NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 491:

  A client had abdominal surgery this morning. The nurse notices that there is a small amount of bloody drainage on his surgical dressing. The nurse would document this as what type of drainage?

  A. Serosanguinous
  B. Purulent
  C. Sanguinous
  D. Catarrhal
  C. Sanguinous

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  (A) Drainage from a surgical incision usually proceeds from sanguinous to serosanguinous. (B) Purulent drainage usually indicates infection and should not be seen initially from a surgical incision. (C) Drainage from a surgical incision is initially sanguinous, proceeding to serosanguinous, and then to serous. (D) Catarrhal is a type of exudate seen in upper respiratory infections, not in surgical incisions.

• Question 492:

  Hypoxia is the primary problem related to near-drowning victims. The first organ that sustains irreversible damage after submersion in water is the:

  A. Kidney (urinary system)
  B. Brain (nervous system)
  C. Heart (circulatory system)
  D. Lungs (respiratory system)
  B. Brain (nervous system)

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  (A) The kidney can survive after 30 minutes of water submersion. (B) The cerebral neurons sustain irreversible damage after 4? minutes of water submersion. (C) The heart can survive up to 30 minutes of water submersion. (D) The lungs can survive up to 30 minutes of water submersion.

• Question 493:

  An obstructing stone in the renal pelvis or upper ureter causes:

  A. Radiating pain into the urethra with labia pain experienced in females or testicular pain in males
  B. Urinary frequency and dysuria
  C. Severe flank and abdominal pain with nausea, vomiting, diaphoresis, and pallor
  D. Dull, aching, back pain
  C. Severe flank and abdominal pain with nausea, vomiting, diaphoresis, and pallor

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  (A) Radiating pain in the urethra in both sexes, extending into the labia in females and into the testicle or penis in the male, indicates a stone in the middle or lower segment of the ureter. (B) Urinary frequency and dysuria are caused by a stone in the terminal segment of the ureter withinthe bladder wall. (C) An obstructing stone in the renal pelvis or upper ureter causes severe flank and abdominal pain with nausea, vomiting, diaphoresis, and pallor. (D) Dull and aching pain may indicate early stages of hydronephrosis. Also, a stone in the renal pelvis or upper ureter causes severe flank and abdominal pain.

• Question 494:

  A 79-year-old client with Alzheimer's disease is exhibiting significant memory impairment, cognitive impairment, extremely impaired judgment in social situations, and agitation when placed in a new situation or around unfamiliar people. The nurse should include the following strategy in the client's care:

  A. Maintain routines and usual structure and adhere to schedules.
  B. Encourage the client to attend all structured activities on the unit, whether she wants to or not.
  C. Ask the client to go to an activity once. If she gives no response right away, change the question around, asking the same thing.
  D. Give the client two or three choices to decide what she wants to do.
  A. Maintain routines and usual structure and adhere to schedules.

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  (A) Alzheimer's clients cope poorly with changes in routine because of memory deficits. Schedule changes cause confusion and frustration, whereas adhering to schedules is helpful and supports orientation. (B) Insisting that the client go to all unit activities may antagonize her and increase her agitation because of cognitive impairments. It may be better to allow the client time for calming down or distraction rather than to insist that she attend every activity. (C) When repeating a question, allow time first for a response; then use the same words the second time to avoid further confusion. (D) The nurse should avoid giving several choices at once. Cognitively impaired clients will become more frustrated with making decisions.

• Question 495:

  After instructing a female client on circumcision care, the nursery nurse asks her to restate some of the key points covered. Which statement shows that the client will properly care for her son's circumcision?

  A. "I'll make sure I soak the gauze with warm water first, before I take it off each time."
  B. "I'll make sure that I report any drainage around where they operated."
  C. "I'll apply alcohol to the area daily to clean it and prevent any infection."
  D. "I'll keep a close watch on it for a day or two."
  A. "I'll make sure I soak the gauze with warm water first, before I take it off each time."

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  (A) Before petrolatum gauze is removed, it should be soaked with warm water to prevent trauma to adherent tissues. (B) A yellow exudate often forms normally over the surgical site. Only if it becomes foul-smelling and purulent would it need to be reported. (C) Alcohol should never be used on the site; this would be extremely painful to the infant. (D) Special care and observance should continue until the site is completely covered with clean, pink granulation tissue, which could take 7?0 days.

