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The NCLEX-RN exam is a critical milestone in a registered nurse's career. Passing the exam is an essential step towards obtaining a nursing license and beginning a career in the healthcare industry. The exam is designed to ensure that nurses possess the necessary knowledge and skills to provide safe and effective care to patients, making it an essential component of the nursing profession.
The NCLEX-RN exam is a critical test for any aspiring registered nurse in the United States. It is administered by the National Council of State Boards of Nursing (NCSBN) and is designed to test the competency and readiness of individuals who wish to practice as registered nurses. The test is computerized and adaptive, meaning that the difficulty of the questions increases or decreases based on the candidate's responses.
NEW QUESTION # 341
At 16 weeks' gestation, a pregnant client is admitted to the maternity unit to have a McDonald procedure (cerclage) done. She tells the RN who is admitting her to the unit that her physician had explained what this procedure was, but that she did not understand. The RN explains to the client that the purpose for this procedure is to:
- A. Evaluate cephalopelvic disproportion
- B. Repair the amniotic sac
- C. Reinforce an incompetent cervix
- D. Dilate the cervix
Answer: C
Explanation:
Explanation
(A) The treatment most commonly uses the Shirodkar-Barter procedure (McDonald procedure) or cerclage to enforce the weakened cervix by encircling it with a suture at the level of the internal os. (B) There is no known procedure that is used to repair the amniotic sac. (C) Cephalopelvic disproportion is evaluated later in pregnancy. It is not related to this procedure. (D) No procedure is done to dilate the cervix at 16 weeks' gestation unless the pregnancy is to be terminated.
NEW QUESTION # 342
The nurse caring for a client who has pneumonia, which is caused by a gram-positive bacteria, inspects her sputum. Because the client's pneumonia is caused by a gram-positive bacteria, the nurse experts to find the sputum to be:
- A. Pink-tinged and frothy
- B. Rust colored
- C. Bright red with streaks
- D. Green colored
Answer: B
Explanation:
(A)
Bright red sputum with streaks is associated with pneumonia caused by gram-negative bacteria, such asKlebsiellapneumonia. (B) Pneumococcal pneumonia, caused by gram-positive bacteria, has a characteristic productive cough with green or rust-colored sputum.
(C)
Green-colored sputum is more characteristic ofPseudomonasthan of gram-positive bacterial pneumonia. (D) Pink-tinged and frothy sputum is more characteristic of pulmonary edema than of gram-positive bacterial pneumonia.
NEW QUESTION # 343
During a client's first postpartum day, the nurse assessed that the fundus was located laterally to the umbilicus.
This may be due to:
- A. Fibroid tumor on the uterus
- B. Endometritis
- C. Urine retention or a distended bladder
- D. Displacement due to bowel distention
Answer: C
Explanation:
(A, B) Endometritis, urine retention, or bladder distention provide good distractors because they may delay involution but do not usually cause the uterus to be lateral. (C) Bowel
distention and constipation are common in the postpartum period but do not displace the uterus laterally. (D) Urine retention or bladder distention commonly displaces the uterus to the right and may delay involution.
NEW QUESTION # 344
A 24-year-old client presents to the emergency department protesting "I am God." The nurse identifies this as a:
- A. Conversion
- B. Illusion
- C. Delusion
- D. Hallucination
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Delusion is a false belief. (B) Illusion is the misrepresentation of a real, external sensory experience.
(C) Hallucination is a false sensory perception involving any of the senses. (D) Conversion is the expression of intrapsychic conflict through sensory or motor manifestations.
NEW QUESTION # 345
Following TURP, which of the following instructions would be appropriate to prevent or alleviate anxiety concerning the client's sexual functioning?
- A. "You may resume sexual intercourse in 2 weeks."
- B. "A transurethral resection does not usually cause impotence."
- C. "Check with your doctor about resuming sexual activity."
- D. "Many men experience impotence following TURP."
