NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 411:

  Which of the following procedures is necessary to establish a definitive diagnosis of breast cancer?

  A. Diaphanography
  B. Mammography
  C. Thermography
  D. Breast tissue biopsy
  D. Breast tissue biopsy

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  (A) Diaphanography, also known as transillumination, is a painless, noninvasive imaging technique that involves shining a light source through the breast tissue to visualize the interior. It must be used in conjunction with a mammogram and physical examination. (B) Mammography is a useful tool for screening but is not considered a means of diagnosing breast cancers. (C) Thermography is a pictorial representation of heat patterns on the surface of the breast. Breast cancers appear as a "hot spot" owing to their higher metabolic rate. (D) Biopsy either by needle aspiration or by surgical incision is the primary diagnostic technique for confirming the presence of cancer cells.

• Question 412:

  Following TURP, which of the following instructions would be appropriate to prevent or alleviate anxiety concerning the client's sexual functioning?

  A. "You may resume sexual intercourse in 2 weeks."
  B. "Many men experience impotence following TURP."
  C. "A transurethral resection does not usually cause impotence."
  D. "Check with your doctor about resuming sexual activity."
  C. "A transurethral resection does not usually cause impotence."

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  (A) Sexual activity should be delayed until cleared by the client's physician. (B) Although many men experience retrograde ejaculation following prostate surgery, potency is seldom affected. (C) Although the client may experience retrograde ejaculation, it will not limit his ability to engage in sexual intercourse. (D) Although the client should obtain clearance from his physician before resuming sexual activity, this statement does not give the client any information or reassurance about future sexual activity or potency that could decrease his anxiety.

• Question 413:

  A 27-year-old primigravida stated that she got up from the chair to fix dinner and bright red blood was running down her legs. She denies any pain previously or currently. The client is very concerned about whether her baby will be all right. Her vital signs include P 120 bpm, respirations 26 breaths/min, BP 104/58 mm Hg, temperature 98.2_F, and fetal heart rate 146 bpm. Laboratory findings revealed hemoglobin 9.0 g/dL, hematocrit 26%, and coagulation studies within normal range. On admission, the peripad she wore was noted to be half saturated with bright red blood. A medical diagnosis of placenta previa is made. The priority nursing diagnosis for this client would be:

  A. Decreased cardiac output related to excessive bleeding
  B. Potential for fluid volume excess related to fluid resuscitation
  C. Anxiety related to threat to self
  D. Alteration in parenting related to potential fetal injury
  A. Decreased cardiac output related to excessive bleeding

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  (A) Based on the client's history, presence of bright red vaginal bleeding, and hemoglobin value on admission, the priority nursing diagnosis would be decreased cardiac output related to excessive bleeding. (B) This nursing diagnosis is a potential problem that does not exist at the present time, and therefore is not the priority problem. (C) The client's expressed anxiety is for her child. The fetus will remain physiologically safe if the decreased cardiac output is resolved. (D) Initial spontaneous bleeding with placenta previa is rarely life threatening to the mother or the fetus. Delivery of the fetus will be postponed until fetal maturity is achieved and survival is likely.

• Question 414:

  The nurse knows that children are more susceptible to respiratory tract infections owing to physiological differences. These childhood differences, when compared to an adult, include:

  A. Fewer alveoli, slower respiratory rate
  B. Diaphragmatic breathing, larger volume of air
  C. Larger number of alveoli, diaphragmatic breathing
  D. Rounded shape of chest, smaller volume of air
  D. Rounded shape of chest, smaller volume of air

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  (A) Although a child has fewer alveoli than an adult, the child's respiratory rate is faster. (B) Although a child may use diaphragmatic breathing, the adult exchanges a larger volume of air. (C) The adult has a larger number of alveoli than a child. (D) The child's chest is rounded whereas the adult chest is more of an oval shape, and the child does exchange a smaller volume of air than an adult.

• Question 415:

  A common complication of cirrhosis of the liver is prolonged bleeding. The nurse should be prepared to administer?

