NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 641:

  A 20-year-old client presents to the obstetrics-gynecology clinic for the first time. She tells the nurse that she is pregnant and wants to start prenatal care. After collecting some initial assessment data, the nurse measures her fundal height to be at the level of the umbilicus. The nurse estimates the fetal gestational age to be approximately:

  A. 10 weeks
  B. 16 weeks
  C. 20 weeks
  D. 30 weeks
  C. 20 weeks

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  (A) At 10 weeks, the fundus is located slightly above the symphysis pubis. (B) At 16 weeks, the fundus is halfway between the symphysis pubis and the umbilicus. (C) At 20 weeks, the fundus is located approximately at the umbilicus. (D) At 30 weeks, the fundal height is about 30 cm, or 10 cm above the umbilicus.

• Question 642:

  A female client has been treated since childhood for mitral valve prolapse. The antibiotic of choice for her during pregnancy would be:

  A. Sulfa
  B. Tetracycline
  C. Hydralazine
  D. Erythromycin
  D. Erythromycin

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  (A) Sulfa is a teratogen and will cause kernicterus. (B) Tetracycline is a teratogen and will effect tooth development. (C) Hydralazine is not an antibiotic but a calcium channel blocker. (D) Erythromycin is safe during pregnancy and can be used when the client is allergic to penicillin.

• Question 643:

  A male client is admitted to the medical-surgical unit from the emergency room with a diagnosis of acute pancreatitis. The nurse performs the admission nursing assessment. He is NPO with IV fluids infusing at 100 mL/hour. He is experiencing excruciating abdominal pain. Based on an analysis of these data, which nursing diagnosis would receive the highest priority?

  A. Pain related to stimulation of nerve endings associated with obstruction of the pancreatic tract
  B. Fluid volume deficit related to vomiting and nasogastric tube drainage
  C. Knowledge deficit related to treatment regimen
  D. Altered nutrition: less than body requirements, related to inadequate intake associated with current anorexia, nausea, vomiting, and digestive enzyme loss
  A. Pain related to stimulation of nerve endings associated with obstruction of the pancreatic tract

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  (A) Relief of pain is the primary goal of nursing intervention because this client is experiencing acute pain. (B) Fluid volume deficit is being treated with IV fluid replacement. (C) Knowledge deficit will not be addressed at this time because a client in acute pain is not ready to learn. (D) Alteration in nutrition is the third priority after relief of pain and fluid volume deficit.

• Question 644:

  A 2-year-old toddler is hospitalized with epiglottitis. In assessing the toddler, the nurse would expect to find:

  A. A productive cough
  B. Expiratory stridor
  C. Drooling
  D. Crackles in the lower lobes
  C. Drooling

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  (A) A productive cough is not associated with epiglottitis. (B) Children with epiglottitis seldom have expiratory stridor. Inspiratory stridor is more common due to edema of the supraglottic tissues. (C) Because of difficulty with swallowing, drooling often accompanies epiglottitis. (D) Crackles are not heard in the lower lobes with epiglottitis because the infection is usually confined to the supraglottic structures.

• Question 645:

  An 11-month-old infant is admitted with a possible diagnosis of pyloric stenosis. Which of the following best describes the characteristic clinical manifestations of pyloric stenosis?

  A. Pain, especially when eating
  B. Poor appetite and sucking reflex
  C. Increased frequency and quantity of stools
  D. Palpable olive-shaped mass in the epigastrium just right of the umbilical cord
  D. Palpable olive-shaped mass in the epigastrium just right of the umbilical cord

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  (A) There is no evidence of pain in infants with pyloric stenosis whether eating or not. (B) There are both good appetite and feeding habits in these children. (C) Because of regurgitation, there is usually decreased frequency and quantity of stools and also signs of dehydration and weight loss. (D) Along with upper abdominal distention, there is a characteristic palpable olive-shaped mass located to the right of the umbilicus.

• Question 646:

  A female client has experienced varying degrees of depression throughout her life. Now that she is postmenopausal, her depression has increased. She is unable to motivate herself to clean her house or even to get out of bed and get dressed in the morning. The client was begun on fluoxetine (Prozac) therapy. When educating her about fluoxetine, what might the nurse caution her about?

