NCLEX NCLEX Certifications NCLEX-RN Questions & Answers

• Question 381:

  Parents of young children often need anticipatory guidance from the nurse. Parents may have little knowledge regarding growth and development. Which of the following toys and activities would the nurse suggest as appropriate for a toddler?

  A. Cutting, pasting, string beads, music, dolls

  B. Mobiles, rattle, squeeze toys

  C. Pull-toys, large ball, dolls, sand and water play, music

  D. Simple card games, puzzles, bicycle, television

  Correct Answer: C

  (A) These activities are suited for the preschool-age child (3? years old). The activities are not safe for a toddler. (B) Infants (0? year) like these toys. (C) These activities provide the toddler (1? years old) with a variety of physical activities for play. (D) The toddler lacks the physical and cognitive abilities for these activities. The tasks are far better suited for the school-age child.

• Question 382:

  When teaching a class of nursing students, the nurse asks why the embryonic period (weeks 4?) of pregnancy is so critical.

  A. Duplication of genetic information takes place.

  B. Organogenesis occurs.

  C. Subcutaneous fat builds up steadily.

  D. Kidneys begin to secrete urine.

  Correct Answer: B

  (A) Duplication of genetic material occurs during the preembryonic period (weeks 1?) following conception. The exact duplication of genetic material is essential for cell differentiation, growth, and biological maintenance of the organism. (B) Weeks 4?, known as the embryonic period, are the time organogenesis occurs and pose the greatest potential for major congenital malformations. All major internal and external organs and systems are formed. (C) Subcutaneous fat does not develop until the latter weeks of gestation. (D) Kidneys begin to secrete urine during the 13th?6th week.

• Question 383:

  Nursing care for the parents of a child with a congenital heart defect would include:

  A. Encouraging the parents not to tell the child about the seriousness of the congenital heart defect, so the child will function as normally as possible

  B. Acknowledging the fear and concern surrounding their child's health and assisting the parents through the grieving process as they mourn the loss of their fantasized healthy child

  C. Identifying anger and resentment as destructive emotions that serve no purpose

  D. Expressing to the parents after the corrective surgery has been completed successfully that all their grief feelings will resolve

  Correct Answer: B

  (A)

  It is important to discuss with parents the need to treat the child as they would any other children, but they must be truthful and honest with the child about the heart defect. As the child grows older, explanations can go into greater depth.

  (B)

  Parents of children with congenital heart defects go through a grieving process over the loss of their "healthy" child. The nurse needs to recognize these feelings and give the parents a role in the child's care when they are ready. (C) Anger and resentment are normal feelings that must be dealt with appropriately. (D) Parents may go through a second grieving process after the repair of the cardiac defect. During this grieving period, they mourn the loss of the "defective" child who now may be essentially "normal."

• Question 384:

  A school-age child with asthma is ready for discharge from the hospital. His physician has written an order to continue the theophylline given in the hospital as an oral home medication. Immediately prior to discharge, he complains of nausea and becomes irritable. His vital signs were normal except for tachycardia. What first nursing actions would be essential in this situation?

  A. Hold the child's discharge for 1 hour.

  B. Notify the physician immediately.

  C. Discharge the child as the physician ordered.

  D. Administer an antiemetic as necessary.

  Correct Answer: B

  (A) Holding the child's discharge alone does not address the client's problem. (B) Nausea, tachycardia, and irritability are all symptoms of theophylline toxicity. The physician should benotified immediately so that a serum theophylline level can be ordered. Theophylline dose should be withheld until the physician is notified. (C) The child must be evaluated for theophylline toxicity before any discharge. (D) Cause of the nausea should be investigated before the administration of an antiemetic.

• Question 385:

  A client who has gout is most likely to form which type of renal calculi?

  A. Struvite stones

  B. Staghorn calculi

  C. Uric acid stones

  D. Calcium stones

  Correct Answer: C

  (A) The presence of urinary tract infection is a factor in the formation of struvite stones. (B) Staghorn calculi is the other name for struvite stones associated with urinary tract infection. (C) Clients who have gout form uric acid stones. (D) Clients who have increased urinary excretion of calcium form calcium stones.

