NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 631:

  The therapeutic blood-level range for lithium is:

  A. 0.25.0 mEq/L
  B. 0.5.5 mEq/L
  C. 1.0.0 mEq/L
  D. 2.0.5 mEq/L
  B. 0.5.5 mEq/L

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  (A) This range is too low to be therapeutic. (B) This is the therapeutic range for lithium. (C) This range is above the therapeutic level. (D) This range is toxic and may cause severe side effects.

• Question 632:

  A 9-year-old child was in the garage with his father, who was repairing a lawnmower. Some gasoline ignited and caused an explosion. His father was killed, and the child has split- thickness and full-thickness burns over 40% of his upper body, face, neck, and arms. All of the following nursing diagnoses are included on his care plan. Which of these nursing diagnoses should have top priority during the first 24?8 hours postburn?

  A. Pain related to tissue damage from burns
  B. Potential for infection related to contamination of wounds
  C. Fluid volume deficit related to increased capillary permeability
  D. Potential for impaired gas exchange related to edema of respiratory tract
  D. Potential for impaired gas exchange related to edema of respiratory tract

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  (A, B, C) These answers are all correct; however, maintenance of airway is the top priority. (D) Persons burned about the face and neck during an explosion are also likely to suffer burns of the respiratory tract, which can lead to edema and respiratory arrest.

• Question 633:

  Before completing a nursing diagnosis, the nurse must first:

  A. Write goals and objectives
  B. Perform an assessment
  C. Plan interventions
  D. Perform evaluation
  B. Perform an assessment

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  (A) Goals and objectives are based on a nursing assessment and diagnosis. (B) Assessment is the first step of nursing process. (C) Interventions are nursing actions to meet goals and objectives. (D) Evaluation process follows nursing interventions.

• Question 634:

  The nurse would expect to include which of the following when planning the management of the client with Lyme disease?

  A. Complete bed rest for 6? weeks
  B. Tetracycline treatment
  C. IV amphotericin B
  D. High-protein diet with limited fluids
  B. Tetracycline treatment

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  (A) The client is not placed on complete bed rest for 6 weeks. (B) Tetracycline is the treatment of choice for children with Lyme disease who are over the age of 9. (C) IV amphotericin B is the treatment for histoplasmosis. (D) The client is not restricted to a high- protein diet with limited fluids.

• Question 635:

  The physician orders medication for a client's unpleasant side effects from the haloperidol. The most appropriate drug at this time is:

  A. Lorazepam
  B. Triazolam (Halcion)
  C. Benztropine
  D. Thiothixene
  C. Benztropine

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  (A) Lorazepam is a benzodiazepine, or antianxiety agent, that potentiates the effects of _- aminobutyric acid in the CNS, which is not the CNS neurotransmitter EPS. (B) Triazolam is a benzodiazepine sedative-hypnotic whose action is mediated in the limbic, thalamic, and hypothalamic levels of the CNS by - aminobutyric acid. (C) Benztropine is an anticholinergic agent, and the drug of choice for blocking CNS synaptic response, which causes EPS. (D) Thiothixene is an antipsychotic and neuroleptic drug that blocks dopamine neurotransmission at the CNS synapses, thereby causing EPS.

• Question 636:

  A child receiving chemotherapeutic drugs experiences a loss of appetite directly related to the therapy. Which of the following strategies should be most effective in encouraging the child to eat?

  A. Provide a well-balanced diet at usual times, and restrict dessert if the child fails to eat well.
  B. Schedule procedures immediately after eating so that the child will not be tired or in pain at mealtime.
  C. Offer the child a diet with a wider variety of foods and with more seasoning than her usual diet.
  D. Offer the child smaller meals more frequently than usual, and include as many of her favorite foods as possible.
  D. Offer the child smaller meals more frequently than usual, and include as many of her favorite foods as possible.

