NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 701:

  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
  C. Smoke only right after meals

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  (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 702:

  A 32-year-old male client is a marketing representative. His job requires him to have a tremendous amount of energy during the day. He frequently uses cocaine to sustain his energy level. Lately he has increased his use of cocaine and even experimented with crack cocaine. Realizing he can no longer continue this destructive behavior, he is seeking treatment for cocaine addiction. In planning nursing care for the client's inpatient stay, which expected outcome is most appropriate?

  A. He will attend four consecutive group educational sessions on substance abuse.
  B. He will name activities that he would most likely be involved in posttreatment.
  C. He will meet with his family in counseling sessions and discuss his feelings.
  D. He will be able to deal with his feelings through participation in group therapy sessions.
  D. He will be able to deal with his feelings through participation in group therapy sessions.

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  (A) This expected outcome is specific as related to attendance, but not specific as related to outcome criteria. (B) Stating activities does not guarantee involvement. (C) This goal may help the recovery process, but postcounseling behavior is not addressed. (D) This statement best describes the expected outcome. The client will be attending group therapy sessions and through them he will deal with his feelings.

• Question 703:

  A pregnant client experiences a precipitous delivery. The nursing action during a precipitous delivery is to:

  A. Control the delivery by guiding expulsion of fetus
  B. Leave the room to call the physician
  C. Push against the perineum to stop delivery
  D. Cross client's legs tightly
  A. Control the delivery by guiding expulsion of fetus

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  (A) Controlling the rapid delivery will reduce the risk of fetal injury and perineal lacerations. (B) The nurse should always remain with a client experiencing a precipitous delivery. (C) Pushing against the perineum may cause fetal distress. (D) Crossing of legs may cause fetal distress and does not stop the delivery process.

• Question 704:

  The physician recommends immediate hospital admission for a client with PIH. She says to the nurse, "It's not so easy for me to just go right to the hospital like that." After acknowledging her feelings, which of these approaches by the nurse would probably be best?

  A. Stress to the client that her husband would want her to do what is best for her health.
  B. Explore with the client her perceptions of why she is unable to go to the hospital.
  C. Repeat the physician's reasons for advising immediate hospitalization.
  D. Explain to the client that she is ultimately responsible for her own welfare and that of her baby.
  B. Explore with the client her perceptions of why she is unable to go to the hospital.

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  (A) This answer does not hold the client accountable for her own health. (B) The nurse should explore potential reasons for the client's anxiety: are there small children at home, is the husband out of town? The nurse should aid the client in seeking support or interventions to decrease the anxiety of hospitalization. (C) Repeating the physician's reason for recommending hospitalization may not aid the client in dealing with her reasons for anxiety. (D) The concern for self and welfare of baby may be secondary to a woman who is in a crisis situation. The nurse should explore the client's potential reasons for anxiety. For example, is there another child in the home who is ill, or is there a husband who is overseas and not able to return on short notice?

• Question 705:

  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
  D. Respirations are>16 breaths/min

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  (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 706:

  A 19-year-old male client arrived via ambulance to the emergency room following a motorcycle accident. He is comatose. His face has evidence of dried blood. On assessment, the nurse notes an obvious injury to his left eye. The preferred positioning for a client with an obvious eye injury is:

  A. Reclining to control bleeding
  B. Any position in which the client is comfortable
  C. Side-lying, either left or right
  D. Sitting with head support
  D. Sitting with head support

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  (A) A reclining position can cause a penetrating object to advance further into the eye. (B) Prevention of further injury is the priority, not comfort. (C) A side-lying position may increase intraocular and intracranial pressure if an accompanying head injury is suspected. (D) A sitting position with the head supported will prevent further injury while allowing injury care to take place.

