NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 621:

  A group of nursing students at a local preschool day care center are going to screen each child's fine and gross motor, language, and social skills. The students will use which one of the most widely used screening tests?

  A. Revised Prescreening Developmental Questionnaire
  B. Goodenough Draw-a-Person Screening Test
  C. Denver Development Screening Test
  D. Caldwell Home Inventory
  C. Denver Development Screening Test

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  (A) The Revised Prescreening Developmental Questionnaire is more age appropriate and offers simplified parent scoring and easier comparison. It is used by parents instead of professionals. (B) The Goodenough Draw-a-Person test is used to assess intellectual development. (C) The Denver Developmental Screening Test is one of the most widely used screening tests. It offers a concise, easy-to-administer, systematic approach to assessing the preschool child. It is widely used because of its reliability and validity. (D) The Caldwell Home Inventory is used to assess the home environment in areas of social, emotional, and cognitive supports.

• Question 622:

  A 2-year-old child will undergo a cardiac catheterization tomorrow to evaluate his ventricular septal defect. Based on his developmental stage, the nurse:

  A. Uses pictures to explain the procedure to the child and his parents that evening
  B. Explains the procedure using simple words and sentences just before the preoperative sedation
  C. Asks the parents to explain the procedure to the child after she explains it to them
  D. Asks the parents to leave the room while the preoperative medication and instructions are given
  B. Explains the procedure using simple words and sentences just before the preoperative sedation

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  (A) A toddler is not capable of conceptualizing about the inside of his body and is concerned about body intactness; therefore, diagrams would not be useful. Also, the previous evening is too far from the procedure for the toddler to remember the instructions. (B) A simple explanation the morning of the procedure is the best developmental strategy to use, because it focuses on the toddler's need for parental support, body intactness, and short attention span. (C) A relationship between the nurse and the child needs to develop. Also, misinformation may be given to the child if the parents explain the procedure to the child. (D) The parents are the child's support system and need to be there to strengthen the child.

• Question 623:

  When a client is receiving vasoactive therapy IV, such as dopamine (Intropin), and extravasation occurs, the nurse should be prepared to administer which of the following medications directly into the site?

  A. Phentolamine (Regitine)
  B. Epinephrine
  C. Phenylephrine (Neo-Synephrine)
  D. Sodium bicarbonate
  A. Phentolamine (Regitine)

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  (A) Phentolamine is given to counteract the-adrenergic effects that cause ischemia and necrosis of local tissue. (B) Epinephrine is an endogenous catecholamine that produces vasoconstriction and increases heart rate and contractility. (C) Phenylephrine causes constriction of arterioles of skin, mucous membranes, and viscera, which in turn can cause ischemia and necrosis. (D) Sodium bicarbonate is an alkalinizing agent that is incompatible with dopamine.

• Question 624:

  A 47-year-old client has been admitted to the general surgery unit for bowel obstruction. The doctor has ordered that an NG tube be inserted to aid in bowel de-compression. When preparing to insert a NG tube, the nurse measures from the:

  A. Lower lip to the shoulder to the upper sternum
  B. Tip of the nose to the lower lip to the umbilicus
  C. End of the tube to the first measurement line on the tube
  D. Tip of the nose to the ear lobe to the xiphoid process or midepigastric area
  D. Tip of the nose to the ear lobe to the xiphoid process or midepigastric area

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  (A) This measurement is _50 cm (48?9 cm). Fifty centimeters is considered the length necessary for the distal end of the tube to be in place in the stomach. This measurement is too short. (B) This measurement is _50 cm (47?8 cm). Fifty centimeters is considered the lengthnecessary for the distal end of the tube to be in place in the stomach. This measurement is too short. (C) This measurement gives an approximate indication of the length necessary for the distal end of the tube to be in place in the stomach, but it is not as accurate as actually measuring the client (nose-earxiphoid). (D) This is the correct measurement of 50 cm from the tip of the client's nose to the tip of the earlobe to the xiphoid process (called the NEX [nose-ear-xiphoid] measurement). It is approximately equal to the distance necessary for the distal end of the tube to be located in the correct position in the stomach.

