NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 431:

  A client's physician has prescribed theophylline (Theo- Dur) to help control the bronchospasm associated with the client's COPD. Instructions that should be given to the client include:

  A. "Call your physician if you develop palpitations, dizziness, or restlessness.''
  B. "Cigarette smoking may significantly increase the risk for theophylline toxicity.''
  C. "Take this medication on an empty stomach.''
  D. "Do not take your medicine if your pulse is less than 60 beats per minute.''
  A. "Call your physician if you develop palpitations, dizziness, or restlessness.''

  ---

  (A) Indications of theophylline toxicity include palpitations, dizziness, restlessness, nausea, vomiting, shakiness, and anorexia. (B) Cigarette smoking significantly lowers theophylline plasma levels. (C) Theophylline should be taken with food to decrease stomach upset. (D) These instructions are appropriate for someone taking digoxin.

• Question 432:

  When assessing a female child for Turner's syndrome, the nurse observes for which of the following symptoms?

  A. Tall stature
  B. Amenorrhea
  C. Secondary sex characteristics
  D. Gynecomastia
  B. Amenorrhea

  ---

  (A) This syndrome is caused by absence of one of the X chromosomes. These children are short in stature. (B) Amenorrhea is a symptom of Turner's syndrome, which appears at puberty. (C) Sexual infantilism is characteristic of this syndrome. (D) Gynecomastia is a symptom in Klinefelter's syndrome.

• Question 433:

  A client is diagnosed with diabetic ketoacidosis. The nurse should be prepared to administer which of the following IV solutions?

  A. D5in normal saline
  B. D5W
  C. 0.9 normal saline
  D. D5in lactated Ringer's
  C. 0.9 normal saline

  ---

  (A) D5in normal saline would increase serum glucose. (B) D5W would increase serum glucose. (C) A concentration of 0.9 NS is used to correct extracellular fluid depletion. (D) D5in Ringer's lactate would increase serum glucose.

• Question 434:

  The nurse working with a client who is out of control should follow a model of intervention that includes which of the following?

  A. Approach the client on a continuum of least restrictive care.
  B. Challenge client's behavior immediately with steps to prevent injury to self or others.
  C. Leave the aggressive client to himself or herself, and take other clients away.
  D. To ensure safety of other clients, place client in seclusion immediately when he or she begins shouting.
  A. Approach the client on a continuum of least restrictive care.

  ---

  (A) Approaching a client's aggressive behavior on a continuum of least restrictive care is in agreement with his or her rights (i.e., verbal methods to help maintain control, medication, seclusion, and restraints, as necessary). (B) Approaching a client in a challenging manner is threatening and inappropriate. A nonchallenging and calm approach reflects staff in control and may increase client's internal control. (C) It is inappropriate to leave an aggressive client who is acting out alone. The nurse should acquire qualified help to prevent client from harm or injury to self or others. (D) Moving a client to seclusion immediately for shouting is inappropriate. The nurse should offer the client an opportunity to control self with limit setting. The client should understand that the staff will assist with control if necessary (i.e., quietly accompany out of environment to decrease stimulation and allow for verbalization) employing the least restrictive care model of intervention.

• Question 435:

  Pin care is a part of the care plan for a client who is in skeletal traction. When assessing the site of pin insertion, which one of the following findings would the nurse know as an indicator of normal wound healing?

  A. Exudate
  B. Crust
  C. Edema
  D. Erythema
  B. Crust

  ---

  (A) Exudate (moist, active drainage) is a clinical sign of wound infection. (B) Crust (dry, scaly) is part of the normal stages of wound healing and should not be removed from around the pin site. It usually sloughs off after the underlying tissue has healed. (C) Edema (swelling) is a clinical sign of wound infection. (D) Erythema (redness) is a clinical sign of wound infection.

• Question 436:

  The nurse would assess the client's correct understanding of the fertility awareness methods that enhance conception, if the client stated that:

  A. "My sexual partner and I should have intercourse when my cervical mucosa is thick and cloudy."
  B. "At ovulation, my basal body temperature should rise about 0.5F."
  C. "I should douche immediately after intercourse."
  D. "My sexual partner and I should have sexual intercourse on day 14 of my cycle regardless of the length of the cycle."
  B. "At ovulation, my basal body temperature should rise about 0.5F."

