NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 401:

  A client had a ruptured abdominal aortic aneurysm that was repaired surgically. Her postoperative recovery progressed without complications, and she is ready for discharge. Client education in preparation for discharge began 7 days ago on her admission to the nursing unit. Evaluation of nursing care related to client education is based on evaluation of expected outcomes. Which statement made by the client would indicate that she is ready for discharge?

  A. "I will not drive but ride in the front seat of the car with a seat belt on for my first doctor's appointment."
  B. "When I bathe tomorrow morning, I will be very careful not to get soap on my incision."
  C. "I am allowed to exercise by walking for short periods."
  D. "Teach my husband about the diet. He'll be doing all the cooking now."
  C. "I am allowed to exercise by walking for short periods."

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  (A)

  Postoperatively, clients with major abdominal surgery are instructed to avoid driving, riding in the front seat, and wearing seat belts because any sudden impact may injure a fresh incision. She should ride in back seat without a seat belt.

  (B)

  Clients should not sit in the tub and allow the incision to soak in water because this may predispose the client to infection. A short, cool shower would be preferable. Allowing soap to come in contact with the incision would not harm it and is frequently used as postoperative wound care at home on discharge from the hospital. (C) Activity instructions include: avoid sitting for long periods and get exercise by walking. Lifting more than 5 lb of weight is also prohibited. (D) The client must also learn her diet. Her husband cooking is probably a temporary measure unless he did the cooking prior to her hospitalization.A statement such as this may indicate the need for further exploration of feelings regarding her illness, dependence, and self-care expectations.

• Question 402:

  A female client has been diagnosed with chronic renal failure. She is a candidate for either peritoneal dialysis or hemodialysis and must make a choice between the two. Which information should the nurse give her to help her decide?

  A. Hemodialysis involves less time to filter the blood; but the client must consider travel time, distance, and inconvenience.
  B. Hemodialysis involves more time to filter the blood than does peritoneal dialysis.
  C. Peritoneal dialysis has almost no complications and is less time consuming than hemodialysis. Therefore it is preferred.
  D. Peritoneal dialysis requires that a home health nurse prepare and administer the treatments.
  A. Hemodialysis involves less time to filter the blood; but the client must consider travel time, distance, and inconvenience.

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  (A) Hemodialysis is faster in clearing the blood of toxins than peritoneal dialysis. However, clients must consider the time that they spend traveling to the dialysis center and the disruption in their daily lives. (B) Peritoneal dialysis requires several exchanges with dwelling time for the dialysate and therefore takes longer than hemodialysis. (C) Several serious complications of peritoneal dialysis include peritonitis, catheter displacement and/or plugging, or pain during dialysis. (D) A client can be taught to self-administer peritoneal dialysis without the aid of a professional.

• Question 403:

  The nurse and prenatal client discuss the effects of cigarette smoking on pregnancy. It would be correct for the nurse to explain that with cigarette smoking there is increased risk that the baby will have:

  A. A low birth weight
  B. A birth defect
  C. Anemia
  D. Nicotine withdrawal
  A. A low birth weight

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  (A) Women who smoke during pregnancy are at increased risk for miscarriage, preterm labor, and IUGR in the fetus. (B) Although smoking produces harmful effects on the maternal vascular system and the developing fetus, it has not been directly linked to fetal anomalies. (C) Smoking during pregnancy has not been directly linked to anemia in the fetus. (D) Smoking during pregnancy has not been linked to nicotine withdrawal symptoms in the newborn.

• Question 404:

  A client is having episodes of hyperventilation related to her surgery that is scheduled tomorrow. Appropriate nursing actions to help control hyperventilating include:

  A. Administering diazepam (Valium) 10?5 mg po q4h and q1h prn for hyperventilating episode
  B. Keeping the temperature in the client's room at a high level to reduce respiratory stimulation
  C. Having the client hold her breath or breathe into a paper bag when hyperventilation episodes occur
  D. Using distraction to help control the client's hyperventilation episodes
  C. Having the client hold her breath or breathe into a paper bag when hyperventilation episodes occur

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  (A) An adult diazepam dosage for treatment of anxiety is 2?0 mg PO 2? times daily. The order as written would place a client at risk for overdose. (B) A high room temperature could increase hyperventilating episodes by stimulating the respiratory system. (C) Breath holding and breathing into a paper bag may be useful in controlling hyperventilation. Both measures increase CO2 retention. (D) Distraction will not prevent or control hyperventilation caused by anxiety or fear.

• Question 405:

  Which of the following nursing orders should be included in the plan of care for a client with hepatitis C?

  A. The nurse should use universal precautions when obtaining blood samples.
  B. Total bed rest should be maintained until the client is asymptomatic.
  C. The client should be instructed to maintain a low semi-Fowler position when eating meals.
  D. The nurse should administer an alcohol backrub at bedtime.
  A. The nurse should use universal precautions when obtaining blood samples.

