NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 711:

  Respiratory function is altered in a 16-year-old asthmatic. Which of the following is the cause of this alteration?

  A. Altered surfactant production
  B. Paradoxical movements of the chest wall
  C. Increased airway resistance
  D. Continuous changes in respiratory rate and depth
  C. Increased airway resistance

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  (A) Altered surfactant production is found in sudden infant death syndrome. (B) Paradoxical breathing occurs when a negative intrathoracic pressure is transmitted to the abdomen by a weakened, poorly functioning diaphragm. (C) Asthma is characterized by spasm and constriction of the airways resulting in increased resistance to airflow. (D) If the pulmonary tree is obstructed for any reason, inspired air has difficulty overcoming the resistance and getting out. The rate of respiration increases in order to compensate, thus increasing air exchange.

• Question 712:

  A 16-year-old diabetic girl has been selected as a cheerleader at her school. She asks the nurse whether she should increase her insulin when she is planning to attend cheerleading practice sessions lasting from 8 to 11 AM. The most appropriate answer would be:

  A. "You should ask your doctor about this."
  B. "Yes, increase your insulin by 1 U for each hour of practice because exercise causes the body to need more insulin."
  C. "No, do not increase your insulin. Exercise will not affect your insulin needs."
  D. "No, do not increase your insulin, but eating a snack prior to practice exercise will make insulin more effective and move more glucose into the cells."
  D. "No, do not increase your insulin, but eating a snack prior to practice exercise will make insulin more effective and move more glucose into the cells."

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  (A) A nurse can give this information to a client. (B) Exercise makes insulin more efficient in moving more glucose into the cells. No more insulin is needed. (C) Exercise makes insulin more efficient unless the diabetes is poorly controlled. (D) Exercise makes insulin more efficient in moving more glucose into the cells.

• Question 713:

  Medication is administered to a client who has been placed in restraints after a sudden violent episode, and his EPSs subside. Restraints can be removed when:

  A. The physician orders it
  B. A therapeutic alliance has been established, and violent behavior subsides
  C. The violent behavior subsides, and the client agrees to behave
  D. The nurse deems that removal of restraints is necessary
  B. A therapeutic alliance has been established, and violent behavior subsides

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  (A) The physicianmayorder release of restraints, but prior to that, the client must meet criteria for release. (B) While the client is still restrained, but after violent behavior has subsided, a therapeutic bridge is built. This alliance encourages dialogue between nurse and client, allowing the client to determine causative factors, feelings prior to loss of control, and adaptive alternatives to violence. (C) If the client only "agrees to behave" after violent behavior subsides, he has developed no insight into cause and effect of violence or his response to stress. (D)Removal of restraints occurs only when the client meets the criteria for release, not just because the nurse says it is necessary.

• Question 714:

  A diagnosis of hepatitis C is confirmed by a male client's physician. The nurse should be knowledgeable of the differences between hepatitis A, B, and C. Which of the following are characteristics of hepatitis C?

  A. The potential for chronic liver disease is minimal.
  B. The onset of symptoms is abrupt.
  C. The incubation period is 2?6 weeks.
  D. There is an effective vaccine for hepatitis B, but not for hepatitis C.
  C. The incubation period is 2?6 weeks.

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  (A) Hepatitis C and B may result in chronic liver disease. Hepatitis A has a low potential for chronic liver disease. (B) Hepatitis C and B have insidious onsets. Hepatitis A has an abrupt onset. (C) Incubation periods are as follows: hepatitis C is 2?6 weeks, hepatitis B is 6?0 weeks, and hepatitis A is 2? weeks. (D) Only hepatitis B has an effective vaccine.

• Question 715:

  Degenerative disorders are attributed to many factors. As a nurse assigned to a convalescent home, one must often educate families about how such conditions occur. Which of the following statements might the nurse need to explore when a daughter tries to explain to her mother what caused her degenerative disorder?

  A. "Some folks believe that aging causes this, Mother."
  B. "Perhaps, it's the way your parents used those double- bind messages, Mother."
  C. "I know some people who are having this problem and they were exposed to chemicals at work, Mother."
  D. "It can be caused by lots of things, toxic agents and even alcohol, Mother."
  B. "Perhaps, it's the way your parents used those double- bind messages, Mother."

