait and postural rigidity and notes a masklike expression on her face. Which side effect is this client exhibiting?

  A. Dystonia
  B. Parkinsonism
  C. Tardive dyskinesia
  D. Akathesia
  B. Parkinsonism

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  (A) This answer is incorrect. Dystonia refers to severe, painful muscle contractions. (B) This answer is correct. Parkinsonism commonly occurs approximately 1? weeks after initiation of antipsychotic drug therapy. Traditional signs are masklike facies, postural rigidity, shuffling gait, and resting tremor. (C) This answer is incorrect. Tardive dyskinesia is characterized by involuntary muscle movements of the face, jaw, and tongue. (D) This answer is incorrect. Akathesia is motor restlessness.

• Question 305:

  To ensure proper client education, the nurse should teach the client taking SL nitroglycerin to expect which of the following responses with administration?

  A. Stinging, burning when placed under the tongue
  B. Temporary blurring of vision
  C. Generalized urticaria with prolonged use
  D. Urinary frequency
  A. Stinging, burning when placed under the tongue

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  (A) Stinging or burning when nitroglycerin is placed under the tongue is to be expected. This effect indicates that the medication is potent and effective for use. Failure to have this response means that the client needs to get a new bottle of nitroglycerin. (B, C, D) The other responses are not expected in this situation and are not even side effects.

• Question 306:

  A 4-week-old infant is admitted to the emergency room in respiratory distress. Which of the following statements indicates the nurse's knowledge of the anatomy of the respiratory system in pediatric clients?

  A. The diameter of the trachea is much smaller in children than in adults.
  B. The tongue is proportionally smaller in children than in adults.
  C. The pediatric airway is more rigid than that of the adults.
  D. The length of the pediatric airway is longer in children than in adults.
  A. The diameter of the trachea is much smaller in children than in adults.

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  (A)

  The airway in children is much smaller than it is in adults. The diameter of the trachea in the newborn is 4 mm and that of the adult is 20 mm. A small change in the diameter of the airway can make a major difference in the pediatric client.

  (B)

  The tongue is proportionally larger in children and fills most of the oral cavity, thereby decreasing air space. (C) The entire pediatric airway is elastic. Elasticity diminishes with age, however. (D) The distances between respiratory structures are shorter than that of adults, and therefore organisms are able to move more rapidly down the throat, leading to more extensive respiratory involvement.

• Question 307:

  A female client admitted to the labor and delivery unit thinks her bag of water "broke" approximately 2 hours ago. She is having mild contractions 5 minutes apart. The most immediate nursing intervention would be to:

  A. Note the color and amount of fluid on her clothes.
  B. Assess the FHR.
  C. Notify the physician.
  D. Place the nitrazine test paper at the cervical os and note the color change.
  B. Assess the FHR.

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  (A)

  Amniotic fluid is generally pale and straw colored. Meconium- stained amniotic fluid would indicate a previous hypoxic episode. This intervention, though appropriate, is not the immediate priority. (B) With rupture of the membranes, the umbilical cord may prolapse if the presenting part does not fill the pelvis. Assessing FHR ascertains fetal well-being. (C) More information regarding fetal status and assessing for membrane rupture is needed prior to contacting the physician.

  (D)

  Nitrazine test paper differentiates amniotic fluid from urine. Amniotic fluid is normally alkaline in contrast to urine, which is acidic. This intervention, though appropriate, is not the immediate priority.

• Question 308:

  A 4-year-old boy is brought to the emergency room with bruises on his head, face, arms, and legs. His mother states that he fell down some steps. The nurse suspects that he may have been physically abused. In accordance with the law, the nurse must:

  A. Tell the physician her concerns
  B. Report her suspicions to the authorities
  C. Talk to the child's father
  D. Confront the child's mother
  B. Report her suspicions to the authorities

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  (A) Although the nurse probably would talk to the physician about these concerns, the nurse is not required by law to do so. (B) All healthcare workers are required by the Federal Child Abuse Prevention and Treatment Act of 1974 to report suspected and actual cases of child abuse and/or neglect. (C) Talking to the child's father may or may not help the child, and the nurse is not required by law to do so. (D) Confrontation may not be indicated; the nurse is not required by law to confront the child's mother with these suspicions.

• Question 309:

  In assessing the nature of the stool of a client who has cystic fibrosis, what would the nurse expect to see?

  A. Clay-colored stools
  B. Steatorrhea stools
  C. Dark brown stools
  D. Blood-tinged stools
  B. Steatorrhea stools

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  (A) Clay-colored stools indicate dysfunction of the liver or biliary tract. (B) In the early stages of cystic fibrosis, fat absorption is primarily affected resulting in fat, foul, frothy, bulky stools. (C) Dark brown stools indicate normal passage through the colon. (D) Blood-tinged stools indicate dysfunction of the gastrointestinal (GI) tract.

• Question 310:

  A client suspected of having anorexia nervosa is placed on bed rest with an IV infusion and a high-carbohydrate liquid diet. Within 72 hours, the results of her lab work show a return to normal limits. She is transferred to the psychiatric service for further treatment. A behavior modification plan is initiated. Three days after her transfer, the client tells the nurse, "I haven't exercised in 6 days. I won't be eating lunch today." This statement by her most likely reflects:

  A. Her lack of internal awareness about the outcome of the behavior
  B. Increased knowledge about personal exercise plans
  C. A manipulative technique to trick the nurse into allowing her to miss a meal
  D. A true desire to stay fit while in the hospital
  A. Her lack of internal awareness about the outcome of the behavior

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  (A) Indirect self-destructive behavior such as that seen in anorexia nervosa is characterized by the client's lack of insight and the awareness that the outcome of the dieting, exercising, and weight loss will ultimately result in death if uninterrupted. (B) Although the client is knowledgeable about exercise, knowledge about the balance between nutrition, exercise, and rest is absent. (C) The client's level of denial and lack of awareness disallow this behavior as a manipulative trick. (D) The client's illness-maintaining behaviors are inconsistent with fitness.