NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 721:

  A 34-year-old client who is gravida 1, para 0 has a history of infertility and conceived this pregnancy while taking fertility drugs. She is at 32 weeks' gestation and is carrying triplets. She is complaining of low back pain and a feeling of pelvic pressure. Her cervical exam reveals a long, closed cervix. The nurse notes that the client is experiencing mild uterine contractions every 7? minutes after the nurse has placed her on the fetal monitor. Her condition should indicate that:

  A. Her cervix shows she will likely deliver soon
  B. The nurse should not be alarmed because mild uterine activity is common at 32 weeks' gestation
  C. She may be in preterm labor because this is more common with multiple pregnancies
  D. She most likely has a urinary tract infection (UTI) because this is common with pregnancy
  C. She may be in preterm labor because this is more common with multiple pregnancies

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  (A) Her cervical exam is normal. There are no cervical changes at this time. (B) Braxton Hicks contractions may be common throughout pregnancy, but they are not regular. (C) Rhythmical contractions in conjunction with low back pain and pelvic pressure at 32 weeks in a woman carrying triplets are of great concern. She may be in preterm labor. (D) UTIs are common in pregnancy due to the enlarging uterus compressing the ureters and the stasis of urine. The woman would be more likely to complain of urinary frequency and urgency, fever or chills, and malodorous urine with a UTI.

• Question 722:

  Nursing care for the parents of a child with a congenital heart defect would include:

  A. Encouraging the parents not to tell the child about the seriousness of the congenital heart defect, so the child will function as normally as possible
  B. Acknowledging the fear and concern surrounding their child's health and assisting the parents through the grieving process as they mourn the loss of their fantasized healthy child
  C. Identifying anger and resentment as destructive emotions that serve no purpose
  D. Expressing to the parents after the corrective surgery has been completed successfully that all their grief feelings will resolve
  B. Acknowledging the fear and concern surrounding their child's health and assisting the parents through the grieving process as they mourn the loss of their fantasized healthy child

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  (A)

  It is important to discuss with parents the need to treat the child as they would any other children, but they must be truthful and honest with the child about the heart defect. As the child grows older, explanations can go into greater depth.

  (B)

  Parents of children with congenital heart defects go through a grieving process over the loss of their "healthy" child. The nurse needs to recognize these feelings and give the parents a role in the child's care when they are ready. (C) Anger and resentment are normal feelings that must be dealt with appropriately. (D) Parents may go through a second grieving process after the repair of the cardiac defect. During this grieving period, they mourn the loss of the "defective" child who now may be essentially "normal."

• Question 723:

  In assisting preconceptual clients, the nurse should teach that the corpus luteum secretes progesterone, which thickens the endometrial lining in which of the phases of the menstrual cycle?

  A. Menstrual phase
  B. Proliferative phase
  C. Secretory phase
  D. Ischemic phase
  C. Secretory phase

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  (A) Menses occurs during the menstrual phase, during which levels of both estrogen and progesterone are decreased. (B) The ovarian hormone responsible for the proliferative phase, during which the uterine endometrium enlarges, is estrogen. (C) The ovarian hormone responsible for the secretory phase is progesterone, which is secreted by the corpus luteum and causes marked swelling in the uterine endometrium. (D) The corpus luteum begins to degenerate in the ischemic phase, causing a fall in both estrogen and progesterone.

• Question 724:

  A male client seeks counseling after his wife of 19 years threatened to divorce him. For most of their marriage, he has physically and verbally abused her. When asked about his behavior in the process of the nursing assessment, the client states, "I was mean to my wife because she insists on cooking meals and wearing clothes that I do not like." This defense mechanism is an example of:

  A. Repression
  B. Regression
  C. Reaction formation
  D. Rationalization
  D. Rationalization

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  (A) Repression is blocking a desire from conscious expression. The client is conscious of his desires. (B) Regression is returning to an earlier form of expression, which is not demonstrated here. (C) Reaction formation is acting out the opposite of true feelings. The client felt anger concerning his wife's cooking and acted out his feelings. (D) Rationalization is unconsciously falsifying an experience by giving a "rational" explanation. The client is attempting to justify his behavior by giving an explanation.

