NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 421:

  Several months after antibiotic therapy, a child is readmitted to the hospital with an exacerbation of osteomyelitis, which is now in the chronic stage. The mother appears anxious and asks what she could have done to prevent the exacerbation. The nurse's response is based on the knowledge that chronic osteomyelitis:

  A. Is caused by poor physical conditions or poor nutrition
  B. Often results from unhygienic conditions or an unclean environment
  C. Is directly related to sluggish circulation in the affected limb
  D. May develop from sinuses in the involved bone that retain infectious material
  D. May develop from sinuses in the involved bone that retain infectious material

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  (A) Poor nutrition and/or poor physical conditions are factors that predispose to the development of osteomyelitis but do not cause it. (B) An unclean or unhygienic environment may predispose to the development of chronic osteomyelitis, but it does not cause an exacerbation of the previous infection. (C) Sluggish circulation through the medullary cavity during acute osteomyelitis may delay healing, but it does not cause the disease to become chronic. (D) Areas of sequestrum may be surrounded by dense bone, become honeycombed with sinuses, and retain infectious organisms for a long time.

• Question 422:

  A 72-year-old male client had the Foley catheter that was inserted during the transurethral resection of his prostate removed today. He is concerned about the urinary incontinence he is having since removal of the Foley catheter. The nurse explains that:

  A. He should not be concerned about it because it will resolve quickly
  B. This is usually temporary
  C. The nurse will keep him dry, and he should notify the nurse when this happens
  D. This is related to the bladder spasms and will soon stop
  B. This is usually temporary

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  (A) This problem is temporary, but it may take some time to resolve, especially in an older man. (B) This problem is usually temporary, but it may take some time to resolve. (C) Keeping the client dry will not relieve his anxiety about his incontinence. (D) The bladder spasms are not the cause of the client's incontinence.

• Question 423:

  The nurse is notified that a 27-year-old primigravida diagnosed with complete placenta previa is to be admitted to the hospital for a cesarean section. The client is now at 36 weeks' gestation and is presently having bright red bleeding of moderate amount. On admission, the nursing intervention that the nurse should give the highest priority to is:

  A. Shave the client's abdomen and arrange her lab work
  B. Determine the status of the fetus by fetal heart tones
  C. Start an IV infusion in the client's arm
  D. Insert an indwelling catheter into her bladder
  B. Determine the status of the fetus by fetal heart tones

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  (A) These nursing actions are necessary prior to the cesarean section, but not immediately necessary to maintain physiological equilibrium. (B) Determining the physiological status of the fetus would constitute the highest priority in evaluating and maintaining fetal life. (C) These nursing actions are necessary prior to the cesarean section, but not immediately necessary to maintain physiological equilibrium. (D) These nursing actions are necessary prior to the cesarean section, but not immediately necessary to maintain physiological equilibrium.

• Question 424:

  The nurse documents a client's surgical incision as having red granulated tissue. This indicates that the wound is:

  A. Infected
  B. Not healing
  C. Necrotic
  D. Healing
  D. Healing

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  (A) The wound is not infected. An infected wound would contain pus, debris, and exudate. (B) The wound is healing properly. (C) A necrotic wound would appear black or brown. (D) The wound is healing properly and is filled with red granulated tissue and fragile capillaries.

• Question 425:

  A premature infant needs supplemental O2 therapy. A nursing intervention that reduces the risk of retrolental fibroplasia is to:

  A. Maintain O2at
  B. Maintain O2at>40%
  C. Give moist O2at>40%
  D. Maintain on 100% O2
  A. Maintain O2at

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  (A) Retrolental fibroplasia is the result of prolonged exposure to high levels of O2in premature infants. Complications are hemorrhage and retinal detachment. (B, C, D) O2concentration is too high.

• Question 426:

  A normal 3-year-old child is suspected of having meningitis. The doctor has ordered a lumbar puncture. In light of this procedure and developmental characteristics of this age group, which nursing measure is most appropriate?

