NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 461:

  Due to his prolonged history of alcohol abuse, an alcoholic client will most likely have deficiencies of which of the following nutrients?

  A. Vitamin C and zinc
  B. Folic acid and niacin
  C. Vitamin A and biotin
  D. Thiamine and pyroxidine
  D. Thiamine and pyroxidine

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  (A) Chronic alcoholism can lead to deficiencies of B complex vitamins including thiamine and pyroxidine. (B) Chronic alcoholism can lead to deficiencies of vitamins A, D, K, and B complex. (C) Chronic alcoholism can lead to deficiencies of vitamins A, D, K, and B complex. (D) Vitamins A, D, K, and B require bile salts to be absorbed from the gastrointestinal tract. A damaged liver does not form bile salts.

• Question 462:

  A client tells the nurse that she has had a history of urinary tract infections. The nurse would do further health teaching if she verbalizes she will:

  A. Drink at least 8 oz of cranberry juice daily
  B. Maintain a fluid intake of at least 2000 mL daily
  C. Wash her hands before and after voiding
  D. Limit her fluid intake after 6 PM so that there is not a great deal of urine in her bladder while she sleeps
  D. Limit her fluid intake after 6 PM so that there is not a great deal of urine in her bladder while she sleeps

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  (A) Cranberry juice helps to maintain urine acidity, thereby retarding bacterial growth. (B) A generous fluid intake will help to irrigate the bladder and to prevent bacterial growth within the bladder. (C) Hand washing is an effective means of preventing pathogen transmission. (D) Restricting fluid intake would contribute to urinary stasis, which in turn would contribute to bacterial growth.

• Question 463:

  During burn therapy, morphine is primarily administered IV for pain management because this route:

  A. Delays absorption to provide continuous pain relief
  B. Facilitates absorption because absorption from muscles is not dependable
  C. Allows for discontinuance of the medication if respiratory depression develops
  D. Avoids causing additional pain from IM injections
  B. Facilitates absorption because absorption from muscles is not dependable

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  (A) Absorption would be increased, not decreased. (B) IM injections should not be used until the client is hemodynamically stable and has adequate tissue perfusion. Medications will remain in the subcutaneous tissue with the fluid that is present in the interstitial spaces in the acute phase of the thermal injury. The client will have a poor response to the medication administered, and a "dumping" of the medication can occur when the medication and fluid are shifted back into the intravascular spaces in the next phase of healing. (C) IV administration of the medication would hasten respiratory compromise, if present. (D) The desire to avoid causing the client additional pain is not a primary reason for this route of administration.

• Question 464:

  In admitting a client to the psychiatric unit, the nurse must explain the rules and regulations of the unit. A client with antisocial personality disorder makes the following remark, "Forget all those rules. I always get along well with the nurses." Which nursing response to him would be most effective?

  A. "OK, don't listen to the rules. See where you end up."
  B. "I'm pleased that you get along so well with the staff. You must still know and abide by the rules."
  C. "It is irrelevant whether you get along with the nurses."
  D. "I'm not the other nurses. You better read the rules yourself."
  B. "I'm pleased that you get along so well with the staff. You must still know and abide by the rules."

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  (A) This answer is incorrect. A nurse should be an appropriate role model. Threats are not appropriate. No limit setting was stated. (B) This answer is correct. The nurse made a positive statement followed by a simple, clear, concise setting of limits. (C) This answer is incorrect. It appears to have a negative connotation. There was no limit setting. (D) This answer is incorrect. The nurse obviously responded in a negative manner. Learning takes place more readily when one is accepted, not rejected. No limits were set.

• Question 465:

  A client is in early labor. Her fetus is in a left occipitoanterior (LOA) position; fetal heart sounds are best auscultated just:

  A. Below the umbilicus toward left side of mother's abdomen
  B. Below the umbilicus toward right side of mother's abdomen
  C. At the umbilicus
  D. Above the umbilicus to the left side of mother's abdomen
  A. Below the umbilicus toward left side of mother's abdomen

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  (A) LOA identifies a fetus whose back is on its mother's left side, whose head is the presenting part, and whose back is toward its mother's anterior. It is easiest to auscultate fetal heart tones (FHTs) through the fetus's back. (B) The identified fetus's back is on its mother's left side, not right side. It is easiest to auscultate FHTs through the fetus's back. (C) In an LOA position, the fetus's head is presenting with the back to the left anterior side of the mother. The umbilicus is too high of a landmark for auscultating the fetus's heart rate through its back. (D) This is the correct auscultation point for a fetus in the left sacroanterior position, where the sacrum is presenting, not LOA.

