NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 341:

  When assessing residual volume in tube feeding, the feeding should be delayed if the amount of gastric contents (residual) exceeds:

  A. 20 mL
  B. 25 mL
  C. 30 mL
  D. 50 mL
  D. 50 mL

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  (A) A residual volume of 20 mL is not excessive. (B) A residual volume of 25 mL is not excessive. (C) A residual volume of 30 mL is not excessive. (D) Tube feedings should be withheld and physician notified for residual volumes of 50?00 mL.

• Question 342:

  A pregnant client continues to visit the clinic regularly during her pregnancy. During one of her visits while lying supine on the examining table, she tells the RN that she is becoming light-headed. The RN notices that the client has pallor in her face and is perspiring profusely.

  The first intervention the RN should initiate is to:

  A. Place the examining table in the Trendelenburg position
  B. Assess the client to see if she is having vaginal bleeding
  C. Obtain the client's vital signs immediately
  D. Help the client to a sitting position
  D. Help the client to a sitting position

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  (A) This position would cause the gravid uterus to bear the increased pressure of the vena cava, which could lead to maternal hypotension, in turn causing the client to continue to have pallor and to feel light-headed. (B) This would not be the first intervention the RN should initiate. TheRN should understand the supine position and its effect on the gravid uterus and vena cava. (C) The RN's first intervention should be one that helps to alleviate the client's symptoms. Obtaining her vital signs will not alleviate her symptoms. (D) This would move the gravid uterus off of the client's vena cava, which would alleviate the maternal hypotension that is the cause of her symptoms.

• Question 343:

  The nurse instructs a pregnant client (G2P1) to rest in a side-lying position and avoid lying flat on her back. The nurse explains that this is to avoid "vena caval syndrome," a condition which:

  A. Occurs when blood pressure increases sharply with changes in position
  B. Results when blood flow from the extremities is blocked or slowed
  C. Is seen mainly in first pregnancies
  D. May require medication if positioning does not help
  B. Results when blood flow from the extremities is blocked or slowed

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  (A) Blood pressure changes are predominantly due to pressure of the gravid uterus. (B) Pressure of the gravid uterus on the inferior vena cava decreases blood return from lower extremities. (C) Inferior vena cava syndrome is experienced in the latter months of pregnancy regardless of parity. (D) There are no medications useful in the treatment of interior vena cava syndrome; alleviating pressure by position changes is effective.

• Question 344:

  A 48-year-old male client is hospitalized with mild ascites, bruising, and jaundice. He has a 20-year history of alcohol abuse. The client is diagnosed with cirrhosis. His serum ammonia level is high, indicating hepatic encephalopathy. He has esophageal varices. Which of the following may cause the varices to rupture?

  A. Lifting heavy objects
  B. Walking briskly
  C. Ingestion of barbiturates
  D. Ingestion of antacids
  A. Lifting heavy objects

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  (A) Lifting heavy objects will increase intrathoracic pressure, thus placing the client at risk for rupturing esophageal varices. (B, C, D) This activity will not cause an increase in intrathoracic pressure.

• Question 345:

  The FHR pattern in a laboring client begins to show early decelerations. The nurse would best respond by:

  A. Notifying the physician
  B. Changing the client to the left lateral position
  C. Continuing to monitor the FHR closely
  D. Administering O2 at 8 L/min via face mask
  C. Continuing to monitor the FHR closely

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  (A) Early decelerations are reassuring and do not warrant notification of the physician. (B) Because early decelerations is a reassuring pattern, it would not be necessary to change the client's position. (C) Early decelerations warrant the continuation of close FHR monitoring to distinguish them from more ominous signs. (D) O2 is not warranted in this situation, but it is warranted in situations involving variable and/or late decelerations.

• Question 346:

  To prevent thrombophlebitis in a client on complete bed rest, the nursing care plan should include:

  A. Dangle the client's legs over the edge of the bed every shift.
  B. Massage the client's calves briskly every shift.
  C. Keep the client's legs extended and discourage any movement.
  D. Have the client tighten and relax leg muscles several times daily.
  D. Have the client tighten and relax leg muscles several times daily.

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  (A) Dangling the client's legs over the edge of the bed will contribute to stasis and pooling of blood and increases the risk of thrombus formation. (B) Massaging the client's calves could result in dislodging an embolus. (C) Decreased movement will contribute to pooling of blood and increased risk of venous thrombosis. (D) Tightening and relaxing leg muscles increases circulation and decreases the risk of venous thrombosis.

• Question 347:

  The physician prescribes phenytoin (Dilantin) for a client with seizure disorders. Phenytoin can only be mixed with which of the following solutions?

  A. Ringer's lactate
  B. D5 in water
  C. D5 with Ringer's lactate
  D. Normal saline
  D. Normal saline

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  (A) Phenytoin will precipitate if mixed with Ringer's lactate and should not be administered. (B, C) Phenytoin will precipitate if mixed with D5 in Ringer's lactate and should not be administered. (D) Phenytoin is compatible only with normal saline and should be mixed only with normal saline for administration.

• Question 348:

  A client delivered a stillborn male at term. An appropriate action of the nurse would be to:

  A. State, "You have an angel in heaven."
  B. Discourage the parents from seeing the baby.
  C. Provide an opportunity for the parents to see and hold the baby for an undetermined amount of time.
  D. Reassure the parents that they can have other children.
  C. Provide an opportunity for the parents to see and hold the baby for an undetermined amount of time.

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  (A) This is not a supportive statement. There are also no data to indicate the family's religious beliefs. (B) Seeing their baby assists the parents in the grieving process. This gives them the opportunity to say "good-bye." (C) Parents need time to get to know their baby. (D) This is not a comforting statement when a baby has died. There are also no guarantees that the couple will be able to have another child.

• Question 349:

  A female client at 10 weeks' gestation complains to her physician of slight vaginal bleeding and mild cramps. On examination, her physician determines that her cervix is closed. The client is exhibiting signs of:

  A. An inevitable abortion
  B. A threatened abortion
  C. An incomplete abortion
  D. A missed abortion
  B. A threatened abortion

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  (A) An inevitable abortion includes the signs of cervical dilation and effacement as well as pain and bleeding. (B) A threatened abortion is a condition in which intrauterine bleeding occurs early in pregnancy, the cervix remains undilated, and the uterine contents are not necessarily expelled. (C) An incomplete abortion occurs when some portions of the products of conception are expelled from the uterus. (D) A missed abortion occurs when the embryo dies in utero and is retained in the uterus.

• Question 350:

  Which of the following should be included in discharge teaching for a client with hepatitis C?

  A. He should take aspirin as needed for muscle and joint pain.
  B. He may become a blood donor when his liver enzymes return to normal.
  C. He should avoid alcoholic beverages during his recovery period.
  D. He should use disposable dishes for eating and drinking.
  C. He should avoid alcoholic beverages during his recovery period.

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  (A) Aspirin is hepatotoxic, may increase bleeding, and should be avoided. (B) Blood should not be donated by a client who has had hepatitis C because of the possibility of transmission of disease. (C) Alcohol is detoxified in the liver. (D) Hepatitis C is not spread through the oral route.