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NCLEX-RN, or National Council Licensure Examination for Registered Nurses, is a standardized exam that all nursing graduates must pass in order to become licensed and practice as a registered nurse in the United States. NCLEX-RN exam is administered by the National Council of State Boards of Nursing (NCSBN) and is designed to test the knowledge, skills, and abilities necessary for safe and effective nursing practice. It is a computerized adaptive test (CAT), meaning that the difficulty of the questions adapts to the test-taker's level of knowledge and ability, and it can take anywhere from 75 to 265 questions to complete.
NCLEX-RN exam is a challenging and rigorous test that requires adequate preparation. Test-takers should review and understand the test content, become familiar with the computer-based format, and practice answering questions in a timed setting. There are several resources available to help RNs prepare for the NCLEX-RN exam, such as review courses, study guides, practice tests, and online resources. With proper preparation and a thorough understanding of the exam content, RNs can successfully pass the NCLEX-RN exam and become licensed to practice nursing in the United States.
NEW QUESTION # 495
To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with which of the following?
- A. Increase in balance of myocardial O2 supply and demand
- B. Negative chronotropic therapy
- C. Afterload reduction therapy
- D. Positive inotropic therapy
Answer: D
Explanation:
Explanation
(A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand. (B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time. This should be used cautiously because tachycardia may be a compensatory mechanism to increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon pump therapy, would decrease myocardial work and O2 demand.
NEW QUESTION # 496
A client presented herself to the mental health center, describing the following symptoms: a weight loss of
20 lb in the past 2 months, difficulty concentrating, repeated absences from work due to "fatigue," and not wanting to get dressed in the morning. She leaves her recorded message on her telephone and has lost interest in answering the phone or doorbell. The nurse's assessment of her behavior would most likely be:
- A. Deep depression
- B. Psychotic depression
- C. Severe anxiety
- D. Severe depression
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) A client in deep depression would have been brought to the mental health center and would not be physically able to seek help for herself. (B) She is not manifesting psychotic symptoms in her behaviors.
(C) The client's symptoms are more indicative of depression than anxiety. (D) Although the client was able to bring herself to the mental health center, the extent of her weight loss and the interference of symptoms with activities of daily living indicate that she is severely depressed.
NEW QUESTION # 497
A 2-year-old boy is in the hospital outpatient department for observation after falling out of his crib and hitting his head. The nurse calls the physician to report:
- A. Pulse fell from 102 to 96
- B. Evidence of perineal irritation
- C. Temperature rose to 102_F rectally
- D. Pulse increased from 96 to 102
Answer: C
Explanation:
Explanation
(A) Perineal irritation needs to be addressed, but it is probably not necessary to call the physician. (B) This fall in pulse rate remains within normal limits and is probably insignificant. It is important to monitor for continued change. (C) This rise in pulse rate is probably not significant, but it is important to monitor for continued change. (D) This temperature is above normal limits and needs medical investigation. It may or may not be related to the head injury.
NEW QUESTION # 498
A 68-year-old man was recently diagnosed with endstage renal disease. He has not yet begun dialysis but is experiencing severe anemia with associated symptoms of dyspnea on exertion and chest pain. Which statement best describes the management of anemia in renal failure?
- A. The renal secretion of erythropoiesis is decreased. The bone marrow requires erythropoietin to mature red blood cells.
- B. Hematocrit levels usually remain slightly below normalin clients with renal failure.
- C. Anemia in renal failure is frequently caused by low serum iron and ferritin and corrected by oral iron and ferritin replacement therapy.
- D. Transfusion is often begun as early as possible to prevent complications of anemia such as dyspnea and angina.
Answer: A
Explanation:
(A) Clients in renal failure typically have very low hematocrits, often in the range of 16-22%. (B) Transfusion is avoided unless the client exhibits acute symptoms such as dyspnea, chest pain, tachycardia, and extreme fatigue. When the client is given a transfusion, the bone marrow adjusts by producing less red blood cells. (C) Anemia in renal failure is caused primarily by decreased erythropoietin. Low serum iron and ferritin may aggravate the anemia and require treatment. (D) Decreased secretion of erythropoietin by the kidney is the primary cause of anemia. The bone marrow requires this hormone to mature red blood cells. Treatment is with replacement therapy.