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Sexual activity should be delayed until cleared by the client's physician. (B) Although many men experience retrograde ejaculation following prostate surgery, potency is seldom affected. (C) Although the client may experience retrograde ejaculation, it will not limit his ability to engage in sexual intercourse. (D) Although the client should obtain clearance from his physician before resuming sexual activity, this statement does not give the client any information or reassurance about future sexual activity or potency that could decrease his anxiety.
NEW QUESTION # 346
A schizophrenic client has made sexual overtures toward her physician on numerous occasions. During lunch, the client tells the nurse, "My doctor is in love with me and wants to marry me." This client is using which of the following defense mechanisms?
- A. Displacement
- B. Projection
- C. Suppression
- D. Reaction formation
Answer: B
Explanation:
Explanation
(A) Displacement involves transferring feelings to a more acceptable object. (B) Projection involves attributing one's thoughts or feelings to another person. (C) Reaction formation involves transforming an unacceptable impulse into the opposite behavior. (D) Suppression involves the intentional exclusion of unpleasant thoughts or experiences.
NEW QUESTION # 347
Assessment of severe depression in a client reveals feelings of hopelessness, worthlessness; inability to feel pleasure; sleep, psychomotor, and nutritional alterations; delusional thinking; negative view of self; and feelings of abandonment. These clinical features of the client's depression alert the nurse to prioritize problems and care by addressing which of the following problems first:
- A. Rest and activity impairment
- B. Impaired thinking
- C. Possible harm to self
- D. Nutritional status
Answer: C
Explanation:
Explanation
(A) Anorexia and weight loss are problems that need attention in severe depression, but they can be addressed secondary to immediate concerns. (B) Impaired thinking and confusion are problems in severe depression that are addressed with administration of medication, through group and individual psychotherapy, and through activity therapy as motivation and interest increase. (C) Possible harm to self as with suicidal ideation; a suicide plan, means to execute plan; and/or overt gestures or an attempt must be addressed as an immediate concern and safety measures implemented appropriate to the risk of suicide. (D) Rest and activity impairment may take time and further assessment to determine client's sleep pattern and amount of psychomotor retardation with the more immediate concern for safety present.
NEW QUESTION # 348
A 10-year-old boy has been diagnosed with Legg-Calve Perthes disease. Which of the client's responses would indicate compliance during initial therapy?
- A. Not bearing weight on affected extremity
- B. Putting self on weight reduction diet
- C. Walking short distances 3 times/day
- D. Drinking large amounts of milk
Answer: A
Explanation:
(A) This condition causes aseptic necrosis of the head of the femur in the acetabulum. Drinking large quantities of milk at this time cannot hasten recovery. (B) The aim of treatment is to keep the head of the femur in the acetabulum. Non-weight-bearing is essential. Activity causes microfractures of the epiphysis. (C) In addition to non-weightbearing, clients are often placed on bedrest, which helps to reduce inflammation. Later, active motion is encouraged. (D) Weight is not generally an issue with this disease. Slipped femoral capital epiphysis, which is most frequently observed in obese pubescent children, usually requires a weight reduction diet.
NEW QUESTION # 349
A client has ascites, which is caused by:
- A. Decreased renal function
- B. Electrolyte imbalance
- C. Decreased plasma proteins
- D. Portal hypertension
Answer: C
Explanation:
(A) A decrease in plasma proteins causes a decrease in intravascular osmotic pressure resulting in leakage of fluid into peritoneal cavity. (B) Fluid and electrolyte imbalance may occur as a result of the ascites. (C) Ascites is a result of hepatic malfunction, not renal malfunction. (D) Portal hypertension causes esophageal varices, not ascites.
NEW QUESTION # 350
The most appropriate method of evaluating whether the diet of a child with cystic fibrosis is meeting his caloric needs is:
- A. Keeping a strict account of the number of calories ingested
- B. Carefully recording amounts and types of foods ingested
- C. Keeping a careful account of the amount of pancreatic enzymes ingested
- D. Careful monitoring of weight loss or gain
Answer: D
Explanation:
(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.