• Question 466:

  An 8-week-old infant has been diagnosed with gastroesophageal reflux. The nurse is teaching the infant's mother to care for the infant at home. Which one of the following statements by the nurse is appropriate regarding the infant's home care?

  A. "Lay the infant flat on her left side after feeding."
  B. "Feed the infant every 4 hours with half-strength formula."
  C. "Antacids need to be given an hour before feeding."
  D. "Play activities should be carried out before instead of after feedings."
  D. "Play activities should be carried out before instead of after feedings."

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  (A) Elevating the child's head to a 30-degree angle is the recommended position for gastroesophageal reflux. The supine position predisposes the child to aspiration. (B) Small, frequent feedings with thickened formula are recommended to minimize vomiting. (C) Antacids should be given at the same time as the feeding to improve their buffering action. (D) The infant should be kept still after feedings to reduce the risk of vomiting and aspiration. Vigorous activities should be carried out before feedings.

• Question 467:

  A 5-year-old child is hospitalized for an acute illness. The nurse encourages the family to bring her favorite objects from home. What is the nurse's rationale?

  A. To reduce fear of the unknown
  B. To keep the child calm
  C. To establish a trusting relationship
  D. To prevent or minimize separation anxiety
  D. To prevent or minimize separation anxiety

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  (A) Objects from home do not reduce fear of the unknown. Children need explanations, reassurance, and preparation for the unknown. Also, parental presence can promote comfort and feelings of security. (B) A calm, relaxed, and reassuring manner will assist in calming the child. The child's objects from home will not assist in calming the child. (C) A trusting relationship is based on the quality of the nurse-client relationship. Objects from home have no impact. (D) Favorite objects from home assist in creating a familiar setting. Also, these objects may prevent or minimize separation from the child's usual routine and family support.

• Question 468:

  A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would expect which of the following to be present in relation to his blood sugar level?

  A. A normal blood sugar level
  B. A decreased blood sugar level
  C. An increased blood sugar level
  D. Fluctuating levels with a predawn increase
  C. An increased blood sugar level

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  (A) Blood sugar levels increase when the body responds to stress and illness. (B) Blood sugar levels increase when the body responds to stress and illness. (C) Hyperglycemia occurs because glucose is produced as the body responds to the stress and illness of cellulitis. (D) Blood sugar levels remain elevated as long as the body responds to stress and illness.

• Question 469:

  The nurse is caring for a 6-week-old girl with meningitis. To help her develop a sense of trust, the nurse should:

  A. Give her a small soft blanket to hold
  B. Give her good perineal care after each diaper change
  C. Leave the door open to her room
  D. Pick her up when she cries
  D. Pick her up when she cries

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  (A) A soft blanket may be comforting, but it is not directed toward developing a sense of trust. (B) Good perineal care is important, but it is not directed toward developing a sense of trust. (C) An infant with meningitis needs frequent attention, but leaving the door open does not foster trust. (D) Consistently picking her up when she cries will help the child feel trust in her caregivers.

• Question 470:

  A 30-year-old client has been admitted to the psychiatric service with the diagnosis of schizophrenia. He tells the nurse that when the woman he had been dating broke up with him, the CIA had replaced her with an identical twin. The client is experiencing:

  A. Grandiose delusions
  B. Paranoid delusions
  C. Auditory hallucinations
  D. Visual hallucinations
  B. Paranoid delusions

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  (A) There are no indications that the client's thoughts reflect special powers or talents characteristic of grandiosity. (B) The client's thought content is fixed, false, persecutory, and suspicious in nature, which is characteristic of paranoid delusions. (C, D) The client is not demonstrating a sensory experience.