NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 331:

  A 52-year-old client's abdominal aortic aneurysm ruptured. She received rapid massive blood transfusions for bleeding. One potential complication of blood administration for which she is especially at risk is:

  A. Air embolus
  B. Circulatory overload
  C. Hypocalcemia
  D. Hypokalemia
  C. Hypocalcemia

  ---

  (A) Air embolism is a potential complication of blood administration, but it is fairly rare and can be prevented by using good IV technique. (B) Circulatory overload is a potential complication of blood administration, but because this client is actively bleeding, she is not at high risk for overload. (C) Hypocalcemia is a potential complication of blood administration that occurs in situations where massive transfusion has occurred over a short period of time. It occurs because the citrate in stored blood binds with the client's calcium. Another potential complication for which this client is especially at risk is hypothermia, which can be prevented by using a blood warmer to administer the blood. (D) Hypokalemia is not a complication of blood administration.

• Question 332:

  A female client plans to bottle-feed her newborn. Her physician has ordered bromocriptine (Parlodel) to suppress lactation. Which of the following instructions about bromocriptine should be given by the nurse?

  A. Bromocriptine stimulates the production of prolactin.
  B. Hypertension is a primary side effect.
  C. Bromocriptine is generally taken for 5 days.
  D. Her blood pressure must be stable before starting bromocriptine.
  D. Her blood pressure must be stable before starting bromocriptine.

  ---

  (A) Bromocriptine inhibits the secretion of prolactin. (B) Hypotension is a side effect of this drug; hypertension is not. (C) Bromocriptine is generally taken for 14 days. (D) The administration of bromocriptine is delayed at least 4 hours postpartum and given only when the client's blood pressure is stable, because it can cause hypotension and syncope.

• Question 333:

  The health team needs to realize that the compulsive concern with cleanliness that a client with severe anxiety exhibits is most likely an attempt to:

  A. Reduce his anxiety
  B. Avoid going to psychotherapy
  C. Manipulate the health team members
  D. Increase his self-image by showing higher standards than the fellow clients
  A. Reduce his anxiety

  ---

  (A) These behaviors are attempts to relieve anxiety. (B) Avoidance is not a pattern in the obsessive client. (C) Although these behaviors may seem to manipulate others, that is not the purpose behind the activity. (D) Inflated self-esteem is not a characteristic of the severely anxious client.

• Question 334:

  A male client is being treated in the burn unit for thirddegree burns on his head, neck, and upper chest received in the last 24 hours. The nurse is evaluating the effectiveness of fluid resuscitation. Which of the following indicates effective fluid balance?

  A. His weight increases from 165 to 175 lb.
  B. His urine output is equal to his total fluid intake.
  C. His urine output has been>35 mL/hr for the past 12 hours.
  D. His blood pressure is 94/62.
  C. His urine output has been>35 mL/hr for the past 12 hours.

  ---

  (A) A weight gain of 10 lb represents a state of overhydration. (B) He is losing fluids through insensible losses; a urine output equal to his intake indicates that he is receiving too little fluids. (C) A urine output greater than his intake indicates that he is receiving adequate fluid resuscitation to account for urinary and insensible losses. (D) A blood pressure of 94/62 indicates a state of underhydration and inadequate circulatory volume.

• Question 335:

  A client on the infectious disease unit is discussing transmission of human immunodeficiency virus (HIV).

  The nurse would need to provide more client education based on which client statement?

  A. "HIV is a virus transmitted by sexual contact."
  B. "Condoms reduce the transmission of HIV."
  C. "HIV is a virus that is easily transmitted by casual contact."
  D. "HIV can be transmitted to an unborn infant."
  C. "HIV is a virus that is easily transmitted by casual contact."

  ---

  (A) HIV is transmitted through unprotected sexual contact. (B) Condoms are an effective barrier to prevent HIV transmission. (C) HIV is not easily transmitted by casual contact. (D) HIV can be transmitted intrauterinely at the time of delivery, and by breast-feeding.

