NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 371:

  The most important goal in the care plan for a child who was hospitalized with an accidental overdose would be to:

  A. Determine child's activity pattern
  B. Reduce mother's sense of guilt
  C. Instruct parents in use of ipecac
  D. Teach parents appropriate safety precautions
  D. Teach parents appropriate safety precautions

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  (A) This goal is not the most important. (B) There is always some guilt when an accident occurs; however, the priority is to be sure future accidents are prevented. (C) Ipecac is not used for caustic alkali and acid ingestions. (D) Determining the parent's knowledge about safety hazards and teaching appropriate preventive measures are likely to prevent recurrence of accidents.

• Question 372:

  Diabetes mellitus is a disorder that affects 3.1 out of every 1000 children younger than 20 years old. It is characterized by an absence of, or marked decrease in, circulating insulin. When teaching a newly diagnosed diabetes client, the nurse includes information on the functions of insulin:

  A. Transport of glucose into body cells and storage of glycogen in the liver
  B. Glycogenolysis and facilitation of glucose use for energy
  C. Glycogenolysis and catabolism
  D. Catabolism and hyperglycemia
  A. Transport of glucose into body cells and storage of glycogen in the liver

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  (A) Lack of insulin causes glycogenolysis, catabolism, and hyperglycemia. (B) Insulin promotes the conversion of glucose to glycogen for storage and regulates the rate at which carbohydrates are used by cells for energy. (C) Insulin is anabolic in nature. (D) Glucose stimulates protein synthesis within the tissue and inhibits the breakdown of protein into amino acids.

• Question 373:

  A 40-year-old client has lived for 8 years with an abusive spouse. She married her husband in her senior year of high school after becoming pregnant. Shortly after the baby was born, he began to physically abuse her. She has attempted to leave him several times, but she has always returned. She is unable to support herself financially, and her husband threatens to kill her if she leaves him. This time, her husband has beaten her so badly she cannot stop the bleeding from the gash above her eye. She admits her husband caused her injury. In assessing a person after experiencing spousal abuse, which need has the highest priority?

  A. Assess the level of anxiety, coping responses, and support systems.
  B. Assess the history of physical abuse.
  C. Assess suicide potential.
  D. Assess drug and alcohol use.
  C. Assess suicide potential.

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  (A) Assessing the level of anxiety, coping responses, and support systems is very important, but not of highest priority at this time. (B) A history of physical abuse is an important part of assessment. The nurses must also always ask if there is abuse of the children. (C) Although all of these answers are very important in assessment, the highest priority is assessment of suicide potential, because this could cause the greatest harm to the client. Feeling there is no other way out, abused spouses may consider suicide. (D) The spouse may be self-medicating herself with alcohol or drugs to escape an awful situation. The abuser may also be abusing drugs or alcohol. If this is so, the nurse should encourage the spouse to seek counseling and not to return to the home.

• Question 374:

  Seven days ago, a 45-year-old female client had an ileostomy. She is self-sufficient and well otherwise. Which of the following long-term objectives would be unrealistic?

  A. She should be able to control evacuation of her bowels.
  B. She should be able to return to a regular diet.
  C. She should be able to resume sexual activity.
  D. She should be able to manage her own care.
  A. She should be able to control evacuation of her bowels.

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  (A) Because of the location of an ileostomy, the client will not be able to control the evacuation of her bowels. The ileostomy will drain liquid stool continuously. (B) The client should be able to return to a normal, well-balanced diet. She should avoid foods that cause diarrhea or excessive gas production, and she should eat small meals. (C) The client should be able to resume sexual activity. She will be able to wear a pouch. (D) The client has no other health or mental problems and should be able to manage her own ileostomy.

• Question 375:

  A female client presents to the obstetric-gynecology clinic for a pregnancy test, the result which turns out to be positive. Her last menstrual period began December 10, 1993. Using N鋑ele's rule, the nurse estimates her date of delivery to be:

  A. September 17, 1994
  B. September 10, 1994
  C. September 3, 1994
  D. August 17, 1994
  A. September 17, 1994

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  (A) According to N鋑ele's rule, the estimated date of delivery is calculated by adding 7 days to the date of the first day of the normal menstrual period (December 10 + 7 days = December 17), and then by counting back 3 months (December 17 -3 mo = September 17). (B, C, D) These answers are incorrect.