NEW QUESTION # 499
A female client has experienced varying degrees of depression throughout her life. Now that she is postmenopausal, her depression has increased. She is unable to motivate herself to clean her house or even to get out of bed and get dressed in the morning. The client was begun on fluoxetine (Prozac) therapy. When educating her about fluoxetine, what might the nurse caution her about?
- A. Rashes or pruritus usually occur early in the therapy and are treatable without discontinuing the medication.
- B. A daily dose of fluoxetine may be taken in the morning or evening.
- C. It is safe to take over-the-counter or other prescription medications with fluoxetine.
- D. Fluoxetine is not sedating; therefore, restrictions on driving and other hazardous activities are not necessary.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) A daily dose of fluoxetine should be taken in the morning. Afternoon doses may cause nervousness and insomnia. (B) Although fluoxetine is less sedating than other antidepressants, it may still cause dizziness or drowsiness in some clients. The nurse should caution clients to avoid driving or hazardous activities until the central nervous system effects of the drug are demonstrated. (C) Rashes or pruritus do commonly occur early in therapy and respond to antihistamines or topical corticosteroids. (D) Advise the client not to take over-the-counter or other prescription drugs without consulting with the physician.
Fluoxetine does interact with other common drugs such as monoamine oxidase inhibitors, diazepam, insulin, oral antidiabetic agents, tricyclic antidepressants, and tryptophan.
NEW QUESTION # 500
A mother brings a 6-month-old infant and a 4-year-old child to the nursing clinic for routine examination and screening. Which of these plans by the nurse would be most successful?
- A. Examine painful areas first to get them "over with."
- B. Provide time for play and becoming acquainted.
- C. Examine the 4 year old first.
- D. Have the mother leave the room with one child, and examine the other child privately.
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) The 6 month old should be examined first. If several children will be examined, begin with the most cooperative and less anxious child to provide modeling. (B) Providing time for play and getting acquainted minimizes stress and anxiety associated with assessment of body parts. (C) Children generally cooperate best when their mother remains with them. (D) Painful areas are best examined last and will permit maximum accuracy of assessment.
NEW QUESTION # 501
The nurse is teaching a 10-year-old insulin-dependent diabetic how to administer insulin. Which one of the following steps must be taught for insulin administration?
- A. Pinch the skin up to form a subcutaneous pocket.
- B. Avoid applying pressure after injection.
- C. Never use abdominal site for a rotation site.
- D. Change needles after injection.
Answer: A
Explanation:
Section: Questions Set B
Explanation:
(A) Sites for injection need to be rotated, including abdominal sites, to enhance insulin absorption. (B) The pinch technique is the most effective method for obtaining skin tightness to allow easy entrance of the needle to subcutaneous tissues. (C) Massaging the site of injection facilitates absorption of the insulin. (D) Changing the needle will break the sterility of the system. It has become acceptable practice to reuse disposable needles and syringes for 3-7 days.
NEW QUESTION # 502
A female client was employed as a client care technician in a hemodialysis unit. She recently began to experience extreme fatigue, being able to sleep for 16-20 hours at a time. She also noted that her urine was tea colored, which she rationalized was a result of the vitamins she began taking to alleviate fatigue. She was diagnosed with hepatitis
B. After a brief hospital stay, she is discharged to her parent's home. Her mother asks the nurse if any precautions are necessary to prevent transmission to the client's family. The nurse explains necessary precautions, which include:
- A. Separate bathroom facilities if possible; if not, then cleansing daily of the facilities with a chloride solution
- B. No necessary precautions because she is beyond the contagious phase
- C. Isolation of the client from the remainder of the family
- D. Laundering clothes separately in cold water with a chloride solution
Answer: A
Explanation:
Section: Questions Set E
Explanation:
(A) Isolation is not necessary, even in the acute phase. (B) Separate bathroom facilities are recommended. If unavailable, daily cleansing with a chloride solution is recommended. (C) Precautions continue to be necessary while the client is in the active phase of hepatitis. (D) Clothes are to be laundered separately in hot water with a chloride solution.
