NCLEX NCLEX Certifications NCLEX-RN Questions & Answers

• Question 811:

  When assessing a child with diabetes insipidus, the nurse should be aware of the cardinal signs of:

  A. Anemia and vomiting

  B. Polyuria and polydipsia

  C. Irritability relieved by feeding formula

  D. Hypothermia and azotemia

  Correct Answer: B

  (A) Anemia and vomiting are not cardinal signs of diabetes insipidus. (B) Polyuria and polydipsia are the cardinal signs of diabetes insipidus. (C) Irritability relieved by feeding water, not formula, is a common sign, but not the cardinal sign, of diabetes insipidus. (D) Hypothermia and azotemia are signs, but not cardinal signs, of diabetes insipidus.

• Question 812:

  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.

  Correct Answer: A

  (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 813:

  The following medications were noted on review of the client's home medication profile. Which of the medications would most likely potentiate or elevate serum digoxin levels?

  A. KCl

  B. Thyroid agents

  C. Quinidine

  D. Theophylline

  Correct Answer: C

  (A) Hypokalemia can cause digoxin toxicity. Administration of KCl would prevent this. (B) Thyroid agents decrease digoxin levels. (C) Quinidine increases digoxin levels dramatically. (D) Theophylline is not noted to have an effect on digoxin levels.

• Question 814:

  When a client questions the nurse as to the purpose of exercise electrocardiography (ECG) in the diagnosis of cardiovascular disorders, the nurse's response should be based on the fact that:

  A. The test provides a baseline for further tests

  B. The procedure simulates usual daily activity and myocardial performance

  C. The client can be monitored while cardiac conditioning and heart toning are done

  D. Ischemia can be diagnosed because exercise increases O2 consumption and demand

  Correct Answer: D

  (A) The purpose of the study is not to provide a baseline for further tests. (B) The test causes an increase in O2 demand beyond that required to perform usual daily activities. (C) Monitoring does occur, but the test is not for the purpose of cardiac toning and conditioning. (D) Exercise ECG, or stress testing, is designed to elevate the peripheral and myocardial needs for O2 to evaluate the ability of the myocardium and coronary arteries to meet the additional demands.

• Question 815:

  The nurse would need to monitor the serum glucose levels of a client receiving which of the following medications, owing to its effects on glycogenolysis and insulin release?

  A. Norepinephrine (Levophed)

  B. Dobutamine (Dobutrex)

  C. Propranolol (Inderal)

  D. Epinephrine (Adrenalin)

  Correct Answer: D

  (A) Norepinephrine's side effects are primarily related to safe, effective care environment and include decreased peripheral perfusion and bradycardia. (B) Dobutamine's side effects include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache. (C) Propranolol's side effects include elevated blood urea nitrogen, serum transaminase, alkaline phosphatase, and lactic dehydrogenase. (D) Epinephrine increases serum glucose levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false elevation of blood urea nitrogen, and decreased coagulation time.

• Question 816:

  The priority nursing goal when working with an autistic child is:

  A. To establish trust with the child

  B. To maintain communication with the family

  C. To promote involvement in school activities

  D. To maintain nutritional requirements

  Correct Answer: A

  (A) The priority nursing goal when working with an autistic child is establishing a trusting relationship. (B) Maintaining a relationship with the family is important but having the trust of the child is a priority. (C) To promote involvement in school activities is inappropriate for a child who is autistic. (D) Maintaining nutritional requirements is not the primary problem of the autistic child.

• Question 817:

  A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the effectiveness of the instruction about diet and weight control?

  A. She is compliant with her diet as previously taught.

  B. She needs further instruction and reinforcement.

  C. She needs to increase her caloric intake.

  D. She needs to be placed on a restrictive diet immediately.

  Correct Answer: B

  (A) She is probably not compliant with her diet and exercise program. Recommended weight gain during second and third trimesters is approximately 12 lb. (B) Because of her excessive weight gain of 10 lb in 2 months, she needs reevaluation of her eating habits and reinforcement of proper dietary habits for pregnancy. A 2200-calorie diet is recommended for most pregnant women with a weight gain of 27?0 lb over the 9-month period. With rapid and excessive weightgain, PIH should also be suspected. (C) She does not need to increase her caloric intake, but she does need to re-evaluate dietary habits. Ten pounds in 2 months is excessive weight gain during pregnancy, and health teaching is warranted. (D) Restrictive dieting is not recommended during pregnancy.

• Question 818:

  Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client's history?

  A. Menarche after age 13

  B. Nulliparity

  C. Maternal family history of breast cancer

  D. Early menopause

  Correct Answer: C

  (A) Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. (B) Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. (C) A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. (D) Early menopause decreases the risk of developing breast cancer.

• Question 819:

  Hematotympanum and otorrhea are associated with which of the following head injuries?

  A. Basilar skull fracture

  B. Subdural hematoma

  C. Epidural hematoma

  D. Frontal lobe fracture

  Correct Answer: A

  (A) Basilar skull fractures are fractures of the base of the skull. Blood behind the eardrum or blood or cerebrospinal fluid (CSF) leaking from the ear are indicative of a dural laceration. Basilar skull fractures are the only type with these symptoms. (B, C, D) These do not typically cause dural lacerations and CSF leakage.

• Question 820:

  The predominant purpose of the first Apgar scoring of a newborn is to:

  A. Determine gross abnormal motor function

  B. Obtain a baseline for comparison with the infant's future adaptation to the environment

  C. Evaluate the infant's vital functions

  D. Determine the extent of congenital malformations

  Correct Answer: C

  (A) Apgar scores are not related to the infant's care, but to the infant's physical condition. (B) Apgar scores assess the current physical condition of the infant and are not related to future environmental adaptation. (C) The purpose of the Apgar system is to evaluate the physical condition of the newborn at birth and to determine if there is an immediate need for resuscitation. (D) Congenital malformations are not one of the areas assessed with Apgar scores.