NEW QUESTION # 351
On morning rounds, the nurse found a manic-depressive client who is taking lithium in a confused mental state, vomiting, twitching, and exhibiting a coarse hand tremor. Which one of the following nursing actions is essential at this time?
- A. Administer her next dosage of lithium, and then call the physician.
- B. Withhold her lithium, and report her symptoms to the physician.
- C. Contact the lab and request a lithium level in 30 minutes, and call the physician.
- D. Place her on NPO to decrease the excretion of lithium from her body, and call the physician.
Answer: B
Explanation:
Explanation
(A) The client has lithium toxicity, and the nurse must withhold further dosages. (B) Because of her level of toxicity, further lithium could cause coma and death. The nurse needs further orders from the physician to stabilize the client's lithium level. (C) Ensuring adequate intake of sodium chloride will promote excretion of lithium and will assist in managing the client's lithiumtoxicity. (D) A lithium blood level must be drawn immediately to determine the seriousness of the toxicity and to provide the physician with data for medical orders.
NEW QUESTION # 352
A client had a ruptured abdominal aortic aneurysm that was repaired surgically. Her postoperative recovery progressed without complications, and she is ready for discharge. Client education in preparation for discharge began 7 days ago on her admission to the nursing unit. Evaluation of nursing care related to client education is based on evaluation of expected outcomes. Which statement made by the client would indicate that she is ready for discharge?
- A. "Teach my husband about the diet. He'll be doing all the cooking now."
- B. "When I bathe tomorrow morning, I will be very careful not to get soap on my incision."
- C. "I will not drive but ride in the front seat of the car with a seat belt on for my first doctor's appointment."
- D. "I am allowed to exercise by walking for short periods."
Answer: D
Explanation:
Section: Questions Set D
Explanation:
(A) Postoperatively, clients with major abdominal surgery are instructed to avoid driving, riding in the front seat, and wearing seat belts because any sudden impact may injure a fresh incision. She should ride in back seat without a seat belt. (B) Clients should not sit in the tub and allow the incision to soak in water because this may predispose the client to infection. A short, cool shower would be preferable. Allowing soap to come in contact with the incision would not harm it and is frequently used as postoperative wound care at home on discharge from the hospital. (C) Activity instructions include: avoid sitting for long periods and get exercise by walking.
Lifting more than 5 lb of weight is also prohibited. (D) The client must also learn her diet. Her husband cooking is probably a temporary measure unless he did the cooking prior to her hospitalization. A statement such as this may indicate the need for further exploration of feelings regarding her illness, dependence, and self-care expectations.
NEW QUESTION # 353
Which of the following findings would be abnormal in a postpartal woman?
- A. An oral temperature of 101F (38.3C) on the third day after delivery
- B. Pulse rate of 60 bpm in morning on first postdelivery day
- C. Urinary output of 3000 mL on the second day after delivery
- D. Chills shortly after delivery
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a nervous response or to vasomotor changes. If not followed by a fever, it is clinically innocuous. (B) The pulse rate during the immediate postpartal period may be low but presents no cause for alarm. The body attempts to adapt to the decreased pressures intra-abdominally as well as from the reduction of blood flow to the vascular bed. (C) Urinary output increases during the early postpartal period (12-24 hours) owing to diuresis. The kidneys must eliminate an estimated 2000-3000 mL of extracellular fluid associated with a normal pregnancy. (D) A temperature of 100.4F (38C) may occur after delivery as a result of exertion and dehydration of labor. However, any temperature greater than 100.4F needs further investigation to identify any infectious process.
NEW QUESTION # 354
A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy of fluid resuscitation in the burned child?
- A. Pulse rate
- B. Serum potassium level
- C. Urine output
- D. Blood pressure
Answer: C
Explanation:
(A) Blood pressure can remain normotensive even in a state of hypovolemia. (B) Serum potassium is not reliable for determining adequacy of fluid resuscitation. (C) Urine output, alteration in sensorium, and capillary refill are the most reliable indicators for assessing adequacy of fluid resuscitation. (D) Pulse rate may vary for many reasons and is not a reliable indicator for assessing adequacy of fluid resuscitation.
