NCLEX NCLEX Certifications NCLEX-RN Questions & Answers

• Question 411:

  Prior to an amniocentesis, a fetal ultrasound is done in order to:

  A. Evaluate fetal lung maturity

  B. Evaluate the amount of amniotic fluid

  C. Locate the position of the placenta and fetus

  D. Ensure that the fetus is mature enough to perform the amniocentesis

  Correct Answer: C

  (A) Amniocentesis can be performed to assess for lung maturity. Fetal ultrasound can be used for gestational dating, although it does not separately determine lung maturity. (B) Ultrasound can evaluate amniotic fluid volume, which may be used to determine congenital anomalies. (C) Amniocentesis involves removal of amniotic fluid for evaluation. The needle, inserted through the abdomen, is guided by ultrasound to avoid needle injuries, and the test evaluates the position of the placenta and the fetus. (D) Amniocentesis can be performed as early as the 15th?7th week of pregnancy.

• Question 412:

  Based on your knowledge of genetic inheritance, which of these statements is true for autosomal recessive genetic disorders?

  A. Heterozygotes are affected.

  B. The disorder is always carried on the X chromosome.

  C. Only females are affected.

  D. Two affected parents always have affected children.

  Correct Answer: D

  (A)

  The term heterozygote refers to an individual with one normal and one mutant allele at a given locus on a pair of homologous chromosomes. An individual who is heterozygous for the abnormal gene does not manifest obvious symptoms.

  (B)

  Disorders carried on either the X or Y sex chromosome are referred to as sex-linked recessive. (C) Either sex may be affected by autosomal recessive genetic disorders because the responsible allele can be on any one of the 46 chromosomes. (D) If both parents are affected by the disorder and are not just carriers, then all their children would manifest the same disorder.

• Question 413:

  A 33-year-old client was brought into the emergency room unconscious, and it is determined that surgery is needed. Informed consent must be obtained from his next of kin. The sequence in which the next of kin would be asked for the consent would be:

  A. Parent, spouse, adult child, sibling

  B. Spouse, adult child, parent, sibling

  C. Spouse, parent, sibling, adult child

  D. Parent, spouse, sibling, adult child

  Correct Answer: B

  (A) Spouse and adult child would be asked before a parent. (B) The order of kin relationship for an adult, as determined from legal intestate succession, is usually spouse, adult child, parent, sibling. (C) Parent and sibling would be asked after adult child. (D) Spouse and adult child would be asked before parent. Sibling would be asked last.

• Question 414:

  Which of the following serum laboratory values would the nurse monitor during gentamicin therapy?

  A. Creatinine

  B. Sodium

  C. Calcium

  D. Potassium

  Correct Answer: A

  (A) A common side effect of gentamicin is nephrotoxicity. The serum laboratory test that best reflects kidney function is serum creatinine. (B) Serum sodium has no relationship to gentamicin. (C) Serum calcium has no relationship to gentamicin. (D) Serum potassium has no relationship to gentamicin. If a client has impaired renal function secondary to gentamicin administration, he or she may also have hyperkalemia as a secondary disorder.

• Question 415:

  Children often experience visual impairments. Refractive errors affect the child's visual activity. The main refractive error seen in children is myopia. The nurse explains to the child's parents that myopia may also be described as:

  A. Cataracts

  B. Farsightedness

  C. Nearsightedness

  D. Lazy eye

  Correct Answer: C

  (A) Cataracts are not considered refractive errors. Cataracts canbe described as opacity of the lens. (B)Hyperopiais the term forfarsightedness. One can see objects at a distance more clearlythan close objects. (C)Myopiais the term for nearsightedness.Objects that are close in distance are more clearly seen. (D) Lazyeye refers to strabismus or misalignment of the eyes.

• Question 416:

  Diagnostic assessment findings for an infant with possible coarctation of the aorta would include:

  A. A third heart sound

  B. A diastolic murmur

  C. Pulse pressure difference between the upper extremities

  D. Diminished or absent femoral pulses

  Correct Answer: D

  (A) S1 and S2 in an infant with coarctation of the aorta are usually normal. S3 and S4 do not exist with this diagnosis. (B) Either no murmur will be heard or a systolic murmur from an associated cardiac defect will be heard along the left upper sternal border. A diastolic murmur is not associated with coarctation of the aorta. (C) Pulse pressure differences of>20 mm Hg exist between the upper extremities and the lower extremities. It is important to evaluate the upper and lower extremities with the appropriate- sized cuffs. (D) Femoral and pedal pulses will be diminished or absent in infants with coarctation of the aorta.

• Question 417:

  An 8-year-old child is admitted to the hospital for surgery. She has had no previous hospitalizations, and both she and her family appear anxious and fearful. It will be most helpful for the nurse to:

  A. Take the child to her room and calmly and matter-offactly begin to get her ready to go to the operating room

  B. Take time to orient the child and her family to the hospital and the forthcoming events

  C. Explain that as soon as the child goes to the operating room she will have time to answer any questions the family has

  D. Tell the child and her family that there is nothing to worry about, that the operation will not take long, and she will soon be as "good as new"

  Correct Answer: B

  (A) This action does nothing to prepare the child and her family for what will happen or to relieve their anxiety and fear. (B) This action provides security by preparing the child and the family for what will happen and will help to relieve fear and anxiety. (C) This action does nothing to help prepare the child for what will happen and does not give the parents permission to ask questions until later. (D) This action provides possibly false reassurance and may prevent the child and/or the family from asking pressing questions.

• Question 418:

  The nurse teaches a pregnant client that a high-risk symptom occurring at any time during pregnancy that needs to be reported immediately to a healthcare provider is:

  A. Constipation

  B. Urinary frequency

  C. Breast tenderness

  D. Abdominal pain

  Correct Answer: D

  (A) Constipation is a result of decreased peristalsis due to smooth muscle relaxation related to changing progesterone levels that occur during pregnancy. (B) Urinary frequency is a common result of the increasing size of the uterus and the resulting pressure it places on the bladder. (C) With the increased vascularity and hypertrophy of the mammary alveoli due to estrogen and progesterone level changes, the breasts will increase in size and may become tender. (D) Abdominal pain may be an indication of early spontaneous abortion, preterm delivery, or a placental abruption.

• Question 419:

  A client had a renal transplant 3 months ago. He has suddenly developed graft tenderness, an increased white blood cell count, and malaise. The client is experiencing which type of rejection?

  A. Acute

  B. Chronic

  C. Hyperacute

  D. Hyperchronic

  Correct Answer: A

  (A) The sudden development of fever, graft tenderness, increased white blood count, and malaise are signs and symptoms of an acute rejection that commonly occurs at 3 months. (B) Chronic rejection occurs slowly over a period of months to years and mimics chronic renal failure. (C) Hyperacute rejection occurs immediately after surgery up to 48 hours postoperatively. (D) Hyperchronic rejection is not a type of rejection.

• Question 420:

  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

  Correct Answer: A

  (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.