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  (A) Because the child's appetite is capricious at best, regular servings may be overwhelming. Praise the child for what is eaten. (B) The child will soon learn that procedures follow meals and may play with food rather than eat it to avoid or delay the procedure. (C) Young children usually do not like highly seasoned foods and may need the security of usual foods. Such a change may actually increase anorexia. (D) Small servings appear more achievable to the child, and the inclusion of favorite foods can add a sense of security.

• Question 637:

  When providing dietary teaching to an individual who has diabetes mellitus, type II, the nurse discusses the importance of consuming the recommended daily allowance of which of the following electrolytes?

  A. Potassium
  B. Magnesium
  C. Sodium
  D. HCO3
  B. Magnesium

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  (A) Potassium intake that meets the recommended daily allowance is important, especially in clients who have a history of cardiac disease. (B) Low levels of magnesium can cause an increase in resistance to insulin and can lead to carbohydrate intolerance. (C) Sodium is an important electrolyte for all clients but has no direct effect on diabetes mellitus. (D) Bicarbonate plays an important role in acid-base balance. It is equally necessary for maintenance of all body functions.

• Question 638:

  A client has had amniocentesis. One of the tests performed on the amniotic fluid is a lecithin/sphingomyelin (L/S) ratio. The results show a ratio of 1:1. This is indicative of:

  A. Lung immaturity
  B. Intrauterine growth retardation (IUGR)
  C. Intrauterine infection
  D. Neural tube defect
  A. Lung immaturity

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  (A) At about 30?2 weeks' gestation, the amounts of the surfactants, lecithin, and sphingomyelin become equal. As the fetal lungs mature, the concentration of lecithin begins to exceed that of sphingomyelin. At 35 weeks, the L/S ratio is 2:1. Respiratory distress syndrome is unlikely if birth occurs at this time. (B) IUGR is associated with compromised uteroplacental perfusion or with viral infections, chromosomal disorders, congenital malformations, and maternal malnutrition. IUGR is not specifically assessed by analysis of the L/S ratio. (C) Analysis of the L/S ratio is not an assessment used to confirm intrauterine infection. (D) Elevated levels of _-fetoprotein in maternal serum or in amniotic fluid have been found to reflect open neural tube defects, such as spina bifida and anencephaly.

• Question 639:

  A 50-year-old depressed client has recently lost his job. He has been reluctant to leave his hospital room. Nursing care would include:

  A. Forcing the client to attend all unit activities
  B. Encouraging the client to discuss why he is so sad
  C. Monitoring elimination patterns
  D. Providing sensory stimulation
  C. Monitoring elimination patterns

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  (A) The client should be encouraged to attend the unit activities. The nurse and client should choose a few activities for the client to attend that will be positive experiences for him. (B) The nurse should encourage the client to discuss his feelings and to begin to deal with the depression. (C) Depressed persons often have little appetite and poor fluid intake. Constipation is common. (D) A calm, consistent level of stimuli is most effective. Sensory deprivation and overstimulation should be avoided.

• Question 640:

  After 7 hours in restraints and a total of 30-mg haloperidol in divided doses, a client complains of stiffness in his neck and his tongue "pulling to one side." These extrapyramidal symptoms (EPS) will most likely be relieved by the administration of:

  A. Lorazepam (Ativan)
  B. Benztropine (Cogentin)
  C. Thiothixene (Navane)
  D. Flurazepan (Dalmane)
  B. Benztropine (Cogentin)

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  (A) Lorazepam is an antianxiety agent that produces muscle relaxation and inhibits cortical and limbic arousal. It has no action in the basal ganglia of the brain. (B) Benztropine acts to reduce EPS by blocking excess CNS cholinergic activity associated with dopamine deficiency in the basal ganglia by displacing acetylcholine at the receptor site. (C) Thiothixene is an antipsychotic known to block dopamine in the limbic system, thereby causing EPS. (D) Flurazepan is a hypnotic that acts in the limbic system, thalamus, and hypothalamus of the CNS to produce sleep. It has no known action in the vasal ganglia.