NEW QUESTION # 355
Following her surgery, a 5-year-old child will return to the pediatric unit with a long-arm cast. She experienced a supracondylar fracture of the humerus near the elbow. Which nursing action is most essential during the first
24 hours after surgery and cast application?
- A. Pain management
- B. Mobilization of the child
- C. Assessment of neurovascular status
- D. Discharge teaching
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) Mobilization is important but not absolutely essential. (B) Discharge teaching should be initiated prior to surgery as well as during the postoperative period. (C) Assessment and management of pain are necessary and high in priority. (D) Neurovascular status of the extremity is of primary importance. The risk of circulatory impairment exists with any cast application. This type of fracture is common in children. A high incidence of neurovascular complications exists with fractures near the elbow.
NEW QUESTION # 356
Following a gastric resection, which of the following actions would the nurse reinforce with the client in order to alleviate the distress from dumping syndrome?
- A. Drinking small amounts of liquids with meals
- B. Taking a long walk after meals
- C. Eating a low-carbohydrate diet
- D. Eating three large meals a day
Answer: C
Explanation:
(A) Six small meals are recommended. (B) Liquids after meals increase the time food empties from the stomach. (C) Lying down after meals is recommended to prevent gravity from producing dumping. (D) A low-carbohydrate diet will prevent a hypertonic bolus, which causes dumping.
NEW QUESTION # 357
A client has been admitted to the nursing unit with the diagnosis of severe anemia. She is slightly short of breath, has episodes of dizziness, and complains her heart sometimes feels like it will "beat out of her chest." The physician has ordered her to receive 2 U of packed red blood cells. The most important nursing action to be taken is:
- A. Having the consent form on the chart
- B. Starting an 18-gauge IV infusion
- C. Administering the correct blood product to the correctclient
- D. Transfusing the blood in a 2-hour time frame
Answer: C
Explanation:
(A) An 18-gauge IV is an appropriate size for administering blood; however, client safety demands that the right blood product must be administered. (B) The consent form is legally necessary to be on the chart, but client safety is maintained by giving the correct blood component to the correct client. (C) Administering the correct blood product to the correct client will maintain physiological safety and minimize transfusion reactions. (D) The blood administration should take place over the ordered time frame designated by the physician.
NEW QUESTION # 358
A 32-year-old female client is being treated for Guillain- Barre syndrome. She complains of gradually increasing muscle weakness over the past several days. She has noticed an increased difficulty in ambulating and fell yesterday. When conducting a nursing assessment, which finding would indicate a need for immediate further evaluation?
- A. Loss of superficial and deep tendon reflexes
- B. Complaints of shortness of breath
- C. Facial paralysis
- D. Complaints of a headache
Answer: B
Explanation:
(A) Headaches are not associated with Guillain-Barre syndrome. (B) Loss of superficial and deep tendon reflexes is expected with this diagnosis. (C) Complaints of shortness of breath must be further evaluated. Forty percent of all clients have some detectable respiratory weakness and should be prepared for a possible tracheostomy. Pneumonia is also a common complication of this syndrome. (D) Facial paralysis is expected and is not considered abnormal.
NEW QUESTION # 359
A client has begun to exhibit signs of alcohol withdrawal. Her blood pressure has risen from 120/60 to
190/100, pulse is increased from 88 to 110 bpm, and she is irritable and agitated and has gross motor tremors of the hands. The nurse notifies the doctor. The nurse can anticipate that the doctor will order which of the following?
