NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 361:

  The predominant purpose of the first Apgar scoring of a newborn is to:

  A. Determine gross abnormal motor function
  B. Obtain a baseline for comparison with the infant's future adaptation to the environment
  C. Evaluate the infant's vital functions
  D. Determine the extent of congenital malformations
  C. Evaluate the infant's vital functions

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  (A) Apgar scores are not related to the infant's care, but to the infant's physical condition. (B) Apgar scores assess the current physical condition of the infant and are not related to future environmental adaptation. (C) The purpose of the Apgar system is to evaluate the physical condition of the newborn at birth and to determine if there is an immediate need for resuscitation. (D) Congenital malformations are not one of the areas assessed with Apgar scores.

• Question 362:

  Iron dextran (Imferon) is a parenteral iron preparation.

  The nurse should know that it:

  A. Is also called intrinsic factor
  B. Must be given in the abdomen
  C. Requires use of the Z-track method
  D. Should be given SC
  C. Requires use of the Z-track method

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  (A) Intrinsic factor is needed to absorb vitamin B12.(B) Iron dextran is given parenterally, but Z-track in a large muscle. (C) A Ztrack method of injection is required to prevent staining and irritation of the tissue. (D) An SC injection is not deep enough and may cause subcutaneous fat abscess formation.

• Question 363:

  In the coronary care unit, a client has developed multifocal premature ventricular contractions. The nurse should anticipate the administration of:

  A. Furosemide
  B. Nitroglycerin
  C. Lidocaine
  D. Digoxin
  C. Lidocaine

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  (A) Furosemide is a loop diuretic. (B) Nitroglycerin is a vasodilator. (C) Lidocaine is the drug of choice to treat ectopic ventricular beats. (D) Digoxin slows down the electrical impulses and increases ventricular contractions, but it does not rapidly correct ventricular ectopy.

• Question 364:

  A client takes warfarin (Coumadin) 15 mg po daily. To evaluate the medication's effectiveness, the nurse should monitor the:

  A. prothrombin time (PT)
  B. partial thromboplastin time (PTT)
  C. PTT-C
  D. Fibrin split products
  A. prothrombin time (PT)

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  (A) PT evaluates adequacy of extrinsic clotting pathway. Adequacy of warfarin therapy is monitored by PT. (B) PTT evaluates adequacy of intrinsic clotting pathway. Adequacy of heparin therapy is monitored by PTT. (C) There is no such laboratory test. (D) Fibrin split products indicate fibrinolysis. This is a screening test for disseminated intravascular coagulation. Heparin therapy may increase fibrin split products.

• Question 365:

  The initial treatment for a client with a liquid chemical burn injury is to:

  A. Irrigate the area with neutralizing solutions
  B. Flush the exposed area with large amounts of water
  C. Inject calcium chloride into the burned area
  D. Apply lanolin ointment to the area
  B. Flush the exposed area with large amounts of water

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  (A) In the past, neutralizing solutions were recommended, but presently there is concern that these solutions extend the depth of burn area. (B) The use of large amounts of water to flush the area is recommended for chemical burns. (C) Calcium chloride is not recommended therapy and would likely worsen the problem. (D) Lanolin is of no benefit in the initial treatment of a chemical injury and may actually extend a thermal injury.

• Question 366:

  A 17-year-old pregnant client who is gravida 1, para 0, is at 36 weeks' gestation. Based on the nurse's knowledge of the maternal physiological changes in pregnancy, which of these findings would be of concern?

  A. Complaints of dyspnea
  B. Edema of face and hands
  C. Pulse of 65 bpm at 8 weeks, 73 bpm at 36 weeks
  D. Hematocrit 39%
  B. Edema of face and hands

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  (A) Dyspnea is a common complaint during the third trimester owing to the increasing size of the uterus and the resulting pressure against the diaphragm. (B) Edema of the face, hands, or pitting edema after 12 hours of bed rest may be indicative of preeclampsia and would be of great concern to the healthcare provider. (C) An increase in heart rate of 10?5 bpm is a normal physiological change in pregnancy due to the multiple hemodynamic changes. (D) A hematocrit value of 39% is within the normal range. A value <35% would indicate anemia.

• Question 367:

  Which of the following lab data is representative of a client with aplastic anemia?

  A. Hemoglobin 9.2, hematocrit 27, red blood cells 3.2 million
  B. White blood cells 4000, erythrocytes 2.5 million, thrombocytes 100,000
  C. White blood cells 3000, hematocrit 27, red blood cells 2.8 million
  D. Red blood cells 1 million, white blood cells 1500, thrombocytes 16,000
  D. Red blood cells 1 million, white blood cells 1500, thrombocytes 16,000

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  (A, B, C) Although all of the lab data are abnormal and although these values are decreased in aplastic anemia, the disorder is defined by severe deficits in red cell, white cell, and platelet counts. (D) Aplastic anemia is typically defined in terms of abnormalities of red blood cell count, usually <1 million, white cell count <2,000, and thrombocytes <20,000.

• Question 368:

  A male client is admitted to the psychiatric unit after experiencing severe depression. He states that he intends to kill himself, but he asks the nurse not to repeat his intentions to other staff members. Which response demonstrates understanding and appropriate action on the part of the nurse?

  A. "I understand you're depressed, but killing yourself is not a reasonable option."
  B. "We need to discuss this further, but right now let's complete these forms."
  C. "Don't do that, you have so much to live for. You have a wonderful wife and children. The client in the next room has no one."
  D. "This is very serious. I do not want any harm to come to you. I will have to report this to the rest of the staff."
  D. "This is very serious. I do not want any harm to come to you. I will have to report this to the rest of the staff."

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  (A) To the client, suicide may be a reasonable action and the only one he can cope with at this time. (B) This response indicates to the client that his intention to commit suicide is not important to the nurse at this time. (C) The client is so depressed that he is not able to see the positive aspects of his life. At no time should the nurse discuss another client's problems in conversation. (D) This statement tells the client that the nurse recognizes his problem is of a serious nature and will take all steps necessary to help him.

• Question 369:

  A 33-year-old client was brought into the emergency room unconscious, and it is determined that surgery is needed. Informed consent must be obtained from his next of kin. The sequence in which the next of kin would be asked for the consent would be:

  A. Parent, spouse, adult child, sibling
  B. Spouse, adult child, parent, sibling
  C. Spouse, parent, sibling, adult child
  D. Parent, spouse, sibling, adult child
  B. Spouse, adult child, parent, sibling

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  (A) Spouse and adult child would be asked before a parent. (B) The order of kin relationship for an adult, as determined from legal intestate succession, is usually spouse, adult child, parent, sibling. (C) Parent and sibling would be asked after adult child. (D) Spouse and adult child would be asked before parent. Sibling would be asked last.

• Question 370:

  Parents should be taught not to prop the bottle when feeding their infants. In addition to the risk of choking, it puts the infant at risk for:

  A. Otitis media
  B. Asthma
  C. Conjunctivitis
  D. Tonsillitis
  A. Otitis media

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  (A) Because the eustachian tube is short and straight in the infant, formula that pools in the back of the throat attacks bacteria which can enter the middle ear and cause an infection. (B) Asthma is not associated with propping the bottle. (C) Conjunctivitis is an eye infection and not associated with propping the bottle. (D) Tonsillitis is usually a result of pharyngitis and not propping the bottle.