• Question 336:

  A 17-year-old client has a T-4 spinal cord injury. At present, he is learning to catheterize himself. When he says, "This is too much trouble. I would rather just have a Foley.'' An appropriate response for the RN teaching him would be:

  A. "I know. It is a lot to learn. In the long run, though, you will be able to reduce infections if you do an intermittent catheterization program.''
  B. "It is not too much trouble. This is the best way to manage urination.''
  C. "OK. I'll ask your physician if we can replace the Foley.''
  D. "You need to learn this because your doctor ordered it.''
  A. "I know. It is a lot to learn. In the long run, though, you will be able to reduce infections if you do an intermittent catheterization program.''

  ---

  (A) This response acknowledges the client's feelings, gives him factual information, and acknowledges that the final decision is his. (B) This response is judgmental and discourages the client from expressing his feelings about the procedure.

  (C) Catheterization is a procedure thattakes time to learn, but which, for the spinal cord璱njured client, can significantly reduce the incidence of urinary tract infections. A young client with a T-4 injury has the hand function to learn this procedure fairly easily. (D) The final decision about bladder elimination management ultimately rests with the client and not the physician.

• Question 337:

  A client with severe PIH receiving MgSO4 is placed in a quiet, darkened room. The nurse bases this action on the following understanding:

  A. The client is restless.
  B. The elevated blood pressure causes photophobia.
  C. Noise or bright lights may precipitate a convulsion.
  D. External stimuli are annoying to the client with PIH.
  C. Noise or bright lights may precipitate a convulsion.

  ---

  (A) The client may be anxious and hyperresponsive to stimuli but not necessarily restless. (B) This is not a physiological response to an elevated blood pressure in PIH. (C) The nurse must know the nursing measures that decrease the potential for convulsions. A quiet, darkened room decreases stimuli and promotes rest. (D) External stimuli might induce a convulsion but are not annoying to the client with PIH.

• Question 338:

  A child sustains a supracondylar fracture of the femur. When assessing for vascular injury, the nurse should be alert for the signs of ischemia, which include:

  A. Bleeding, bruising, and hemorrhage
  B. Increase in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase
  C. Pain, pallor, pulselessness, paresthesia, and paralysis
  D. Generalized swelling, pain, and diminished functional use with muscle rigidity and crepitus
  C. Pain, pallor, pulselessness, paresthesia, and paralysis

  ---

  (A) Bleeding, bruising, and hemorrhage may occur due to injury but are not classic signs of ischemia. (B) An increase in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase is related to the disruption of muscle

  integrity. (C) Classic signs of ischemia related to vascular injury secondary to long bone fractures include the five "P's":

  pain, pallor, pulselessness, paresthesia, and paralysis. (D) Generalized swelling, pain, and diminished functional use with muscle rigidity and crepitus are common clinical manifestations of a fracture but not ischemia.

• Question 339:

  A client is hyperactive and not sleeping. She will not remain at the table during mealtime. She is getting very limited calories and is using a lot of energy in her hyperactive state. The most therapeutic nursing action is to:

  A. Insist that she remain at the table and eat a balanced diet.
  B. Order a high-calorie diet with supplements.
  C. Provide nutritious finger foods several times a day.
  D. Offer to go to the dining room with her and allow her to open the food and inspect what she eats.
  C. Provide nutritious finger foods several times a day.

  ---

  (A) The client is not able to sit for long periods. Forcing her to remain at the table will increase her anxiety and cause her to become hostile. (B) This action will not ensure that the client eats what is ordered. Dietary orders are not within the nurse's scope of practice. (C) Providing finger foods increases the likelihood of eating for hyperactive persons. They may be eating "on the run." (D) These clients are not suspicious of the food or insecure in moving about the unit alone.

• Question 340:

  The most commonly known vectors of Lyme disease are:

  A. Mites
  B. Fleas
  C. Ticks
  D. Mosquitoes
  C. Ticks

  ---

  (A) Mites are not the common vector of Lyme disease. (B) Fleas are not the common vector of Lyme disease. (C) Ticks are the common vector of Lyme disease. (D) Mosquitoes are not the common vector of Lyme disease.