• Question 496:

  On the third postpartum day, a client complains of extremely tender breasts. On palpation, the nurse notes a very firm, shiny appearance to the breasts and some milk leakage. She is bottle feeding. The nurse should initially recommend to her to:

  A. Take 2 ibuprofen (Motrin) tablets by mouth now because the baby will be returning for feeding in 20 minutes
  B. Allow the infant to breast-feed at the next feeding time to empty the breasts
  C. Apply ice packs to the breasts and wear a supportive, well-fitting bra
  D. Take a warm shower and express milk from both breasts until empty
  C. Apply ice packs to the breasts and wear a supportive, well-fitting bra

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  (A) Judicious use of analgesics is appropriate with breast engorgement; however, mechanical suppression would be the initial recommendation. (B) Breast-feeding every 112? hours will reduce and/or prevent breast engorgement. Breastfeeding will promote milk production, which will compound the distention and stasis of the venous circulation of engorgement in a bottlefeeding mother. (C) Ice packs reduce milk flow while the snug, supportive bra provides mechanical suppression and decreases pulling on Cooper's ligament. In addition, breast binders or ace bandages may be used for some women. (D) Warmth promotes milk production and may stimulate the let-down reflex. These measures would contribute to the venous congestion of engorgement.

• Question 497:

  In planning daily care for a client with multiple sclerosis, the nurse would take into consideration that multiple sclerosis:

  A. Becomes progressively debilitating without remission
  B. Has unpredictable remissions and exacerbations
  C. Is rapidly fatal
  D. Responds quickly to antimicrobial therapy
  B. Has unpredictable remissions and exacerbations

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  (A) Multiple sclerosis eventually becomes debilitating, but it is characterized by remission of symptoms. (B) Remissions and exacerbations are unpredictable with multiple sclerosis. The client experiences progressive dysfunction after each exacerbation episode. (C) Multiple sclerosis is usually slowly progressive. (D) Multiple sclerosis is an autoimmune disease. Antimicrobial therapy has no effect on its course.

• Question 498:

  A 45-year-old male client experiences a sense of depression because he has not yet achieved his life's goals. His career has not been satisfying. He is still looking for the right job. His wife spends too much money, and his children seem to ignore him while being very selfish. He is tired of all of their attitudes and is considering buying a red Corvette convertible. While obtaining these data concerning the client's feelings about his life, the nurse is able to determine he is experiencing what psychological crisis according to Erikson's stages?

  A. Identity versus role confusion
  B. Integrity versus despair
  C. Intimacy versus isolation
  D. Generativity versus self-absorption
  D. Generativity versus self-absorption

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  (A) Identity versus role confusion is experienced by adolescents making the transition from childhood to adulthood as they attempt to develop a sense of identity. (B) Integrity versus despair is experienced by the elderly as they reflect on their life in an attempt to find meaning. (C) Intimacy versus isolation is experienced by young adults as they establish intimate bonds of love and friendship. (D) Generativity versus self-absorption is experienced by middle-aged adults as they fulfill life goals that involve family, career, and society. The client is experiencing this crisis.

• Question 499:

  While the nurse is taking a male client's blood pressure, he makes flirtatious remarks to her. The nurse will handle this effectively if she:

  A. Politely tells the client, "Keep your hands off "
  B. Ignores the remarks and hopes he will not try it again
  C. Confronts the remarks but attempts not to reject the client
  D. Leaves the room in order to compose herself
  C. Confronts the remarks but attempts not to reject the client

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  (A) This response does not recognize normal feelings of attraction and rejects the client. (B) By ignoring the situation, the nurse has not set limits to discourage other remarks or perhaps more sexually aggressive behavior. (C) By confronting the remarks, she can recognize that his feelings of attraction may be normal but are not appropriate within the context of their nurse-client relationship. (D) Leaving the room does not deal with setting limits for future interactions.

• Question 500:

  A client is medically cleared for ECT and is tentatively scheduled for six treatments over a 2-week period. Her husband asks, "Isn't that a lot?" The nurse's best response is:

  A. "Yes, that does seem like a lot."
  B. "You'll have to talk to the doctor about that. The physician knows what's best for the client."
  C. "Six to 10 treatments are common. Are you concerned about permanent effects?"
  D. "Don't worry. Some clients have lots more than that."
  C. "Six to 10 treatments are common. Are you concerned about permanent effects?"

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  (A) This response indicates that the nurse is unsure of herself and not knowledgeable about ECT. It also reinforces the husband's fears. (B) This response is "passing the buck" unnecessarily. The information needed to appropriately answer the husband's question is well within the nurse's knowledge base. (C) The most common range for affective disorders is 6?0 treatments. This response confirms and reinforces the physician's plan for treatment. It also opens communicationwith the husband to identify underlying fears and knowledge deficits. (D) This response offers false reassurance and dismisses the husband's underlying concerns about his wife.