NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 391:

  A 50-year-old male client is to receive chemotherapy. The physician's orders include antiemetics. When planning his care, the nurse should take into consideration that antiemetics are best administered in the following way:

  A. Give antiemetics when nausea is experienced and continue on a regular schedule for 124 hours.
  B. Give antiemetics prior to the client receiving chemotherapy and continue on a regular basis for at least 248 hours after chemotherapy.
  C. Give antiemetics one at a time because combinations of antiemetics cause overwhelming side effects.
  D. Give antiemetics intermittently during the entire course of chemotherapy.
  B. Give antiemetics prior to the client receiving chemotherapy and continue on a regular basis for at least 248 hours after chemotherapy.

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  (A)

  Nausea is more difficult to control if antiemetics are withheld until nausea is experienced. (B) Antiemetics should be given prophylactically at the beginning of chemotherapy and continued on an around-the-clock basis to prevent nausea.

  (C)

  Combinations of antiemetics give the best control for nausea by blocking various causes of nausea induced by chemotherapy. (D) Antiemetics should be given around the clock during the course of chemotherapy. This prevents nausea from developing and prevents anticipatory nausea during subsequent chemotherapy administrations.

• Question 392:

  A client had a transurethral resection of the prostate yesterday. He is concerned about the small amount of blood that is still in his urine. The nurse explains that the blood in his urine:

  A. Should not be there on the second day
  B. Will stop when the Foley catheter is removed
  C. Is normal and he need not be concerned about it
  D. Can be removed by irrigating the bladder
  C. Is normal and he need not be concerned about it

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  (A) Some hematuria is usual for several days after surgery. (B) The client will continue to have a small amount of hematuria even after the Foley catheter is removed. (C) Some hematuria is usual for several days after surgery. The client should not be concerned about it unless it increases. (D) Irrigating the bladder will not remove the hematuria. Irrigation is done to remove blood clots and facilitate urinary drainage.

• Question 393:

  A 3-year-old child has had symptoms of influenza including fever, productive cough, nausea, vomiting, and sore throat for the past several days. In caring for a young child with symptoms of influenza, the mother must be cautioned about:

  A. Giving aspirin and bismuth subsalicylate (Pepto-Bismol) to treat the symptoms
  B. Giving clear liquids too soon
  C. Allowing the child to come in contact with other children for 3 days
  D. The possibility of pneumonia as a complication
  A. Giving aspirin and bismuth subsalicylate (Pepto-Bismol) to treat the symptoms

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  (A) Aspirin should never be given to children with influenza because of the possibility of causing Reye's syndrome. Pepto- Bismol is also classified as a salicylate and should be avoided. (B) Depending on the severity of symptoms, the child may be receiving IV therapy or clear liquids. (C) The disease has a 1? day incubation period and affected children are most infectious 24 hours before and after the onset of symptoms. (D) Although viral pneumonia can be a complication of influenza, this would not be an initial priority.

• Question 394:

  A male client has experienced low back pain for several years. He is the primary support of his wife and six children. Although he would qualify for disability, he plans to continue his employment as long as possible. His back pain has increased recently, and he is unable to control it with non-steroidal anti-inflammatory agents. He refuses surgery and cannot take narcotics and remain alert enough to concentrate at work. His physician has suggested application of a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following is an appropriate rationale for using a TENS unit for relief of pain?

  A. TENS units have an ultrasonic effect that relaxes muscles, decreases joint stiffness, and increases range of motion.
  B. TENS units produce endogenous opioids that affect the central nervous system with analgesic potency comparable to morphine.
  C. TENS units work on the gate-control theory of pain; biostimulation therapy of large fibers block painful stimuli.
  D. TENS units prevent muscle spasms, decrease the potential for further injury, and minimize pressure on joints.
  C. TENS units work on the gate-control theory of pain; biostimulation therapy of large fibers block painful stimuli.

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  (A) TENS units do not have this effect, but whirlpool therapy does. (B) TENS units do not produce endogenous opioids, only the body can do that. (C) TENS units do work based on the gatecontrol theory of pain control. (D) TENS units do not have this effect, but possibly changing the client's position would.

• Question 395:

  Two hours after the second injection of haloperidol, a client complains to the nurse of a stiff neck and inability to sit still. He is experiencing symptoms consistent with:

  A. Parkinsonism and dystonia
  B. Dystonia and akathisia
  C. Akathisia and parkinsonism
  D. Neuroleptic malignant syndrome
  B. Dystonia and akathisia

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  (A) Stiff neck is consistent with a dystonic reaction, but the client has no symptoms of drooling, shuffling gait, or pill-rolling movements characteristic of parkinsonism. (B) Stiff neck is consistent with a dystonic reaction, and inability to sit still with varying degrees of psychomotor agitation is characteristic of akathisia. (C) The client has symptoms of dystonia but not of parkinsonism. (D) The client has none of the characteristic symptoms of neuroleptic malignant syndrome: hyperpyrexia, generalized muscle rigidity, mutism, obtundation, agitation, sweating, increased blood pressure and pulse.

