NCLEX NCLEX-RN Online Practice Questions and Exam Preparation

NCLEX NCLEX-RN Online Questions & Answers

• Question 741:

  The most appropriate method of evaluating whether the diet of a child with cystic fibrosis is meeting his caloric needs is:

  A. Careful monitoring of weight loss or gain
  B. Carefully recording amounts and types of foods ingested
  C. Keeping a strict account of the number of calories ingested
  D. Keeping a careful account of the amount of pancreatic enzymes ingested
  A. Careful monitoring of weight loss or gain

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  (A)

  Consistent weight gain, even if it is slow, is an indication that the child is eating and digesting sufficient calories. (B) Recording how much the child eats is useful, but it is not an indicator of how well his body is using the foods consumed.

  (C)

  Counting calories will indicate how much he is eating, but it will not reflect whether or not the foods are properly digested. (D) Keeping track of the enzyme intake will indicate compliance with medication but not whether the child is getting sufficient calories.

• Question 742:

  On an assessment of a client's mouth, the nurse notices white patches on the buccal mucosa. The nurse tries to obtain a sample for a culture, but the lesion cannot be rubbed off. The nurse would suspect that this lesion is:

  A. Xerosteromia
  B. Candidiasis
  C. Leukoplakia
  D. Stomatitis
  C. Leukoplakia

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  (A) Xerostomia is dry mouth. (B) Candidiasis can be rubbed off, but it will bleed. (C) Leukoplakia cannot be rubbed off. (D) Stomatitis is caused by candidiasis and gram- negative bacteria.

• Question 743:

  The physician prescribes amitriptyline (Elavil) for a client. What does the patient need to know about this medication?

  A. Prolonged use of this medication will result in extrapyramidal side effects.
  B. When the medication is effective, he will experience no anxiety.
  C. The medication should relieve his symptoms of depression.
  D. Blood must be drawn weekly to test for toxicity.
  C. The medication should relieve his symptoms of depression.

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  (A) Phenothiazines cause extrapyramidal symptoms. (B) No amount of medication can relieve all anxiety in all cases. (C) The purpose of amitriptyline is to relieve the symptoms of depression because it is an antidepressant. It increases the action of norepinephrine and serotonin on nerve cells. (D) Periodic blood tests are done when lithium is prescribed.

• Question 744:

  A laboratory technique specific for diagnosing Lyme disease is:

  A. Polymerase chain reaction
  B. Heterophil antibody test
  C. Decreased serum calcium level
  D. Increased serum potassium level
  A. Polymerase chain reaction

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  (A) Polymerase chain reaction is the laboratory technique specific for Lyme disease. (B) Heterophil antibody test is used to diagnose mononucleosis. (C) Lyme disease does not decrease the serum calcium level. (D) Lyme disease does not increase the serum potassium level.

• Question 745:

  A laboring client presents with a prolapsed cord. The nurse should immediately place the client in what position?

  A. Reverse Trendelenburg
  B. Fowler's
  C. Trendelenburg
  D. Sims'
  C. Trendelenburg

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  (A) Reverse Trendelenburg position increases pressure on the perineum. This position will not relieve cord pressure. (B) Fowler's position increases perineal pressure. Cord pressure would not be relieved. (C) Trendelenburg position will decrease perineal pressure. Cord compression will be decreased and increase in fetal blood flow occurs. (D) Sims' position does not relieve pressure on cord or perineum.

• Question 746:

  Which of the following serum laboratory values would the nurse monitor during gentamicin therapy?

  A. Creatinine
  B. Sodium
  C. Calcium
  D. Potassium
  A. Creatinine

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  (A) A common side effect of gentamicin is nephrotoxicity. The serum laboratory test that best reflects kidney function is serum creatinine. (B) Serum sodium has no relationship to gentamicin. (C) Serum calcium has no relationship to gentamicin. (D) Serum potassium has no relationship to gentamicin. If a client has impaired renal function secondary to gentamicin administration, he or she may also have hyperkalemia as a secondary disorder.

• Question 747:

  A 15-year-old client is admitted to the adolescent unit. The nurse recognizes that encouraging a client to speak openly depends on how clearly questions are phrased. Which of the following statements is most desirable in eliciting information from an adolescent client?

  A. "Do you get along well with your family?"
  B. "Do you communicate with your parents?"
  C. "You don't hate your family, do you?"
  D. "What is it like between you and your family?"
  D. "What is it like between you and your family?"

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  (A, B) This statement can be answered with a simple yes or no. (C) This statement is asked in a negative manner and therefore has a negative connotation. (D) This statement is open ended and positively stated.

• Question 748:

  The nurse explains perineal hygiene self-care postpartum to the client. She should be instructed to:

  A. Wear gloves for the procedure
  B. Place and adjust the pad from back to front
  C. Cleanse and wipe the perineum from front to back
  D. Protect the outer surface of the pad from contamination
  C. Cleanse and wipe the perineum from front to back

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  (A) Perineal hygiene is a clean procedure and does not require the client to wear gloves. A care provider should wear gloves to adhere to universal precautions. (B) The pad should be applied from front to back to prevent contamination of the birth canal or urinary tract from rectal bacteria. (C) Wiping from front to back and discarding the wipe prevents contamination of the urinary tract and birth canal from rectal bacteria. (D) The inner surface of the pad should not be touched to maintain asepsis.

• Question 749:

  A client was admitted with rib fractures and a pneumothorax, which were sustained as a result of a motor vehicle accident. A chest tube was placed on the left side to reinflate his lung, and he was transferred to a client unit. Twenty-four hours after admission he continues to have bloody sputum, develops increasing hypoxemia, and his chest x-ray shows patchy infiltrates. The nurse analyzes these symptoms as being consistent with:

  A. Pneumonia
  B. Pulmonary contusions
  C. Pulmonary edema
  D. Tension pneumothorax
  B. Pulmonary contusions

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  (A) Pneumonia may be reflected by patchy infiltrates. In addition, fever, an increasing white blood cell count, and copious sputum production would be present. (B) Blunt chest traumacauses a bruising process in which interstitial and alveolar edema and hemorrhage occur. This is manifest by gradual deterioration over 24 hours of arterial blood gases and the continued production of bloody sputum. Patchy infiltrates are evident on chest xray 24 hours postinjury. (C) Pulmonary edema usually results from left heart failure. It is manifest by pink, frothy sputum; increasing dyspnea; tachycardia; and crackles on auscultation. (D) Tension pneumothorax is a potential complication for someone with rib fractures and a chest tube. It is manifest by diminished breath sounds on the affected side, rapidly deteriorating arterial blood gases in the presence of an open airway, and shock that is unexplained by other injuries.

• Question 750:

  The nurse is interviewing a client with a diagnosis of possible abdominal aortic aneurysm. Which of the following statements will be reflected in the client's chief complaint?

  A. "I've been having a dull pain at the upper left shoulder."
  B. "My legs have been numb for three months."
  C. "I've only been urinating three times a day lately."
  D. "I don't remember anything in particular, I just haven't felt well."
  D. "I don't remember anything in particular, I just haven't felt well."

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  (A, B, C) These complaints are not specific signs and symptoms associated with abdominal aortic aneurysm. If symptoms are present, the aneurysm is expanding or rupture is imminent. (D) Many clients may experience no symptoms. The only symptom may be a pulsation noted in the abdomen in the reclining position.