• Question 707:

  A 4-year-old child with a history of sickle cell anemia is admitted to the nursing unit with dizziness, shortness of breath, and pallor. Nursing assessment findings reveal tenderness in the abdomen. The child is most likely experiencing a/an:

  A. Aplastic crisis
  B. Vaso-occlusive crisis
  C. Dactylitis crisis
  D. Sequestration crisis
  D. Sequestration crisis

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  (A) Aplastic anemia is characterized by a lack of reticulocytes in the blood. Platelet and white blood cell counts are usually not depressed. It is usually self-limiting, lasting 5?0 days. (B) Vaso-occlusive crisis is the most common type of crisis in sickle cell anemia. Sickled cells become clogged, leading to distal tissue hypoxia and infarction. Joints and extremities are the most commonly affected areas. (C) Dactylitis crisis, or "hand-foot syndrome," causes symmetrical infarction of the bones in the hands and feet, resulting in painful swelling in the soft tissues of the hands and feet. (D) Sequestration crisis occurs as enormous volumes of blood pool within the spleen. The spleen enlarges, causing tenderness. Signs of shock including pallor, tachypnea, and faintness result, related to the deficient intravascular volume. This type of crisis is potentially fatal.

• Question 708:

  A 14-year-old teenager is hospitalized for anorexia nervosa. She is admitted to the adolescent mental health unit and placed on a behavior modification program. Nursing interventions for the teenager will most likely include:

  A. Establishing routine tasks and activities around mealtimes
  B. Administering medications such as lithium
  C. Requiring the client to eat more during meals
  D. Checking the client's room frequently
  A. Establishing routine tasks and activities around mealtimes

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  (A) Providing a more structured, supportive environment addresses safety and comfort needs, thereby helping the anorexic client develop more internal control. (B) Medications (commonly antidepressants) are frequently ordered for the anorexic client. However, lithium (used primarily with bipolar disorder) is not commonly used to treat the anorexic client. (C) Requiring and/or demanding that the anorexic client "eat more" at mealtimes increases the client's feelings of powerlessness. (D) Like the previous strategy, checking the client's room frequently contributes to the client's feelings of powerlessness.

• Question 709:

  A 5-year-old child has suffered second-degree thermal burns over 30% of her body. Forty- eight hours after the burn injury, the nurse must begin to monitor the child for which one of the following complications?

  A. Fluid volume deficit
  B. Fluid volume excess
  C. Decreased cardiac output
  D. Severe hypotension
  B. Fluid volume excess

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  (A) Fluid volume deficit resulting from fluid shifts to the interstitial spaces occurs in the first 48 hours. (B) Forty-eight hours to 72 hours after the burn injury and fluid resuscitation, capillary permeability is restored and fluid requirements decrease. Interstitial fluid returns rapidly to the vascular compartment, and the nurse must monitor the child for signs and symptoms of hypervolemia. (C) Increased cardiac output results as fluids shift back to the vascular compartment. (D) Hypertension is the result of hypervolemia.

• Question 710:

  A 44-year-old client had an emergency cholecystectomy 3 days ago for a ruptured gallbladder. She complains of severe abdominal pain. Assessment reveals abdominal rigidity and distention, increased temperature, and tachycardia. Diagnostic testing reveals an elevated WBC count. The nurse suspects that the client has developed:

  A. Gastritis
  B. Evisceration
  C. Peritonitis
  D. Pulmonary embolism
  C. Peritonitis

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  (A) Assessment findings for gastritis would reveal anorexia, nausea and vomiting, epigastric fullness and tenderness, and discomfort. (B) Evisceration is the extrusion of abdominal viscera as a result of trauma or sutures failing in a surgical incision. (C) Peritonitis, inflammation of the peritoneum, can occur when an abdominal organ, such as the gallbladder, perforates and leaks blood and fluid into the abdominal cavity. This causes infection and irritation. (D) Assessment findings of pulmonary embolism would reveal severe substernal chest pain, tachycardia, tachypnea, shortness of breath, anxiety or panic, and wheezing and coughing often accompanied by blood-tinged sputum.