  A. A daily dose of fluoxetine may be taken in the morning or evening.
  B. Fluoxetine is not sedating; therefore, restrictions on driving and other hazardous activities are not necessary.
  C. Rashes or pruritus usually occur early in the therapy and are treatable without discontinuing the medication.
  D. It is safe to take over-the-counter or other prescription medications with fluoxetine.
  C. Rashes or pruritus usually occur early in the therapy and are treatable without discontinuing the medication.

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  (A) A daily dose of fluoxetine should be taken in the morning. Afternoon doses may cause nervousness and insomnia. (B) Although fluoxetine is less sedating than other antidepressants, it may still cause dizziness or drowsiness in some clients. The nurse should caution clients to avoid driving or hazardous activities until the central nervous system effects of the drug are demonstrated. (C) Rashes or pruritus do commonly occur early in therapy and respond to antihistamines or topical corticosteroids. (D) Advise the client not to take over-the-counter or other prescription drugs without consulting with the physician. Fluoxetine does interact with other common drugs such as monoamine oxidase inhibitors, diazepam, insulin, oral antidiabetic agents, tricyclic antidepressants, and tryptophan.

• Question 647:

  When assessing the client 6 hours postpartum, the fundus is found to be U +3, displaced to the right of midline, and slightly boggy. The nurse would first:

  A. Increase the IV oxytocin drip rate
  B. Give methergine IM
  C. Assess for a full bladder
  D. Grasp the uterus and massage vigorously
  C. Assess for a full bladder

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  (A) Oxytocin may not be necessary if the bladder is emptied and if the uterus remains firm, midline, and at about U11 after massage. (B) The same rationale as for answer "A" applies. (C) A full bladder is the most common cause of uterine atony. If the bladder is full, it should be emptied and the uterus reassessed before further intervention. (D) If the bladder is full, the uteruswill not stay contracted or return to a normal position. Overly vigorous massage also encourages uterine atony.

• Question 648:

  A 42-year-old male client has been treated at an alcoholic rehabilitation center for physiological alcohol dependence. The nurse will be able to determine that he is preparing for discharge and is effectively coping with his problem when he shares with her the following information:

  A. "I know that I will not ever be able to socially drink alcohol again and will need the support of the AA group."
  B. "I know that I can only drink one or two drinks at social gatherings in the future, but at least I don't have to continue AA."
  C. "I really wasn't addicted to alcohol when I came here, I just needed some help dealing with my divorce."
  D. "It really wasn't my fault that I had to come here. If my wife hadn't left, I wouldn't have needed those drinks."
  A. "I know that I will not ever be able to socially drink alcohol again and will need the support of the AA group."

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  (A) The client has insight into the severity of his alcohol addiction and has chosen one of the most effective treatment strategies to support him--Alcoholics Anonymous. (B) The client is still using denial and is not dealing with his alcohol addiction. (C) The client is exhibiting denial about his alcohol addiction and projecting blame on his divorce. (D) The client is projecting blame onto his wife for being in the hospital while still denying his alcohol addiction.

• Question 649:

  During discharge planning, parents of a child with rheumatic fever should be able to identify which of the following as toxic symptoms of sodium salicylate?

  A. Tinnitus and nausea
  B. Dermatitis and blurred vision
  C. Unconsciousness and acetone odor of the breath
  D. Chills and an elevation of temperature
  A. Tinnitus and nausea

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  (A) These are toxic symptoms of sodium salicylate. (B, C, D) These are not symptoms associated with sodium salicylate.

• Question 650:

  A type I diabetic client delivers a male newborn. The newborn is 45 minutes old. What is the primary nursing goal in the nursery during the first hours for this newborn?

  A. Bonding
  B. Maintain normal blood sugar
  C. Maintain normal nutrition
  D. Monitor intake and output
  B. Maintain normal blood sugar

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  (A) Bonding is necessary but would not be the priority with this newborn in the nursery. (B) The infant will be at risk for hypoglycemia because of excess insulin production. (C) Normal nutrition is a goal for all newborns. (D) Monitoring intake and output is necessary but is not the most critical nursing goal.