• Question 396:

  A 16-year-old client with anorexia nervosa is on an inpatient psychiatric unit. She has a fear of gaining weight and is refusing to eat sufficient amounts to maintain body weight for her age, height, and stature. To assist with the problem of powerlessness and plan for the client to no longer need to withhold food to feel in control, the nurse uses the following strategy:

  A. Establish a structured environment with routine tasks and activities. Also, serve meals at the same time each day.
  B. Distract the client during meals to get her to eat because she must take in sufficient amounts to keep from starving.
  C. Do frequent room checks to be sure that the client is not hiding food or throwing it away.
  D. Listen attentively and participate in in-depth discussions about food, because these actions may encourage her to eat.
  A. Establish a structured environment with routine tasks and activities. Also, serve meals at the same time each day.

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  (A) Anorexia nervosa clients feel out of control. Providing a structured environment offers safety and comfort and can help them to develop internal control, thus reducing their need to control by self-starvation. (B) Distraction does not focus on the client's need for control. (C) Doing frequent room checks reinforces feelings of powerlessness and the need to continue with the dysfunctional behavior. (D) Participating in long discussions about food does not make the client want to eat, but rather this strategy allows her to indulge in her preoccupation and to continue with the dysfunctional behavior.

• Question 397:

  A client suspects that she is pregnant. She reports two missed menstrual periods. The first day of her last menstrual period was August 3. Her estimated date of confinement would be:

  A. November 7
  B. November 10
  C. May 7
  D. May 10
  D. May 10

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  (A) Wrong calculation (B) Wrong calculation (C) Wrong calculation (D) N鋑ele's rule is: Expected Date of Confinement = Last Menstrual Period - 3 months + 7 days + 1 year

• Question 398:

  Primary nursing diagnoses for the antisocial client are:

  A. Alteration in perception and altered self-concept
  B. Impaired social interaction, ineffective individual coping, and altered self-concept
  C. Altered communication processes and altered recreational patterns
  D. Altered body image and altered thought processes
  B. Impaired social interaction, ineffective individual coping, and altered self-concept

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  (A) This answer is incorrect. Perception is not altered because the client is not psychotic. (B) This answer is correct. The antisocial client lacks responsibility, accountability, and social commitment; has impaired problem-solving ability; tends to overuse defense mechanisms; lies and steals; and is often grandiose concerning self. (C) This answer is incorrect. Altered communication processes do not characterize this client. The antisocial person communicates well and tends to have a charming personality. (D) This answer is incorrect. Altered thought processes refer to delusional thinking, which is bizarre and fixed, and do not characterize this client.

• Question 399:

  The mother of a client is apprehensive about taking home her 2 year old who was diagnosed with asthma after being admitted to the emergency room with difficulty breathing and cyanosis. She asks the nurse what symptoms she should look for so that this problem will not happen again. The nurse instructs her to watch for the following early symptoms:

  A. Fever, runny nose, and hyperactivity
  B. Changes in breathing pattern, moodiness, fatigue, and edema of eyes
  C. Fatigue, dark circles under the eyes, changes in breathing pattern, glassy eyes, and moodiness
  D. Fever, cough, paleness, and wheezing
  C. Fatigue, dark circles under the eyes, changes in breathing pattern, glassy eyes, and moodiness

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  (A) The child with asthma may not have fever unless there is an underlying infection. (B) Edema of the eyes will not be present because the child with asthma is more likely to have dehydration related to excessive water loss during the work of breathing. (C) All of these symptoms indicate decreased oxygenation and are early symptoms of asthma. (D) Coughing and wheezing are not early signs of difficulty.

• Question 400:

  A mother came to the pediatric clinic with her 17- month-old child. The mother would like to begin toilet training. What should the nurse teach her about implementing toilet training?

  A. Take two or three favorite toys with the child.
  B. Have a child-sized toilet seat or training potty on hand.
  C. Explain to the child she is going to "void" and "defecate."
  D. Show disapproval if she does not void or defecate.
  B. Have a child-sized toilet seat or training potty on hand.

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  (A) Giving her toys will distract her and interfere with toilet training because of inappropriate reinforcement. (B) A child-sized toilet seat or training potty gives a child a feeling of security. (C) She should use words that are age appropriate for the child. (D) Children should be praised for cooperative behavior and/or successful evacuation.