  A. Emphasize those aspects of the procedure that require cooperation.
  B. Tell the child not to cry or yell.
  C. Tell the child that he will get a "stick" in his back.
  D. Use medical terminology when explaining the procedure to the client.
  A. Emphasize those aspects of the procedure that require cooperation.

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  (A) The nurse should emphasize what is required to elicit cooperation and help to develop a sense of autonomy. (B) The child may express discomfort verbally and should be encouraged to express his feelings. (C) Selecting nonthreatening words to explain a procedure will prevent misinterpretation. (D) When explaining the procedure to the parent with the child present, the nurse should use words that the child can understand to avoid misunderstanding.

• Question 427:

  A client is having a vertical partial laryngectomy, and the nurse is planning his postoperative care. A priority postoperative nursing diagnosis for a client having a vertical partial laryngectomy would be:

  A. Activity intolerance
  B. Ineffective airway clearance
  C. High risk for infection
  D. Altered oral mucous membrane
  B. Ineffective airway clearance

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  (A) The laryngectomy client should be able to gradually increase activities without difficulty. (B) The laryngectomy client may have copious amounts of secretions and require suctioning for the first 24?8 hours. The cannula will require cleaning even after the first 24 hours because mucus collects in it. (C) The client does have a potential for infection, but it is not a more importantnursing priority than the ineffective airway clearance. (D) This problem is not a more important nursing priority than ineffective airway clearance. The client's mouth may become dry, but good oral care should take care of the dryness.

• Question 428:

  A 64-year-old client is admitted to the hospital with benign prostatic hypertrophy (BPH). He has a history of adult-onset diabetes and hypertension and is scheduled to undergo a resection of the prostate. When recording his health history, the nurse asks about his chief complaint. The most serious symptom that may accompany BPH is:

  A. Acute urinary retention
  B. Hesitancy in starting urination
  C. Increased frequency of urination
  D. Decreased force of the urinary stream
  A. Acute urinary retention

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  (A) Acute urinary retention requires urgent medical attention. If measures such as a warm tub bath or warm tea do not occur after 6 hours, the client should go to the ED for catheterization. (B, C, D) This choice is a symptom of BPH, but it is not serious or life threatening.

• Question 429:

  The physician of a client diagnosed with alcoholism orders neomycin 0.5 g q6h to prevent hepatic coma. Neomycin decreases serum ammonia levels by:

  A. Decreasing nitrogen-forming bacteria in the intestines
  B. Acidifying colon contents by causing ammonia retention in the colon
  C. Decreasing the uptake of vitamin D, thereby drawing more water into the colon
  D. Irritating the bowel and promoting evacuation of stool
  A. Decreasing nitrogen-forming bacteria in the intestines

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  (A) Neomycin interferes with protein synthesis in the bacterial cell, causing bacterial death. Neomycin reduces the growth of the ammonia-producing bacteria in the intestines and is used for the treatment of hepatic coma. (B) This choice describes the action of lactulose, another drug commonly used to decrease systemic ammonia levels. (C) Neomycin's action doesnotdecrease uptake of vitamin D to reduce serum ammonia levels. (D) Bowel irritation with diarrhea is more likely to occur with administration of lactulose rather than of neomycin. Besides, diarrhea is a side effect of a drug, not the action of the drug.

• Question 430:

  A behavioral modification program is recommended by the multidisciplinary team working with a 15-year-old client with anorexia nervosa. A nursing plan of care based on this modality would include:

  A. Role playing the client's eating behaviors
  B. Restriction to the unit until she has gained 2 lb
  C. Encouraging her to verbalize her feelings concerning food and food intake
  D. Provision for a high-calorie, high-protein snack between meals
  B. Restriction to the unit until she has gained 2 lb

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  (A) This answer is incorrect. Role playing is based on learning but is not based on the behavioral modification model. (B) This answer is correct. The behavioral modification model is based on negative and positive reinforcers to change behavior. (C) This answer is incorrect. Verbal catharsis is not an intervention based on behavioral modification. (D) This answer is incorrect. Although an acceptable nursing intervention, it is not based on behavioral modification.