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  (A) The source of infection with hepatitis C is contaminated blood products. (B) Modified bed rest should be maintained while the client is symptomatic. Routine activities can be slowly resumed once the client is asymptomatic. (C) Nausea and vomiting occur frequently with hepatitis C. A high Fowler position may decrease the tendency to vomit. (D) The buildup of bilirubin in the client's skin may cause pruritus. Alcohol is a drying agent.

• Question 406:

  A male client has been an insulin-dependent diabetic for approximately 30 years. He frequently indulges in highsugar foods and forgets to take his insulin. He has not experienced acute diabetic emergencies over the years but is now beginning to demonstrate symptoms of diabetic peripheral neuropathy. This distresses him because dancing is one of his favorite pastimes. He decides to question his wife's home health nurse about diabetic peripheral neuropathy. The nurse points out his noncompliance to his diabetic diet and insulin regimen. The client answers the nurse, "It has been my experience that the diabetic diet is very difficult to follow. As far as the insulin, isn't a fellow allowed to forget now and then?" The client's actions and response best demonstrate:

  A. Depression
  B. Anger
  C. Denial
  D. Bargaining
  C. Denial

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  (A) Depression may be an underlying feature, but it is not evident from limited data presented here. (B) Anger is not exhibited in his response. (C) Denial is evident in the client's actions; through the years, he has had a casual approach to his illness. He only becomes concerned when bodily changes affect his present lifestyle, when in fact he should have been concerned all along. His verbal response also reflects denial. (D) There is no evidence of bargaining in the client's actions or verbal response.

• Question 407:

  Azulfidine (Sulfasalazine) may be ordered for a client who has ulcerative colitis. Which of the following is a nursing implication for this drug?

  A. Limit fluids to 500 mL/day.
  B. Administer 2 hours before meals.
  C. Observe for skin rash and diarrhea.
  D. Monitor blood pressure, pulse.
  C. Observe for skin rash and diarrhea.

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  (A) Fluids up to 2500?000 mL/day are needed to prevent kidney stones. (B) The client should be instructed to take oral preparations with meals or snacks to lessen gastric irritation. (C) Sulfasalazine causes skin rash and diarrhea. (D) Blood pressure and pulse are not altered by sulfasalazine.

• Question 408:

  A female client is anticipating a visit with her parents over the Thanksgiving holidays. She has recently begun experiencing periods of extreme shortness of breath, which her physician has labeled as panic attacks. Which of the following statements by the nurse would enhance therapeutic communication?

  A. "Why do you feel this way?"
  B. "Tell me about your dislike for your parents."
  C. "Don't worry, everything will be all right on your visit with your parents."
  D. "Perhaps you and I can discover what produces your anxiety."
  D. "Perhaps you and I can discover what produces your anxiety."

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  (A) Asking the client to provide an explanation for her feelings is often intimidating. (B) This response is probing and may make the client feel used and valued only for the information she can provide. (C) This underrates the client's feelings and belittles her concerns. It may cause the client to stop sharing feelings for fear that they will be ridiculed. (D) The emphasis is on working with the client. It shows that there is hope for change through collaboration.

• Question 409:

  A client has been diagnosed with thrombophlebitis. She asks, "What is the most likely cause of thrombophlebitis during my pregnancy?" The nurse explains:

  A. Increased levels of the coagulation factors and a decrease in fibrinolysis
  B. An inadequate production of platelets
  C. An inadequate intake of folic acid during pregnancy
  D. An increase in fibrinolysis and a decrease in coagulation factors
  A. Increased levels of the coagulation factors and a decrease in fibrinolysis

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  (A) During pregnancy, the potential for thromboses increases owing to the increased levels of coagulation factors and a decrease in the breakdown of fibrin. (B) An inadequate production of platelets would result in thrombocytopenia with resulting signs and symptoms of bleeding such as petechiae, hematuria, or hematemesis. (C) A deficiency of folic acid during pregnancy produces a megaloblastic anemia. It is usually found in combination with iron deficiency. (D) This combination would result in bleeding disorders because more fibrin would be broken down and fewer clotting factors would be available.

• Question 410:

  A postpartum client complains of rectal pressure and severe pain in her perineum; this may be indicative of:

  A. Afterbirth pains
  B. Constipation
  C. Cystitis
  D. A hematoma of the vagina or vulva
  D. A hematoma of the vagina or vulva

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  (A) Afterbirth pains are a common complaint in the postpartum client, but they are located in the uterus. (B) Constipation may cause rectal pressure but is not usually associated with "severe pain." (C) Cystitis may cause pain, but the location is different. (D) Hematomas are frequently associated with severe pain and pressure. Further assessments are indicated for this client.