• Question 376:

  A mother who is breast-feeding her newborn asks the RN, "How can I express milk from my breasts manually?" The RN tells her that the correct method for manual milk expression includes using the thumb and the index finger to: A. Alternately compress and release each nipple

  B. Roll the nipple and gently pull the nipple forward
  C. Slide the thumb and index finger forward from the outer border of the areola toward the end of the nipple
  D. Compress and release each breast at the outer border of the areola
  D. Compress and release each breast at the outer border of the areola

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  (A) Manipulation of nipples will cause soreness and trauma. (B) Pulling the nipples will cause discomfort and soreness. (C) Sliding the thumb and index finger forward over the nipple will cause soreness. (D) The best method to express milk from the breast is to position the thumb and index finger at the outer border of the areola and compress. This is the location of the milk sinuses.

• Question 377:

  With a geriatric client, the nurse should also assess whether he has been obtaining a yearly vaccination against influenza. Why is this assessment important?

  A. Influenza is growing in our society.
  B. Older clients generally are sicker than others when stricken with flu.
  C. Older clients have less effective immune systems.
  D. Older clients have more exposure to the causative agents.
  C. Older clients have less effective immune systems.

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  (A) Although influenza is common, the elderly are more at risk because of decreased effectiveness of their immune system, not because the incidence is increasing. (B) Older clients have the same degree of illness when stricken as other populations. (C) As people age, their immune system becomes less effective, increasing their risk for influenza. (D) Older clients have no more exposure to the causative agents than do school-age children, for example.

• Question 378:

  A 48-year-old client is being seen in her physician's office for complaints of indigestion, heartburn, right upper quadrant pain, and nausea of 4 days' duration, especially after meals. The nurse realizes that these symptoms may be associated with cholecystitis and therefore would check for which specific sign during the abdominal assessment?

  A. Cullen's sign
  B. Rebound tenderness
  C. Murphy's sign
  D. Turner's sign
  C. Murphy's sign

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  (A) This sign is a faint blue discoloration around the umbilicus found in clients who have hemorrhagic pancreatitis. (B) This sign indicates areas of inflammation within the peritoneum, such as with appendicitis. It is a deep palpation technique used on a nontender area of the abdomen, and when the palpating hand is removed suddenly, the client experiences a sharp, stabbing pain at an area of peritoneal inflammation. (C) This sign is considered positive with acute cholecystitis when the client is unable to take a deep breath while the right upper quadrant is being deeply palpated. The client will elicit a sudden, sharp gasp, which means the gallbladder is acutely inflamed. (D) This is a sign of acute hemorrhagic pancreatitis and manifests as a green or purple discoloration in the flanks.

• Question 379:

  Which of the following findings would be abnormal in a postpartal woman?

  A. Chills shortly after delivery
  B. Pulse rate of 60 bpm in morning on first postdelivery day
  C. Urinary output of 3000 mL on the second day after delivery
  D. An oral temperature of 101F (38.3C) on the third day after delivery
  D. An oral temperature of 101F (38.3C) on the third day after delivery

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  (A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a nervous response or to vasomotor changes. If not followed by a fever, it is clinically innocuous. (B) The pulse rate during the immediate postpartal period may be low but presents no cause for alarm. The body attempts to adapt to the decreased pressures intra-abdominally as well as from the reduction of blood flow to the vascular bed. (C) Urinary output increases during the early postpartal period (12?4 hours) owing to diuresis. The kidneys must eliminate an estimated 2000?000 mL of extracellular fluid associated with a normal pregnancy. (D) A temperature of 100.4F (38C) may occur after delivery as a result of exertion and dehydration of labor. However, any temperature greater than 100.4F needs further investigation to identify any infectious process.

• Question 380:

  A 4-year-old child has Down syndrome. The community health nurse has coordinated a special preschool program. The nurse's primary goal is to:

  A. Provide respite care for the mother
  B. Facilitate optimal development
  C. Provide a demanding and challenging educational program
  D. Prepare child to enter mainstream education
  B. Facilitate optimal development

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  (A) Respite care for the family may be needed, but it is not the primary goal of a preschool program. (B) Facilitation of optimal growth and development is essential for every child. (C) A demanding and challenging educational program may predispose the child to failure. Children with retardation should begin with simple and challenging educational programs. (D) Mental retardation associated with Down syndrome may not permit mainstream education. A preschoolprogram's primary goal is not preparation for mainstream education but continuation of optimal development.