NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 471:

  To prevent fungal infections of the mouth and throat, the nurse should teach clients on inhaled steroids to:

  A. Rinse the plastic holder that aerosolizes the drug with hydrogen peroxide every other day
  B. Rinse the mouth and gargle with warm water after each use of the inhaler
  C. Take antacids immediately before inhalation to neutralize mucous membranes and prevent infection
  D. Rinse the mouth before each use to eliminate colonization of bacteria
  B. Rinse the mouth and gargle with warm water after each use of the inhaler

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  (A)

  It is sufficient to rinse the plastic holders with warm water at least once per day. (B) It is important to rinse the mouth after each use to minimize the risk of fungal infections by reducing the droplets of the glucocorticoid left in the oral cavity.

  (C)

  Antacids act by neutralizing or reducing gastric acid, thus decreasing the pH of the stomach. "Neutralizing" the oral mucosa prior to inhalation of a steroid inhaler does not minimize the risk of fungal infections. (D) Rinsing prior to the use of the glucocorticoid will not eliminate the droplets left on the oral mucous membranes following the use of the inhaler.

• Question 472:

  Home-care instructions for the child following a cardiac catheterization should include:

  A. Notify the physician if a slight bruise develops around the insertion site.
  B. Use sponge bathing until stitches are removed.
  C. Give aspirin if the child complains of pain at the insertion site.
  D. Keep a clean, dry dressing on the insertion site for 2 days.
  B. Use sponge bathing until stitches are removed.

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  (A) A small bruise may develop around the insertion site and is not a reason for alarm. (B) It is best to keep the child out of the bathtub until the sutures are removed. (C) Acetaminophen, not aspirin, is the drug of choice if there is pain at the insertion site. (D) The insertion site should be kept clean and dry and open to air.

• Question 473:

  In cleansing the perineal area around the site of catheter insertion, the nurse would:

  A. Wipe the catheter toward the urinary meatus
  B. Wipe the catheter away from the urinary meatus
  C. Apply a small amount of talcum powder after drying the perineal area
  D. Gently insert the catheter another 12 inch after cleansing to prevent irritation from the balloon
  B. Wipe the catheter away from the urinary meatus

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  (A) Wiping toward the urinary meatus would transport microorganisms from the external tubing to the urethra, thereby increasing the risk of bladder infection. (B) Wiping away from the urinary meatus would remove microorganisms from the point of insertion of the catheter, thereby decreasing the risk of bladder infection. (C) Talcum powder should not be applied following catheter care, because powders contribute to moisture retention and infection likelihood. (D) The catheter should never be inserted further into the urethra, because this would serve no useful purpose and would increase the risk of infection.

• Question 474:

  A 3-year-old child is in the burn unit following a home accident. The first sign of sepsis in burned children is:

  A. Disorientation
  B. Low-grade fever
  C. Diarrhea
  D. Hypertension
  A. Disorientation

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  (A) Disorientation is the first sign of sepsis in burn children. (B) Low-grade fever is not indicative of sepsis. (C) Diarrhea is not indicative of sepsis. (D) Hypertension is not indicative of sepsis.

• Question 475:

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

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  (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 476:

  Clinical manifestations seen in left-sided rather than in right-sided heart failure are:

  A. Elevated central venous pressure and peripheral edema
  B. Dyspnea and jaundice
  C. Hypotension and hepatomegaly
  D. Decreased peripheral perfusion and rales
  D. Decreased peripheral perfusion and rales

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  (A, B, C) Clinical manifestations of right-sided heart failure are weakness, peripheral edema, jugular venous distention, hepatomegaly, jaundice, and elevated central venous pressure. (D) Clinical manifestations of left-sided heart failure are left ventricular dysfunction, decreased cardiac output, hypotension, and the backward failure as a result of increased left atrium and pulmonary artery pressures, pulmonary edema, and rales.

• Question 477:

  Assessment of parturient reveals the following: cervical dilation 6 cm and station 22; no progress in the last 4 hours. Uterine contractions decreasing in frequency and intensity. Marked molding of the presenting fetal head is described. The physician orders, "Begin oxytocin induction at 1 mU/min." The nurse should:

  A. Begin the oxytocin induction as ordered
  B. Increase the dosage by 2 mU/min increments at 15-minute intervals
  C. Maintain the dosage when duration of contractions is 400 seconds and frequency is at 212 minute intervals
  D. Question the order
  D. Question the order

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  (A) Oxytocin stimulates labor but should not be used until CPD (cephalopelvic disproportion) is ruled out in a dysfunctional labor. (B) This answer is the correct protocol for oxytocin administration, but the medication should not be used until CPD is ruled out. (C) This answer is the correct manner to interpret effective stimulation, but oxytocin should not be used until CPD is ruled out. (D) This answer is the appropriate nursing action because the scenario presents adysfunctional labor pattern that may be caused by CPD. Oxytocin administration is contraindicated in CPD.

• Question 478:

  A client develops an intestinal obstruction postoperatively. A nasogastric tube is attached to low, intermittent suction with orders to "Irrigate NG tube with sterile saline q1h and prn." The rationale for using sterile saline, as opposed to using sterile water to irrigate the NG tube is:

  A. Water will deplete electrolytes resulting in metabolic acidosis.
  B. Saline will reduce the risk of severe, colicky abdominal pain during NG irrigation.
  C. Water is not isotonic and will increase restlessness and insomnia in the immediate postoperative period.
  D. Saline will increase peristalsis in the bowel.
  A. Water will deplete electrolytes resulting in metabolic acidosis.

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  (A) Water is a hypotonic solution and will deplete electrolytes and cause metabolic acidosis when used for nasogastric irrigation. (B) Irrigating with saline does not cause abdominal discomfort. Severe, colicky abdominal pain is a symptom of intestinal obstruction. (C) Irrigating with water will not cause restlessness or insomnia in the postoperative client. Restlessness and insomnia can be emotional complications of surgery. (D) A nasogastric tube placed in the stomach is used to decompress the bowel. Irrigating with saline ensures a patent, well-functioning tube. Irrigating with saline will not increase peristalsis.

• Question 479:

  A mother frantically calls the emergency room (ER) asking what to do about her 3-year-old girl who was found eating pills out of a bottle in the medicine cabinet. The ER nurse tells the mother to:

  A. Give the child 15 mL of syrup of ipecac.
  B. Give the child 10 mL of syrup of ipecac with a sip of water.
  C. Give the child 1 cup of water to induce vomiting.
  D. Bring the child to the ER immediately.
  D. Bring the child to the ER immediately.

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  (A) Before giving any emetic, the substance ingested must be known. (B) At least 8 oz of water should be administered along with ipecac syrup to increase volume in the stomach and facilitate vomiting. (C) Water alone will not induce vomiting. An emetic is necessary to facilitate vomiting. (D) Vomiting should never be induced in an unconscious client because of the risk of aspiration.

• Question 480:

  A 5-year-old child cries continually in her bed. Her parents have been unsuccessful in assisting her in expressing her feelings. Which activity should the nurse provide the child to assist her in expressing her feelings?

  A. Books with colorful pictures
  B. Music
  C. Riding toys
  D. Puppets
  D. Puppets

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  (A) Books increase cognition, assist with fine motor skills, and augment language development. (B) Music provides auditory stimulation and large-muscle activity. (C) Riding toys provide large-muscle activity. (D) Puppets allow expression of feelings and fears that otherwise could not be directly communicated.