• Question 625:

  A client who has sustained a basilar skull fracture exhibits blood-tinged drainage from his nose. After establishing a clear airway, administering supplemental O2, and establishing IV access, the next nursing intervention would be to:

  A. Pass a nasogastric tube through the left nostril
  B. Place a 4 X 4 gauze in the nares to impede the flow
  C. Gently suction the nasal drainage to protect the airway
  D. Perform a halo test and glucose level on the drainage
  D. Perform a halo test and glucose level on the drainage

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  (A) Basilar skull fracture may cause dural lacerations, which result in CSF leaking from the ears or nose. Insertion of a tube could lead to CSF going into the brain tissue or sinuses. (B) Tamponading flow could worsen the problem and increase ICP. (C) Suction could increase brain damage and dislocate tissue. (D) Testing the fluid from the nares would determine the presence of CSF. Elevation of the head, notification of the medical staff, and prophylactic antibiotics are appropriate therapy.

• Question 626:

  A newborn is admitted to the newborn nursery with tremors, apnea periods, and poor sucking reflex. The nurse should suspect:

  A. Central nervous system damage
  B. Hypoglycemia
  C. Hyperglycemia
  D. These are normal newborn responses to extrauterine life
  B. Hypoglycemia

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  (A) Central nervous system damage presents as seizures, decreased arousal, and absence of newborn reflexes. (B) In a diabetic mother, the infant is exposed to high serum glucose. The fetal pancreas produces large amounts of insulin, which causes hypoglycemia after birth. (C) Hypoglycemia is a common newborn problem. Increased insulin production causes hypoglycemia, not hyperglycemia. (D) These are not normal adaptive behaviors to extrauterine life.

• Question 627:

  A 45-year-old client has a permanent colostomy. Which of the following foods should he avoid?

  A. Peanut butter and jelly sandwich and milk
  B. Corn beef and cabbage and boiled potatoes
  C. Oatmeal, whole-wheat toast, and milk
  D. Tuna on whole-wheat bread and iced tea
  B. Corn beef and cabbage and boiled potatoes

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  (A, C, D) These foods are allowed with a colostomy. (B) Gasforming foods such as cabbage should be avoided.

• Question 628:

  A pregnant client complains of varicosities in the third trimester. Which of the following activities should she be advised to avoid?

  A. Sitting with legs crossed at ankles
  B. Wearing thromboembolic disease (TED) stockings
  C. Wearing support pantyhose
  D. Wearing knee-high stockings
  D. Wearing knee-high stockings

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  (A) Sitting with the legs crossed at the ankles does not interfere with circulation or create pressure points. (B) TED stockings will help to reduce the varicosity by supporting the vein. Stockings must be applied with legs elevated. (C) Support pantyhose help to reduce the varicosity by supporting the vein. They also provide support to the uterus and allow for better return circulation. Hose must be applied like TED stockings. (D) Knee-high stockings create constriction and pressure points that interfere with circulation in the lower extremities.

• Question 629:

  A 15-year-old child is admitted to the pediatric unit with a diagnosis of thalassemia. Which of the following would be included in educating the mother and child as part of discharge planning?

  A. Give oral iron medication every day.
  B. Have the child's blood pressure monitored every week.
  C. Know the signs and symptoms of iron overload.
  D. Keep exercise at a minimum to reduce stress.
  C. Know the signs and symptoms of iron overload.

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  (A) Oral iron supplements are contraindicated in thalassemia. (B) Although heart failure may be an end result of this disease, this action is unnecessary. (C) Iron overload is a potential complication of frequent blood transfusions of children with thalassemia. (D) Children should be encouraged to pursue activities related to their exercise tolerance.

• Question 630:

  A male client has burns over 90% of his body after an automobile accident resulting in a fire. He was trapped inside the auto and pulled out by a bystander. After several months in the hospital and over 20 surgeries, discharge planning has begun. Throughout his hospitalization the nursing staff has been aware of psychological changes the client faces after burns over a large portion of his body resulting in disfigurement. The nursing staff can best foster the client's self-esteem by:

  A. Adhering to a strict schedule of diet, exercise, and wound care
  B. Allowing him to go to physical therapy for whirlpool treatment when other clients were not in physical therapy
  C. Following a standardized plan of care for burn clients formulated by a world-renowned burn center
  D. Allowing him to plan, assist in, and perform his own care whenever possible
  D. Allowing him to plan, assist in, and perform his own care whenever possible

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  (A) A regimented schedule, allowing no flexibility, will not foster the client's self-esteem. (B) Isolating the client may only enhance his feelings of social isolation due to his disfigurement. (C) Standardized care plans must be personalized and adapted to each client's situation. (D) Allowing the client control over his care will foster his self-esteem and prepare him for life outside of the hospital.