  A. Vitamin C
  B. Vitamin K
  C. Vitamin E
  D. Vitamin A
  B. Vitamin K

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  (A) Vitamin C does not directly affect clotting. (B) Vitamin K is a fat-soluble vitamin that depends on liver function for absorption. Vitamin K is essential for clotting. (C) Vitamin E does not directly affect clotting. (D) Vitamin A does not directly affect clotting.

• Question 416:

  A client who has been diagnosed with anorexia nervosa reluctantly agrees to eat all prescribed meals. The most important intervention in monitoring her dietary compliance would be to:

  A. Allow her privacy at mealtimes
  B. Praise her for eating everything
  C. Observe behavior for 1? hours after meals to prevent vomiting
  D. Encourage her to eat in moderation, choose foods that she likes, and avoid foods that she dislikes
  C. Observe behavior for 1? hours after meals to prevent vomiting

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  (A) Eating alone is not recommended for anorexic clients because they tend to hoard food instead of eating it. (B) The client should be praised for whatever she eats, which is usually a small portion or percentage of what is served. Praise should not be withheld until she eats everything. (C) The client should be observed eyeto- eye for at least 1 hour following meals to prevent discarding food stashed in her clothing at mealtime or engaging in selfinduced vomiting. (D) If offered these choices, the client would choose low-caloric foods, not a nutritious diet.

• Question 417:

  A pregnant client is at the clinic for a third trimester prenatal visit. During this examination, it has been determined that her fetus is in a vertex presentation with the occiput located in her right anterior quadrant. On her chart this would be noted as:

  A. Right occipitoposterior
  B. Right occipitoanterior
  C. Right sacroanterior
  D. LOA
  B. Right occipitoanterior

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  (A) The fetus in the right occipitoposterior position would be presenting with the occiput in the maternal right posterior quadrant. (B) Fetal position is defined by the location of the fetal presenting part in the four quadrants of the maternal pelvis. The right occipitoanterior is a fetus presenting with the occiput in mother's right anterior quadrant. (C) The fetus in right sacroanterior position would be presenting a sacrum, not an occiput. (D) The fetus in left occipitoanterior position would be presenting with the occiput in the mother's left anterior quadrant.

• Question 418:

  A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:

  A. Take a baseline set of vital signs
  B. Hang Ringer's lactate as the companion fluid
  C. Use microdrip tubing for the blood administration
  D. Have the registered nurse in charge assume responsibility for verifying the client and blood product information
  A. Take a baseline set of vital signs

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  (A) A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. (B) The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringer's lactate can cause clotting. (C) Only a blood administration set should be used. A microdrip tube would cause lysis of the red blood cells. (D) Proper identification of the recipient and the blood product must be validated by at least two people.

• Question 419:

  An 82-year-old former restaurant owner walks to the nursing station and states, "I have to go. The restaurant opens at 11 am." Which response by the nurse is the most appropriate?

  A. "Go back to your room. You do not own a restaurant."
  B. "You are in the hospital now. Calm down."
  C. "You once owned a restaurant. Tell me about it."
  D. "It is snowing outside. The restaurant is closed."
  C. "You once owned a restaurant. Tell me about it."

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  (A) This response cuts off communication with the client. It does not address her feelings. (B) Reality orientation frequently does not work alone. Feelings must be addressed. Telling a client to calm down is frequently ineffective. (C) Reminiscence is used here to reorient and recall past pleasant events. Talking about the restaurant will allay anxiety. (D) This response may confirm to the client that she indeed does still own a restaurant, buying into her confusion. Her feelings and anxiety require nursing intervention.

• Question 420:

  A young child has been placed in a spica cast. The chief concern of the nurse during the first few hours is:

  A. Prevention of neurovascular complications
  B. Prevention of loss of muscle tone
  C. Immobilization of the affected limb
  D. Using heated fans to dry the cast
  A. Prevention of neurovascular complications

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  (A) Because the extremity may continue to swell and the cast could constrict circulation, the nurse should elevate the limb and observe for capillary refill, warmth, mobility of toes and circulation. (B) Although muscle tone may diminish over time in the affected limb, this is not the immediate concern. (C) The limb has been immobilized already by the cast, and therefore immobilization is not a concern. (D) Heated fans and dryers are discouraged because the outside cast will dry quickly, yet the area beneath the cast remains wet and could cause burns.