NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 481:

  A primigravida with a blood type A negative is at 28 weeks' gestation. Today her physician has ordered a RhoGAM injection. Which statement by the client demonstrates that more teaching is needed related to this therapy?

  A. "I'm getting this shot so that my baby won't develop antibodies against my blood, right?"
  B. "I understand that if my baby is Rh positive I'll be getting another one of these injections."
  C. "This shot should help to protect me in future pregnancies if this baby is Rh positive, like my husband."
  D. "This shot will prevent me from becoming sensitized to Rh-positive blood."
  A. "I'm getting this shot so that my baby won't develop antibodies against my blood, right?"

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  (A) RhoGAM is given to Rh-negative mothers to prevent the maternal Rh immune response to fetal Rh-positive antigens. (B) If the infant is Rh positive, the mother will receive another dose postdelivery to prevent maternal sensitization. (C) Prevention of maternal sensitization will protect future pregnancies because the mother's blood will be free of antibodies against her fetus. (D) RhoGAM prevents maternal sensitization to Rh-positive blood.

• Question 482:

  Succinylcholine chloride (Anectine) is ordered prior to electroconvulsive therapy treatment for depressed clients. The nurse explains that the purpose of the drug is to:

  A. Relax muscles
  B. Relieve anxiety
  C. Reduce secretions
  D. Act as an anesthetic
  A. Relax muscles

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  (A) Succinylcholine chloride relaxes muscles and decreases the intensity of the seizure. (B) Succinylcholine chloride does not relieve anxiety. (C) Atropine is given to reduce secretions. (D) Thiamylal sodium (Surital) or other phenobarbital preparations are used as brief anesthetics.

• Question 483:

  The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be exhibiting a toxic reaction to:

  A. Digoxin (Lanoxin)
  B. Lidocaine (Xylocaine)
  C. Quinidine gluconate or sulfate (Quinaglute, Quinidex)
  D. Nitroglycerin IV (Tridil)
  B. Lidocaine (Xylocaine)

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  (A) Side effects of digoxin include headache, hypotension, AV block, blurred vision, and yellow-green halos. (B) Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor, lethargy, and convulsions. (C) Side effects of quinidine include heart block, hepatotoxicity, thrombocytopenia, and respiratory depression. (D) Side effects of nitroglycerin include postural hypotension, headache, dizziness, and flushing.

• Question 484:

  A client is admitted to the labor room. She is dilated 4 cm. She is placed on electric fetal monitoring. Which of the following observations necessitates notifying the physician?

  A. Contractions every 2 minutes, lasting 100 seconds
  B. Fetal heart decelerations during a contraction
  C. Beat-to-beat variability between contractions
  D. Fetal heart decelerations at the beginning of contractions
  A. Contractions every 2 minutes, lasting 100 seconds

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  (A) These are tetanic in nature and can cause rupture of the uterus. (B) The FHR decreases during contractions owing to vasoconstriction and should recover after the contraction. (C) Beat-to-beat variability is a normal finding and demonstrates fetal well- being. (D) The FHR may decrease at the beginning of a contraction owing to head compression.

• Question 485:

  A client has been diagnosed with congestive heart failure. His fluid intake and output are strictly regulated. For lunch, he drank 8 oz of milk, 4 oz of tea, and 6 oz of coffee. His intake would be recorded as:

  A. 500 mL
  B. 540 mL
  C. 600 mL
  D. 655 mL
  B. 540 mL

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  (A, C, D) This answer is a miscalculation. (B) 1 oz = 30 mL; therefore, 18 oz x.

• Question 486:

  A newborn infant is exhibiting signs of respiratory distress. Which of the following would the nurse recognize as the earliest clinical sign of respiratory distress?

  A. Cyanosis
  B. Increased respirations
  C. Sternal and subcostal retractions
  D. Decreased respirations
  C. Sternal and subcostal retractions

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  (A) Cyanosis is a late clinical sign of respiratory distress. (B) Rapid respirations are normal in a newborn. (C) The newborn has to exert an extra effort for ventilation, which is accomplished by using the accessory muscles of ventilation. The diaphragm and abdominal muscles are immature and weak in the newborn. (D) Decreased respirations are a late clinical sign. In the newborn, decreased respirations precede respiratory failure.

• Question 487:

  A seventh grader lost consciousness after being hit in the head with a basketball. In the emergency room his vital signs are stable, and he demonstrates no neurologic deficit. He will not be admitted to the hospital. It is most important that you advise his mother to:

  A. Encourage him to drink plenty of fluids
  B. Expect him to have nausea with vomiting
  C. Keep him awake for the next 12 hours
  D. Wake him up every 1? hours during the night
  D. Wake him up every 1? hours during the night

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  (A) Fluid intake should be normal. Fluid intake may be restricted when there is a risk for increased ICP in a hospitalized client. (B) Nausea is possible, but vomiting without nausea is more likely with increased ICP. Neither one should be expected, but the mother should know to notify the physician or hospital if they occur. (C) The child does not need to be kept awake. It is important that he can be aroused from sleep. (D) If the child cannot be awakened from sleep after head injury, it is an indication of serious increase in ICP. The mother should call an ambulance right away.

• Question 488:

  The serial sevens test is often used to determine delirium and dementia. This test aids in assessing which of the following?

  A. Abstract thinking
  B. Ability to focus and concentrate thoughts
  C. Judgment
  D. Memory
  B. Ability to focus and concentrate thoughts

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  (A) This answer is incorrect. The test measures the abilities to concentrate and calculate. The use of proverbs is the most common way to test abstraction. (B) This answer is correct. The serial sevens test is a common test of calculation ability. It is difficult for the demented or delirious client to perform. (C) This answer is incorrect. The test for judgment should predict whether the individual will behave in a socially accepted manner. (D) This answer is incorrect. In testingmemory, the nurse would attempt to get the client either to recall recent events or to think about past events.

• Question 489:

  Chorioamnionitis is a maternal infection that is usually associated with:

  A. Prolonged rupture of membranes
  B. Postterm deliveries
  C. Maternal pyelonephritis
  D. Maternal dehydration
  A. Prolonged rupture of membranes

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  (A) Chorioamnionitis is an inflammation of the chorion and amnion that is generally associated with premature or prolonged rupture of membranes. (B) Postterm deliveries have not been shown to increase the risk of chorioamnionitis unless there has been prolonged rupture of membranes. (C) Pyelonephritis is a kidney infection that develops in 20%?0% of untreated maternal UTIs. (D) Maternal dehydration, though of great concern, is not related to chorioamnionitis.

• Question 490:

  A 19-year-old client has sustained a C-7 fracture, which resulted in his spinal cord being partially transected. By 2 weeks' postinjury, his neck has been surgically stabilized, and he has been transferred from the intensive care unit. A potential life-threatening complication the nurse monitors the client for is:

  A. Autonomic dysreflexia
  B. Bradycardia
  C. Central cord syndrome
  D. Spinal shock
  A. Autonomic dysreflexia

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  (A) Autonomic dysreflexia is the exaggerated sympathetic nervous system response to various stimuli in the anesthetized area. Sympathetic stimulation results in severe, uncontrolled hypertension, which may result in myocardial infarction or cerebral hemorrhage. (B) Bradycardia occurs as a result of sympathetic blockade in the immediate postinjury period. After spinal shock recedes, cardiovascular stability returns, but the client will be bradycardiac for life. (C) Central cord syndrome is a specific type of spinal cord injury that occurs as a result of either hyperextension injuries or disrupted blood flow to the spinal cord. (D) Spinal shock occurs in the immediate postinjury phase and usually resolves in approximately 72 hours.