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  (A) Aging is a factor in the cause of degenerative disorders. (B) Double-bind messages may be found in the histories of families of individuals who develop schizophrenia, but they are not related to degenerative disorders. (C) Chemicals (toxic agents) in work environments are predisposing factors to degenerative disorders. (D) Alcohol causes some degenerative disorders, such as Wernicke's syndrome.

• Question 716:

  The nurse is assessing breath sounds in a bronchovesicular client. She should expect that:

  A. Inspiration is longer than expiration
  B. Breath sounds are high pitched
  C. Breath sounds are slightly muffled
  D. Inspiration and expiration are equal
  D. Inspiration and expiration are equal

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  (A) Inspiration is normally longer in vesicular areas. (B) Highpitched sounds are normal in bronchial area. (C) Muffled sounds are considered abnormal. (D) Inspiration and expiration are equal normally in this area, and sounds are medium pitched.

• Question 717:

  A client states to his nurse that "I was told by the doctor not to take one of my drugs because it seems to have caused decreasing blood cells." Based on this information, which drug might the nurse expect to be discontinued?

  A. Prednisone
  B. Timolol maleate (Blocadren)
  C. Garamycin (Gentamicin)
  D. Phenytoin (Dilantin)
  D. Phenytoin (Dilantin)

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  (A) Prednisone is not linked with hematological side effects. (B) Timolol, a -adrenergic blocker is metabolized by the liver. It has not been linked to blood dyscrasia. (C) Gentamicin is ototoxic and nephrotoxic. (D) Phenytoin usage has been linked to blood dyscrasias such as aplastic anemia. The drug most commonly linked to aplastic anemia is chloramphenicol (Chlormycetin).

• Question 718:

  A violent client remains in restraints for several hours. Which of the following interventions is most appropriate while he is in restraints?

  A. Give fluids if the client requests them.
  B. Assess skin integrity and circulation of extremities before applying restraints and as they are removed.
  C. Measure vital signs at least every 4 hours.
  D. Release restraints every 2 hours for client to exercise.
  D. Release restraints every 2 hours for client to exercise.

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  (A) Fluids (nourishment) should be offered at regular intervals whether the client requests (or refuses) them or not. (B) Skin integrity and circulation of the extremities should be checked regularly while the client is restrained, not only before restraints are applied and after they are removed. (C) Vital signs should be checked at least every 2 hours. If the client remains agitated in restraints, vital signs should be monitored even more closely, perhaps every 1? hours. (D) Restraints should be released every 2 hours for exercise, one extremity at a time, to maintain muscle tone, skin and joint integrity, and circulation.

• Question 719:

  A 35-year-old client is admitted to the hospital for elective tubal ligation. While the nurse is doing preoperative teaching, the client says, "The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?" The best explanation for the nurse to give the client would be that balanced anesthesia:

  A. Is a type of regional anesthesia
  B. Uses equal amounts of inhalation agents and liquid agents
  C. Does not depress the central nervous system
  D. Is a combination of several anesthetic agents or drugs producing a smooth induction and minimal complications
  D. Is a combination of several anesthetic agents or drugs producing a smooth induction and minimal complications

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  (A) Regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. (B) Varying amounts of anesthetic agents are used when employing balanced anesthesia. Amounts depend on age, weight, condition of the client, and surgical procedure. (C) General anesthesia is a drug-induced depression of the central nervous system that produces loss of consciousness and decreased muscle activity. (D) Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.

• Question 720:

  The child with iron poisoning is given IV deforoxamine mesylate (Desferal). Following administration, the child suffers hypotension, facial flushing, and urticaria. The initial nursing intervention would be to:

  A. Discontinue the IV
  B. Stop the medication, and begin a normal saline infusion
  C. Take all vital signs, and report to the physician
  D. Assess urinary output, and if it is 30 mL an hour, maintain current treatment
  B. Stop the medication, and begin a normal saline infusion

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  (A) The IV line should not be discontinued because other IV medications will be needed. (B) Stop the medication and begin a normal saline infusion. The child is exhibiting signs of an allergic reaction and could go into shock if the medication is not stopped. The line should be kept opened for other medication. (C) Taking vital signs and reporting to the physician is not an adequate intervention because the IV medication continues to flow. (D) Assessing urinary output and, if it is 30 mL an hour, maintaining current treatment is an inappropriate intervention owing to the child's obvious allergic reaction.