NCLEX NCLEX Certifications NCLEX-RN Questions & Answers

• Question 331:

  A female client was employed as a client care technician in a hemodialysis unit. She recently began to experience extreme fatigue, being able to sleep for 16?0 hours at a time. She also noted that her urine was tea colored, which she rationalized was a result of the vitamins she began taking to alleviate fatigue. She was diagnosed with hepatitis B. After a brief hospital stay, she is discharged to her parent's home. Her mother asks the nurse if any precautions are necessary to prevent transmission to the client's family. The nurse explains necessary precautions, which include:

  A. Isolation of the client from the remainder of the family

  B. Separate bathroom facilities if possible; if not, then cleansing daily of the facilities with a chloride solution

  C. No necessary precautions because she is beyond the contagious phase

  D. Laundering clothes separately in cold water with a chloride solution

  Correct Answer: B

  (A) Isolation is not necessary, even in the acute phase. (B) Separate bathroom facilities are recommended. If unavailable, daily cleansing with a chloride solution is recommended. (C) Precautions continue to be necessary while the client is in the active phase of hepatitis. (D) Clothes are to be laundered separately in hot water with a chloride solution.

• Question 332:

  A 22-year-old client is 16 weeks pregnant. She and her husband are expecting their first baby. The client tells the nurse that her last normal menstrual period was February 16, with 3 days of spotting on February 17, 18, and 19. The nurse calculates her expected date of delivery to be:

  A. November 23rd

  B. December 26th

  C. September 14th

  D. December 9th

  Correct Answer: A

  (A) Naele's rule is as follows: add 7 days to the 1st day of the last menstrual period, subtract 3 months, and then add 1 year. (B) Naele's rule presumes that the woman has a 28-day menstrual cycle, with conception occurring on the 14th day of the cycle. Slight vaginal spotting may occur in early gestation for unknown reasons but is insignificant in the calculation of Naele's rule. (C) Naele's rule presumes that the woman has a 28-day menstrual cycle, with conception occurringon the 14th day of the cycle. Slight vaginal spotting may occur in early gestation for unknown reasons but is insignificant in the calculation of Naele's rule. (D) Naele's rule presumes that the woman has a 28-day menstrual cycle, with conception occurring on the 14thday of the cycle. Slight vaginal spotting may occur in early gestation for unknown reasons but is insignificant in the calculation of Naele's rule.

• Question 333:

  A client is experiencing visual problems at school. She has complained of difficulty seeing the blackboard and squinting. She no longer likes to participate in physical activities such as softball. The client has displayed possible classic symptoms of which refractive error?

  A. Astigmatism

  B. Hyperopia

  C. Myopia

  D. Amblyopia

  Correct Answer: C

  (A) Visual images are blurred and distorted. (B) Symptoms are headaches, burning eyes, fatigue, squinting, and difficulty reading. (C) These symptoms are classic for myopia. (D) Amblyopia is not a refractive error. It is a loss of vision in one or both eyes.

• Question 334:

  A 74-year-old client seen in the emergency room is exhibiting signs of delirium. His family states that he has not slept, eaten, or taken fluids for the past 24 hours. The planning of nursing care for a delirious client is based on which of the following premises?

  A. The delirious client is capable of returning to his previous level of functioning.

  B. The delirious client is incapable of returning to his previous level of functioning.

  C. Delirium entails progressive intellectual and behavioral deterioration.

  D. Delirium is an insidious process.

  Correct Answer: A

  (A) This answer is correct. If the cause is removed, the delirious client will recover completely. (B) This answer is incorrect. The demented client is incapable of returning to previous level of functioning. The delirious client is capable of returning to previous functioning. (C) This answer is incorrect. The demented client, not the delirious client, has progressive intellectual and behavioral deterioration. (D) This answer is incorrect. Delirium develops rapidly, whereas dementia is insidious.

• Question 335:

  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

  Correct Answer: A

  (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 336:

  A postoperative TURP client is ordered continuous bladder irrigations. Later in the evening on the first postoperative day, he complains of increasing suprapubic pain. When assessing the client, the nurse notes diminished flow of bloody urine and several large blood clots in the drainage tubing. Which one of the following should be the initial nursing intervention?