  ---

  (A) At ovulation, the cervical mucus is increased, stretchable, and watery clear. (B) Under the influence of progesterone, the basal body temperature increases slightly after ovulation. (C) To enhance fertility, measures should be taken that promote retention of sperm rather than removal. (D) Ovulation, the optimal time for conception, occurs 14+2 days before the next menses; therefore, the date of ovulation is directly related to the length of the menstrual cycle.

• Question 437:

  A chronic alcoholic client's condition deteriorates, and he begins to exhibit signs of hepatic coma. Which of the following is an early sign of impending hepatic coma?

  A. Hiccups
  B. Anorexia
  C. Mental confusion
  D. Fetor hepaticus
  C. Mental confusion

  ---

  (A)

  Hiccups are not a sign of impending hepatic coma. (B) Anorexia is not a sign of impending hepatic coma. (C) One of the earliest symptoms of hepatic coma is mental confusion. Asterixis, a flapping tremor of the hand, may also be seen.

  (D)

  This sign is associated with the later stages of hepatic coma. Fetor hepaticus, a characteristic odor on the breath that smells like acetone, may sometimes be noted when the liver fails.

• Question 438:

  At 30 weeks' gestation, a client is admitted to the unit in premature labor. Her contractions are every 5 minutes and last 60 seconds, her cervix is closed, and the suture placed around her cervix during her 16th week of gestation, when she had the MacDonald procedure, can still be felt by the physician. The amniotic sac is still intact. She is very concerned about delivering prematurely. She asks the RN, "What is the greatest risk to my baby if it is born prematurely?" The RN's answer should be:

  A. Hyperglycemia
  B. Hypoglycemia
  C. Lack of development of the intestines
  D. Lack of development of the lungs
  D. Lack of development of the lungs

  ---

  (A) Any infant would be at risk for hyperglycemia because the infant's liver is missing the islets of Langerhans, which secrete insulin to break down glucose for cellular use. Prematurity is not an added risk for hyperglycemia. (B) Both premature and mature infants can be at risk for hypoglycemia if their mother had gestational diabetes during pregnancy or entered the pregnancy with diabetes mellitus. These infants are exposed to high levels of maternal glucose while in utero, which causes the islets of Langerhans in the infant's liver to produce insulin. After birth when the umbilical cord is severed, the generous amount of maternal blood glucose is eliminated; however, there is continued islet cell hyperactivity in the infant's liver, which can lead to excessive insulin levels and depleted blood glucose. (C) Mature infants are born with an immature GI system. The nervous control of the stomach is incomplete at birth, salivary glands are immature at birth, and the intestinal tract is sterile. This is not the greatest risk to the premature infant. (D) Infants born before 37 weeks' gestation are at greatest risk for an insufficient amount of surfactant in the alveoli system of the lungs. Surfactant helps to prevent lung collapse and ensures stability of the respiratory system so that the infant can maintain his own respirations once the umbilical cord is severed at birth.

• Question 439:

  Hematotympanum and otorrhea are associated with which of the following head injuries?

  A. Basilar skull fracture
  B. Subdural hematoma
  C. Epidural hematoma
  D. Frontal lobe fracture
  A. Basilar skull fracture

  ---

  (A) Basilar skull fractures are fractures of the base of the skull. Blood behind the eardrum or blood or cerebrospinal fluid (CSF) leaking from the ear are indicative of a dural laceration. Basilar skull fractures are the only type with these symptoms. (B, C, D) These do not typically cause dural lacerations and CSF leakage.

• Question 440:

  A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimer's disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:

  A. Allowing the client to perform activities of daily living as much as possible unassisted
  B. Confronting confabulations
  C. Reality testing
  D. Providing a highly stimulating environment
  A. Allowing the client to perform activities of daily living as much as possible unassisted

  ---

  (A) This answer is correct. The more the client is able to control her daily routine, the less anxiety she will experience. (B) This answer is incorrect. Confrontation tends to increase anxiety. (C) This answer is incorrect. Reality testing is an assessment tool. It does not decrease anxiety. (D) This answer is incorrect. A highly stimulating environment increases distractibility and anxiety.