• Question 725:

  A 28-year-old woman was admitted to the hospital for a thyroidectomy. Postoperatively she is taken to the postanesthesia care unit for several hours. In preparing for the client's return to her room, which nursing measure best demonstrates the nurse's thorough understanding of possible postthyroidectomy complications?

  A. Dressings are placed at the bedside for dressing changes, which are to be done every 2 hours to best detect postoperative bleeding.
  B. Narcotics are readily available and administered when the client returns to her room to prevent excruciating pain.
  C. A tracheostomy set, O2, and suction are available at the bedside.
  D. The nurse should instruct the client as soon as possible on alternative means of communication.
  C. A tracheostomy set, O2, and suction are available at the bedside.

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  (A) Dressing changes are done as necessary for bleeding. However, frequently, post- thyroidectomy bleeding may not be visible on the dressing, but blood may drain down the back of the neck by gravity. (B) Narcotics are administered for acute pain as necessary. They are not necessarily given on return of the client to her room. (C) The most serious postthyroidectomy complication is ineffective airway and breathing pattern related to tracheal compression and edema. A tracheostomy set, O2, and suction should be available at bedside for at least the first 24 hours postoperatively. (D) Impaired verbal communication may occur due to laryngeal edema or nerve damage, but most commonly, it occurs due to endotracheal intubation. The client is usually able to communicate but is hoarse.

• Question 726:

  Which of the following would the nurse expect to find following respiratory assessment of a client with advanced emphysema?

  A. Distant breath sounds
  B. Increased heart sounds
  C. Decreased anteroposterior chest diameter
  D. Collapsed neck veins
  A. Distant breath sounds

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  (A) Distant breath sounds are found in clients with emphysema owing to increased anteroposterior chest diameter, overdistention, and air trapping. (B) Deceased heart sounds arepresent because of the increased anteroposterior chest diameter. (C) A barrel- shaped chest is characteristic of emphysema. (D) Increased distention of neck veins is found owing to right-sided heart failure, which may be present in advanced emphysema.

• Question 727:

  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
  D. 6-Mercaptopurine

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  (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 728:

  Following a gastric resection, a 70-year-old client is admitted to the postanesthesia care unit. He was extubated prior to leaving the suite. On arrival at the postanesthesia care unit, the nurse should:

  A. Check airway, feeling for amount of air exchange noting rate, depth, and quality of respirations
  B. Obtain pulse and blood pressure readings noting rate and quality of pulse
  C. Reassure the client that his surgery is over and that he is in the recovery room
  D. Review physician's orders, administering medications as ordered
  A. Check airway, feeling for amount of air exchange noting rate, depth, and quality of respirations

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  (A) Adequate air exchange and tissue oxygenation depend on competent respiratory function. Checking the airway is the nurse's priority action. (B) Obtaining the vital signs is an important action, but it is secondary to airway management. (C) Reorienting a client to time, place, and person after surgery is important, but it is secondary to airway and vital signs. (D) Airway management takes precedence over physician's orders unless they specifically relate to airway management.

• Question 729:

  Which of the following statements relevant to a suicidal client is correct?

  A. The more specific a client's plan, the more likely he or she is to attempt suicide.
  B. A client who is unsuccessful at a first suicide attempt is not likely to make future attempts.
  C. A client who threatens suicide is just seeking attention and is not likely to attempt suicide.
  D. Nurses who care for a client who has attempted suicide should not make any reference to the word "suicide" in order to protect the client's ego.
  A. The more specific a client's plan, the more likely he or she is to attempt suicide.

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  (A) This is a high-risk factor for potential suicide. (B) A previous suicide attempt is a definite risk factor for subsequent attempts. (C) Every threat of suicide should be taken seriously. (D) The client should be asked directly about his or her intent to do bodily harm. The client is never hurt by direct, respectful questions.

• Question 730:

  The nurse is admitting an infant with bacterial meningitis and is prepared to manage the following possible effects of meningitis:

  A. Constipation
  B. Hypothermia
  C. Seizure
  D. Sunken fontanelles
  C. Seizure

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  (A) Constipation may occur if the child is dehydrated, but it is not directly associated with meningitis. (B) It is more likely the child will have fever. (C) Seizure is often the initial sign of meningitis in children and could become frequent. (D) It is more likely the child will have bulging fontanelles.