  A. Call the physician about the problem.

  B. Irrigate the Foley catheter.

  C. Change the Foley catheter.

  D. Administer a prescribed narcotic analgesic.

  Correct Answer: B

  (A) The physician should be notified as problems arise, but in this case, the nurse can attempt to irrigate the Foley catheter first and call the physician if irrigation is unsuccessful. Notifying the physician of problems is a subsequent nursing intervention. (B) This answer is correct. Assessing catheter patency and irrigating as prescribed are the initial priorities to maintain continuous bladder irrigation. Manual irrigation will dislodge blood clots that have blocked the catheter and prevent problems of bladder distention, pain, and possibly fresh bleeding. (C) The Foley catheter would not be changed as an initial nursing intervention, but irrigation of the catheter should be done as ordered to dislodge clots that interfere with patency. (D) Even though the client complains of increasing suprapubic pain, administration of a prescribed narcotic analgesic is not the initial priority. The effect of the medication may mask the symptoms of a distended bladder and lead to more serious complications.

• Question 337:

  A 49-year-old obese woman has been admitted to the general surgery unit with choledocholithiasis. As the nurse is admitting her to the unit, she states, "The doctor said I have stones that need to be removed; where are they?" The nurse knows that the best explanation for this is to tell her that:

  A. There are stones present in her gallbladder

  B. There are stones present in her kidneys

  C. There are stones present in her common bile duct

  D. There are no stones, but her gallbladder is irritated and caused her nausea, vomiting, and pain

  Correct Answer: C

  (A)Cholelithiasisis the correct term used to describe the presence of stones in the gallbladder. (B)Nephrolithiasis,orrenal calculi,is the correct term used to describe the presence of stones in the kidney. (C)Choledocholithiasisis the correct term used to describe the presence of stones in the common bile duct. (D)Cholecystitisis the correct term used to describe inflammation of the gallbladder and can be associated with cystic duct obstructions from impacted stones.

• Question 338:

  As a nurse works with an adolescent with cystic fibrosis, the nurse begins to notice that he appears depressed and talks about suicide and feelings of worthlessness. This is an important factor to consider in planning for his care because:

  A. It may be a bid for attention and an indication that more diversionary activity should be planned for him

  B. No threat of suicide should be ignored or challenged in any way

  C. He needs to be observed carefully for signs that his depression has been relieved

  D. He needs to be confronted with his feelings and forced to work through them

  Correct Answer: B

  (A) Threats of suicide should always be taken seriously. (B) This client has a life- threatening chronic illness. He may be concerned about dying or he may actually be contemplating suicide. (C) Sometimes clients who have made the decision to commit suicide appear to be less depressed. (D) Forcing him to look at his feelings may cause him to build a defense against the depression with behavioral or psychosomatic disturbances.

• Question 339:

  A client is diagnosed with diabetic ketoacidosis. The nurse should be prepared to administer which of the following IV solutions?

  A. D5in normal saline

  B. D5W

  C. 0.9 normal saline

  D. D5in lactated Ringer's

  Correct Answer: C

  (A) D5in normal saline would increase serum glucose. (B) D5W would increase serum glucose. (C) A concentration of 0.9 NS is used to correct extracellular fluid depletion. (D) D5in Ringer's lactate would increase serum glucose.

• Question 340:

  A 15-year-old client is admitted to the adolescent unit. The nurse recognizes that encouraging a client to speak openly depends on how clearly questions are phrased. Which of the following statements is most desirable in eliciting information from an adolescent client?

  A. "Do you get along well with your family?"

  B. "Do you communicate with your parents?"

  C. "You don't hate your family, do you?"

  D. "What is it like between you and your family?"

  Correct Answer: D

  (A, B) This statement can be answered with a simple yes or no. (C) This statement is asked in a negative manner and therefore has a negative connotation. (D) This statement is open ended and positively stated.