NCLEX NCLEX Certifications NCLEX-RN Questions & Answers

• Question 671:

  A 54-year-old client is admitted to the hospital with a possible gastric ulcer. He is a heavy smoker. When discussing his smoking habits with him, the nurse should advise him to:

  A. Smoke low-tar, filtered cigarettes

  B. Smoke cigars instead

  C. Smoke only right after meals

  D. Chew gum instead

  Correct Answer: C

  (A, B, D) Cigarettes, cigars, and chewing gum would stimulate gastric acid secretion. (C) Smoking on a full stomach minimizes effect of nicotine on gastric acid.

• Question 672:

  Following a gastric resection, which of the following actions would the nurse reinforce with the client in order to alleviate the distress from dumping syndrome?

  A. Eating three large meals a day

  B. Drinking small amounts of liquids with meals

  C. Taking a long walk after meals

  D. Eating a low-carbohydrate diet

  Correct Answer: D

  (A) Six small meals are recommended. (B) Liquids after meals increase the time food empties from the stomach. (C) Lying down after meals is recommended to prevent gravity from producing dumping. (D) A low-carbohydrate diet will prevent a hypertonic bolus, which causes dumping.

• Question 673:

  In addition to changing the mother's position to relieve cord pressure, the nurse may employ the following measure (s) in the event that she observes the cord out of the vagina:

  A. Immediately pour sterile saline on the cord, and repeat this every 15 minutes to prevent drying.

  B. Cover the cord with a wet sponge.

  C. Apply a cord clamp to the exposed cord, and cover with a sterile towel.

  D. Keep the cord warm and moist by continuous applications of warm, sterile saline compresses.

  Correct Answer: D

  (A) Saline should be warmed; waiting 15 minutes may not keep the cord moist. (B) This choice does not specify what the sponge was "wet" with. (C) This measure would stop circulation to the fetus. (D) The cord should be kept warm and moist to maintain fetal circulation. This measure is an accepted nursing action.

• Question 674:

  A gravida 2 para 1 client is hospitalized with severe preeclampsia. While she receives magnesium sulfate

  (MgSO4) therapy, the nurse knows it is safe to repeat the dosage if:

  A. Deep tendon reflexes are absent

  B. Urine output is 20 mL/hr

  C. MgSO4serum levels are>15 mg/dL

  D. Respirations are>16 breaths/min

  Correct Answer: D

  (A) MgSO4is a central nervous system depressant. Loss of reflexes is often the first sign of developing toxicity. (B) Urinary output at <25 mL/hr or 100 mL in 4 hours may result in the accumulation of toxic levels of magnesium. (C) The therapeutic serum range for MgSO4is 6? mg/dL. Higher levels indicate toxicity. (D) Respirations o>;16 breaths/min indicate that toxic levels of magnesium have not been reached. Medication administration would be safe.

• Question 675:

  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

  Correct Answer: C

  (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 676:

  A mother is unsure about the type of toys for her 17-month-old child. Based on knowledge of growth and development, what toy would the nurse suggest?

  A. A pull toy to encourage locomotion

  B. A mobile to improve hand-eye coordination

  C. A large toy with movable parts to improve pincer grasp

  D. Various large colored blocks to teach visual discrimination

  Correct Answer: A

  (A) Increased locomotive skills make push-pull toys appropriate for the energetic toddler. (B) Infants progress from reflex activity through simple repetitive behaviors to imitative behavior. Hand-eye coordination forms the foundation of other movements. (C) At age 8 months, infants begin to have pincer grasp. Toys that help infants develop the pincer grasp are recommended for this age group. (D) Various large colored blocks are suggested toys for infants 6?2 months of age to help visual stimulation.

• Question 677:

  An 8-week-old infant has been diagnosed with gastroesophageal reflux. The nurse is teaching the infant's mother to care for the infant at home. Which one of the following statements by the nurse is appropriate regarding the infant's home care?

  A. "Lay the infant flat on her left side after feeding."

  B. "Feed the infant every 4 hours with half-strength formula."

  C. "Antacids need to be given an hour before feeding."

  D. "Play activities should be carried out before instead of after feedings."

  Correct Answer: D

  (A) Elevating the child's head to a 30-degree angle is the recommended position for gastroesophageal reflux. The supine position predisposes the child to aspiration. (B) Small, frequent feedings with thickened formula are recommended to minimize vomiting. (C) Antacids should be given at the same time as the feeding to improve their buffering action. (D) The infant should be kept still after feedings to reduce the risk of vomiting and aspiration. Vigorous activities should be carried out before feedings.

• Question 678:

  Other drugs may be ordered to manage a client's ulcerative colitis. Which of the following medications, if ordered, would the nurse question?

  A. Methylprednisolone sodium succinate (Solu-Medrol)

  B. Loperamide (Imodium)

  C. Psyllium

  D. 6-Mercaptopurine

  Correct Answer: D

  (A) Methylprednisolone sodium succinate is used for its anti-inflammatory effects. (B) Loperamide would be used to control diarrhea. (C) Psyllium may improve consistency of stools by providing bulk. (D) An immunosuppressant such as 6mercaptopurine is used for chronic unrelenting Crohn's disease.

• Question 679:

  A client is experiencing muscle weakness and lethargy. His serum K+is 3.2. What other symptoms might he exhibit?

  A. Tetany

  B. Dysrhythmias

  C. Numbness of extremities

  D. Headache

  Correct Answer: B

  (A) Tetany is seen with low calcium. (B) Low potassium causes dysrhythmias because potassium is responsible for cardiac muscle activity. (C) Numbness of extremities is seen with high potassium. (D) Headache is not associated with potassium excess or deficiency.

• Question 680:

  The nurse is teaching a 10-year-old insulin-dependent diabetic how to administer insulin. Which one of the following steps must be taught for insulin administration?

  A. Never use abdominal site for a rotation site.

  B. Pinch the skin up to form a subcutaneous pocket.

  C. Avoid applying pressure after injection.

  D. Change needles after injection.

  Correct Answer: B

  (A)

  Sites for injection need to be rotated, including abdominal sites, to enhance insulin absorption. (B) The pinch technique is the most effective method for obtaining skin tightness to allow easy entrance of the needle to subcutaneous tissues.

  (C)

  Massaging the site of injection facilitates absorption of the insulin. (D) Changing the needle will break the sterility of the system. It has become acceptable practice to reuse disposable needles and syringes for 3? days.