• Question 386:

  A 4-year-old child with a history of sickle cell anemia is admitted to the nursing unit with dizziness, shortness of breath, and pallor. Nursing assessment findings reveal tenderness in the abdomen. The child is most likely experiencing a/an:

  A. Aplastic crisis

  B. Vaso-occlusive crisis

  C. Dactylitis crisis

  D. Sequestration crisis

  Correct Answer: D

  (A) Aplastic anemia is characterized by a lack of reticulocytes in the blood. Platelet and white blood cell counts are usually not depressed. It is usually self-limiting, lasting 5?0 days. (B) Vaso-occlusive crisis is the most common type of crisis in sickle cell anemia. Sickled cells become clogged, leading to distal tissue hypoxia and infarction. Joints and extremities are the most commonly affected areas. (C) Dactylitis crisis, or "hand-foot syndrome," causes symmetrical infarction of the bones in the hands and feet, resulting in painful swelling in the soft tissues of the hands and feet. (D) Sequestration crisis occurs as enormous volumes of blood pool within the spleen. The spleen enlarges, causing tenderness. Signs of shock including pallor, tachypnea, and faintness result, related to the deficient intravascular volume. This type of crisis is potentially fatal.

• Question 387:

  A 26-year-old client is diagnosed with an astrocytoma, a benign brain tumor. From the nurse's knowledge of the central nervous system, the nurse knows that benign tumors:

  A. Can be just as dangerous as malignant tumors

  B. Grow more rapidly than malignant tumors

  C. Do not warrant concern because they do not become malignant tumors

  D. Can be removed surgically

  Correct Answer: A

  (A) Both a benign and a malignant tumor can displace or destroy nearby structures or increase intracranial pressure. (B) Benign or malignant brain tumors grow at different rates depending on the type of tumor. (C) Some benign tumors do become malignant tumors. (D) Whether or not a tumor is operable depends on its location and the amount of damage its removal will cause.

• Question 388:

  To facilitate maximum air exchange, the nurse should position the client in:

  A. High Fowler

  B. Orthopneic

  C. Prone

  D. Flat-supine

  Correct Answer: B

  (A) The high Fowler position does increase air exchange, but not to the extent of orthopneic position. (B) The orthopneic position is a sitting position that allows maximum lung expansion. (C) The prone position places pressure on diaphragm and does not promote maximum air exchange. (D) The flat-supine position places pressure on diaphragm by abdominal organs and does not promote maximum air exchange.

• Question 389:

  A 55-year-old woman entered the emergency room by ambulance. Her primary complaint is chest pain. She is receiving O2 via nasal cannula at 2 L/min for dyspnea. Which of the following findings in the client's nursing assessment demand immediate nursing action?

  A. Associated symptoms of indigestion and nausea

  B. Restlessness and apprehensiveness

  C. Inability to tolerate assessment session with the admitting nurse

  D. History of hypertension treated with pharmacological therapy

  Correct Answer: B

  (A) Indigestion or nausea may accompany angina or myocardial infarction, but they do not indicate imminent danger for the client. (B) Restlessness and apprehensiveness require immediate nursing action because they are indicative of very low oxygenation of body tissues and are frequently the first indication of impending cardiac or respiratory arrest. (C) It is common for the cardiac client to experience fatigue and inability to physically tolerate long assessment sessions. (D) A history of hypertension requires no immediate nursing intervention. In the situation described, the blood pressure is not given and therefore cannot be assumed to be elevated.

• Question 390:

  During his hospitalization, a 3-year-old child has become unusually aggressive in his play activities. His parents report this change in behavior to the primary nurse. How could the nurse explain the child's change in behavior?

  A. Deep-seated feelings of hostility

  B. A lack of interest in socializing

  C. Usual behavior for this child

  D. A coping response

  Correct Answer: D

  (A) Unusually aggressive behavior does not indicate a deepseated problem. (B) A lack of social interest results in poor participation in play activities with peers. Aggression would not be an expected behavior. (C) The aggressive behavior was newly developed and not a routine behavior. (D) Play provides the child with opportunities for coping and adaptation. Aggression during the play activities would indicate a coping response.