- A. A tricyclic antidepressant such as amitriptyline (Elavil)
- B. A benzodiazepine such as chlordiazepoxide (Librium)
- C. A phenothiazine such as chlorpromazine (Thorazine)
- D. An opiate such as propoxyphene napsylate (Darvocet)
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) This answer is incorrect. Benzodiazepines are drugs of choice for alcohol withdrawal. (B) This answer is correct. The drug has a sedative effect, is safe, and has an anticonvulsant effect.(C) This answer is incorrect. Amitriptyline is an antidepressant. (D) This answer is incorrect. Chlorpromazine is most effective in psychotic disorders.
NEW QUESTION # 360
In acute episodes of mania, lithium is effective in 1-2 weeks, but it may take up to 4 weeks, or even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during the first few days or weeks of an acute episode to manage severe behavioral excitement and acute psychotic symptoms. In addition to the lithium, which one of the following medications might the physician prescribe?
- A. Haloperidol (Haldol)
- B. Sertraline (Zoloft)
- C. Diazepam (Valium)
- D. Alprazolam (Xanax)
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Diazepam is an antianxiety medication and is not designed to reduce psychotic symptoms. (B) Haloperidol is an antipsychotic medication and may be used until the lithium takes effect. (C) Sertraline is an antidepressant and is used primarily to reduce symptoms of depression. (D) Alprazolam is an antianxiety medication and is not designed to reduce psychotic symptoms.
NEW QUESTION # 361
A client with bipolar disorder taking lithium tells the nurse that he has ringing in his ears, blurred vision, and diarrhea. The nurse notices a slight tremor in his left hand and a slurring pattern to his speech. Which of the following actions by the nurse is appropriate?
- A. Administer a stat dose of lithium as necessary.
- B. Request an order for a stat blood lithium level.
- C. Recognize this as an expected response to lithium.
- D. Give an oral dose of lithium antidote.
Answer: B
Explanation:
(A)
These symptoms are indicative of lithium toxicity. A stat dose of lithium could be fatal.
(B)
These are toxic effects of lithium therapy. (C) The client is exhibiting symptoms of lithium toxicity, which may be validated by lab studies. (D) There is no known lithium antidote.
NEW QUESTION # 362
A behavioral modification program is recommended by the multidisciplinary team working with a 15-year- old client with anorexia nervosa. A nursing plan of care based on this modality would include:
- A. Provision for a high-calorie, high-protein snack between meals
- B. Role playing the client's eating behaviors
- C. Restriction to the unit until she has gained 2 lb
- D. Encouraging her to verbalize her feelings concerning food and food intake
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) This answer is incorrect. Role playing is based on learning but is not based on the behavioral modification model. (B) This answer is correct. The behavioral modification model is based on negative and positive reinforcers to change behavior. (C) This answer is incorrect. Verbal catharsis is not an intervention based on behavioral modification. (D) This answer is incorrect. Although an acceptable nursing intervention, it is not based on behavioral modification.
NEW QUESTION # 363
A 17-year-old pregnant client who is gravida 1, para 0, is at 36 weeks' gestation. Based on the nurse's knowledge of the maternal physiological changes in pregnancy, which of these findings would be of concern?
- A. Hematocrit 39%
- B. Edema of face and hands
- C. Pulse of 65 bpm at 8 weeks, 73 bpm at 36 weeks
- D. Complaints of dyspnea
Answer: B
Explanation:
Section: Questions Set D
Explanation:
(A) Dyspnea is a common complaint during the third trimester owing to the increasing size of the uterus and the resulting pressure against the diaphragm. (B) Edema of the face, hands, or pitting edema after 12 hours of bed rest may be indicative of preeclampsia and would be of great concern to the healthcare provider. (C) An increase in heart rate of 10-15 bpm is a normal physiological change in pregnancy due to the multiple hemodynamic changes. (D) A hematocrit value of 39% is within the normal range. A value <35% would indicate anemia.
NEW QUESTION # 364
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The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a test that must be passed by nursing graduates in order to become licensed as Registered Nurses (RNs) in the United States. The exam is developed and administered by the National Council of State Boards of Nursing (NCSBN) and is designed to test the knowledge and skills needed to provide safe and effective nursing care.
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