NCLEX NCLEX Certifications NCLEX-RN Questions & Answers

• Question 51:

  The physician decides to prescribe both a short-acting insulin and an intermediate-acting insulin for a newly diagnosed 8-year-old diabetic client. An example of a short-acting insulin is:

  A. Novolin Regular

  B. Humulin NPH

  C. Lente Beef

  D. Protamine zinc insulin

  Correct Answer: A

  (A) Novolin is a short-acting insulin. (B, C) NPH and Lente are intermediate-acting insulins. (D) Protamine zinc insulin is a long-acting insulin preparation.

• Question 52:

  A male client is considering having laser abdominal surgery and asks the nurse if there is any advantage in having this type of surgery? The nurse will respond based on the knowledge that laser surgery:

  A. Has a smaller postoperative infection rate than routine surgery

  B. Will eliminate the need for preoperative sedation

  C. Will result in less operating time

  D. Generally eliminates problems with complications

  Correct Answer: B

  (A) A lower postoperative infection has been documented as a result of laser therapy versus routine surgery. (B) Clients will still need preoperative sedation to facilitate anxiety reduction. (C) Operating time may actually increase in some laser surgeries. (D) The client must still be observed for postoperative complications.

• Question 53:

  Which of the following findings would necessitate discontinuing an IV potassium infusion in an adult with ketoacidosis?

  A. Urine output 22 mL/hr for 2 hours

  B. Serum potassium level of 3.7

  C. Small T wave of ECG

  D. Serum glucose level of 180

  Correct Answer: A

  (A) Adequate renal flow of 30 mL/hr is a necessity with potassium infusions because potassium is excreted renally. (B) Because potassium level will decrease during correction of diabetic ketoacidosis, potassium will be infused even if plasma levels of potassium are normal. (C) A small T wave is normal and desired on the electrocardiogram. A tall, peaked T-wave could indicate overinfusion of potassium and hyperkalemia. (D) Glucose levels of <200 are desirable.

• Question 54:

  A client with a head injury asks why he cannot have something for his headache. The nurse's response is based on the understanding that analgesics could:

  A. Counteract the effects of antibiotics

  B. Elevate the blood pressure

  C. Mask symptoms of increasing intracranial pressure

  D. Stimulate the central nervous system

  Correct Answer: C

  (A) Analgesic medication does not counteract the effects of antibiotics. (B) Analgesic medication may lower blood pressure elevated due to anxiety. (C) Analgesic medication, especially CNS depressants, is not given if there is danger of increasing ICP, because neurological changes may not be apparent. Also, further depression of the CNS is contraindicated. (D) Analgesics do not stimulate the CNS.

• Question 55:

  The pediatric nurse charts that the parents of a 4-yearold child are very anxious. Which observation would indicate to the nurse unhealthy coping by these parents:

  A. Discussing their needs with the nursing staff

  B. Discussing their needs with other family members

  C. Seeking support from their minister

  D. Refusing to participate in the child's care

  Correct Answer: D

  (A, B, C) These methods are healthy ways of dealing with anxiety. (D) Participation minimizes feelings of helplessness and powerlessness. It is important that parents have accurate information and that they seek support from sources available to them.

• Question 56:

  A child with celiac disease is being discharged from the hospital. The mother demonstrates knowledge of nutritional needs of her child when she is able to state the foods which are included in a:

  A. Lactose-restricted diet

  B. Gluten-restricted diet

  C. Phenylalanine-restricted diet

  D. Fat-restricted diet

  Correct Answer: B

  (A)

  A lactose-restricted diet is prescribed for children with lactose intolerance or diarrhea. (B) A gluten-restricted diet is the diet for children with celiac disease. (C) A phenylalaninerestricted diet is prescribed for children with phenylketonuria.

  (D)

  A fat- restricted diet is prescribed for children with disorders of the liver, gallbladder, or pancreas.

• Question 57:

  The family member of a child scheduled for heart surgery states, "I just don't understand this open-heart or closed-heart business. I'm so confused! Can you help me understand it?" The nurse explains that patent ductus arteriosus repair is:

  A. Open-heart surgery. The child will be placed on a heart-lung machine while the surgery is being performed.

  B. Closed-heart surgery. It does not require that the child be placed on the heart-lung machine while the surgery is being performed.

  C. A pediatric version of the coronary artery bypass graft surgery performed on adults. It is an open-heart surgery.

  D. A pediatric version of percutaneous transluminal coronary angioplasty performed on adults. It is a closed-heart surgery.

  Correct Answer: B

  (A) Patent ductus arteriosus repair is a closed-heart procedure. The client is not placed on a heart-lung machine. (B) Patent ductus arteriosus is a ductus arteriosus that does not close shortlyafter birth but remains patent. Repair is a closed-heart procedure involving ligation of the patent ductus arteriosus. (C) Coronary artery bypass graft surgery is an open-heart surgical procedure in which blocked coronary arteries are bypassed using vessel grafts. (D) Percutaneous transluminal coronary angioplasty is a closedheart procedure that improves coronary blood flow by increasing the lumen size of narrowed vessels.

• Question 58:

  The parents of a 9-year-old child with acute lymphocytic leukemia expressed concern about his alopecia from cranial irradiation. The nurse explains that: A. Alopecia is an unavoidable side effect.

  B. There are several wig makers for children.

  C. Most children select a favorite hat to protect their heads.

  D. His hair will grow back in a few months.

  Correct Answer: D

  (A) Alopecia has occurred, and knowing it is a side effect does not address their concern. (B) Although true, it does not give them hope for the future. (C) Although true, it does not provide them with information of the temporary nature of the situation. (D) Knowing the hair will grow back provides comfort that the alopecia is temporary.

• Question 59:

  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

  Correct Answer: A

  (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 60:

  A 25-year-old client is admitted for a tonsillectomy. She tells the nurse that she has had episodes of muscle cramps, weakness, and unexplained temperature elevation. Many years ago her father died shortly after surgery after developing a high fever. She further tells the nurse that her surgeon is having her take dantrolene sodium (Dantrium) prophylactically prior to her tonsillectomy. Dantrolene sodium is ordered preoperatively to reduce the risk or prevent:

  A. Infection postoperatively

  B. Malignant hyperthermia

  C. Neuroleptic malignant syndrome

  D. Fever postoperatively

  Correct Answer: B

  (A, D) Dantrolene sodium is a peripheral skeletal muscle relaxant and would have no effect on a postoperative infection. (B) Dantrolene sodium is indicated prophylactically for clients with malignant hyperthermia or with a family history of the disorder. The mortality rate for malignant hyperthermia is high. (C) Neuroleptic malignant syndrome is an exercise-induced muscle pain and spasm and is unrelated to malignant hyperthermia.