NEW QUESTION # 503
Seven days ago, a 45-year-old female client had an ileostomy. She is self-sufficient and well otherwise. Which of the following long-term objectives would be unrealistic?
- A. She should be able to manage her own care.
- B. She should be able to resume sexual activity.
- C. She should be able to control evacuation of her bowels.
- D. She should be able to return to a regular diet.
Answer: C
Explanation:
Explanation
(A) Because of the location of an ileostomy, the client will not be able to control the evacuation of her bowels.
The ileostomy will drain liquid stool continuously. (B) The client should be able to return to a normal, well-balanced diet. She should avoid foods that cause diarrhea or excessive gas production, and she should eat small meals. (C) The client should be able to resume sexual activity. She will be able to wear a pouch. (D) The client has no other health or mental problems and should be able to manage her own ileostomy.
NEW QUESTION # 504
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. Taking a long walk after meals
- B. Eating three large meals a day
- C. Drinking small amounts of liquids with meals
- D. Eating a low-carbohydrate diet
Answer: D
Explanation:
Explanation/Reference:
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 # 505
A client is dilated 8 cm and entering the transition phase of labor. Common behaviors of the laboring woman during transition are:
- A. Frustration, vague in communication
- B. Calmness, follows directions easily
- C. Excitement, openness to instructions
- D. Seriousness, some difficulty following directions
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) During the transition phase, the mother may become frustrated and unclear in her communication owing to severe pain and fear of loss of control. (B) These behaviors are common in the active phase of labor. (C) These behavioral clues are seen in the latent phase of labor. (D) These characteristics are observed in the latent phase of labor.
NEW QUESTION # 506
Which of the following ECG changes would be seen as a positive myocardial stress test response?
- A. ST-segment depression
- B. Hyperacute T wave
- C. Prolongation of the PR interval
- D. Pathological Q wave
Answer: A
Explanation:
Explanation
(A) Hyperacute T waves occur with hyperkalemia. (B) Prolongation of the P R interval occurs with first-degree AV block. (C) Horizontal ST-segment depression of>1 mm during exercise isdefinitely a positive criterion on the exercise ECG test. (D) Patho-logical Q waves occur with MI.
NEW QUESTION # 507
A 17-year-old client has a T-4 spinal cord injury. At present, he is learning to catheterize himself. When he says, "This is too much trouble. I would rather just have a Foley.'' An appropriate response for the RN teaching him would be:
- A. "I know. It is a lot to learn. In the long run, though, you will be able to reduce infections if you do an intermittent catheterization program.''
- B. "You need to learn this because your doctor ordered it.''
- C. "It is not too much trouble. This is the best way to manage urination.''
- D. "OK. I'll ask your physician if we can replace the Foley.''
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) This response acknowledges the client's feelings, gives him factual information, and acknowledges that the final decision is his. (B) This response is judgmental and discourages the client from expressing his feelings about the procedure. (C) Catheterization is a procedure thattakes time to learn, but which, for the spinal cord-injured client, can significantly reduce the incidence of urinary tract infections. A young client with a T-4 injury has the hand function to learn this procedure fairly easily. (D) The final decision about bladder elimination management ultimately rests with the client and not the physician.
NEW QUESTION # 508
Hematotympanum and otorrhea are associated with which of the following head injuries?
- A. Epidural hematoma
- B. Frontal lobe fracture
- C. Basilar skull fracture
- D. Subdural hematoma
Answer: C
Explanation:
Explanation
(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.
NEW QUESTION # 509
The nurse enters the playroom and finds an 8-year-old child having a grand mal seizure. Which one of the following actions should the nurse take?
- A. Move furniture out of the way and place a blanket under his head.
- B. Restrain the child so he will not injure himself.
- C. Place a tongue blade in the child's mouth.
- D. Go to the nurses station and call the physician.
Answer: A
Explanation:
(A) The nurse should not put anything in the child's mouth during a seizure; this action could obstruct the airway. (B) Restraining the child's movements could cause constrictive injury. (C) Staying with the child during a seizure provides protection and allows the nurse to observe the seizure activity. (D) The nurse should provide safety for the child by moving objects and protecting the head.
NEW QUESTION # 510
The nurse is caring for a client who has had a tracheostomy for 7 years. The client is started on a fullstrength tube feeding at 75 mL/hr. Prior to starting the tube feeding, the nurse confirms placement of the tube in the stomach. The hospital policy states that all tube feeding must be dyed blue. On suctioning, the nurse notices the sputum to be a blue color. This is indicative of which of the following?
- A. The client aspirated tube feeding.
- B. The nurse has placed the suction catheter in the esophagus.
- C. This is a normal finding.
- D. The feeding is infusing into the trachea.
Answer: A
Explanation:
Explanation
(A) Once the feeding tube placement is confirmed in the stomach, aspiration can occur if the client's stomach becomes too full. When suctioning the trachea, if secretions resemble tube feeding, the client has aspirated the feeding. (B) Because the trachea provides direct access to a client's airway, it would not be possible to place the catheter in the esophagus. (C) Blue-colored sputum is never considered a normal finding and should be reported and documented. (D) The nurse confirmed placement of the feeding tube in the stomach prior to initiating the tube feeding; therefore, it is highly unlikely that the feeding tube would be located in the trachea.
NEW QUESTION # 511
Which of the following should the nurse anticipate receiving as an as-needed order for a postoperative carotid endarterectomy client?
- A. Nitroglycerin gr 1/150 for chest pain
- B. Nifedipine 10 mg SL for B/P 140/90
- C. Furosemide 20 mg/PO for decreased urine output
- D. Magnesium salicylate to decrease inflammation
Answer: B
Explanation:
(A) It is important to maintain a normal to slightly lower pressure to prevent the graft from blowing and excessive pressure to surgical vascular areas. (B, C, D) None of these drugs is related to managing the problem at hand. Also, none of the problems for which these drugs would be indicated is expected with this type of surgery, except if there is a prior history.
NEW QUESTION # 512
A 5-year-old child was recently diagnosed as having acute lymphoid leukemia. She is hospitalized for additional tests and to begin a course of chemotherapy designed to induce a remission. She is scheduled to have a bone marrow aspiration tomorrow. She has had a bone marrow test previously and is apprehensive about having another. Which of the following interventions will be most effective in relieving her anxiety?
- A. Explain what will take place and what she will see, feel, and hear.
- B. Tell her not to worry about it, that it will be over soon and she can join her friends in the playroom.
- C. Give her a big hug and tell her that she is a big girl now and that she will do just fine.
- D. Remind her that she has had this procedure before and that it is nothing to be afraid of.
Answer: A
Explanation:
Explanation
(A) Even though the child has had the procedure before, she will probably need additional explanations and emotional support. (B) The fact that the child has had the procedure before and possibly found it painful or uncomfortable may increase, not relieve, her stress. (C) This intervention does nothing to reassure the child and may well prevent her from expressing her feelings. (D) This does not prepare the child for the test and burdens her with the expectation that she act bigger and braver than she is.
NEW QUESTION # 513
In planning daily care for a client with multiple sclerosis, the nurse would take into consideration that multiple sclerosis:
- A. Responds quickly to antimicrobial therapy
- B. Becomes progressively debilitating without remission
- C. Is rapidly fatal
- D. Has unpredictable remissions and exacerbations
Answer: D
Explanation:
Section: Questions Set G
Explanation:
(A) Multiple sclerosis eventually becomes debilitating, but it is characterized by remission of symptoms. (B) Remissions and exacerbations are unpredictable with multiple sclerosis. The client experiences progressive dysfunction after each exacerbation episode. (C) Multiple sclerosis is usually slowly progressive. (D) Multiple sclerosis is an autoimmune disease. Antimicrobial therapy has no effect on its course.
NEW QUESTION # 514
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