Best Quality NCLEX NCLEX-RN Exam Questions Exam4PDF Realistic Practice Exams [2023]
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NEW QUESTION 37
A child receiving chemotherapeutic drugs experiences a loss of appetite directly related to the therapy. Which of the following strategies should be most effective in encouraging the child to eat?
- A. Offer the child a diet with a wider variety of foods and with more seasoning than her usual diet.
- B. Provide a well-balanced diet at usual times, and restrict dessert if the child fails to eat well.
- C. Schedule procedures immediately after eating so that the child will not be tired or in pain at mealtime.
- D. Offer the child smaller meals more frequently than usual, and include as many of her favorite foods as possible.
Answer: D
Explanation:
Section: Questions Set D
Explanation:
(A) Because the child's appetite is capricious at best, regular servings may be overwhelming. Praise the child for what is eaten. (B) The child will soon learn that procedures follow meals and may play with food rather than eat it to avoid or delay the procedure. (C) Young children usually do not like highly seasoned foods and may need the security of usual foods. Such a change may actually increase anorexia. (D) Small servings appear more achievable to the child, and the inclusion of favorite foods can add a sense of security.
NEW QUESTION 38
A 16-year-old female client is admitted to the hospital because she collapsed at home while exercising with videotaped workout instructions. Her mother reports that she has been obsessed with losing weight and staying slim since cheerleader try-outs 6 months ago, when she lost out to two of her best friends. The client is 5'4" and weighs 92 lb, which represents a weight loss of 28 lb over the last 4 months. The most important initial intervention on admission is to:
- A. Assess vital signs
- B. Obtain an accurate weight
- C. Search the client's purse for pills
- D. Assign her to a room with someone her own age
Answer: A
Explanation:
(A)
On admission, vital signs are the highest priority. Weight is not a vital sign. (B) Belongings are routinely searched on admission to a psychiatric unit, but this search is not a high priority. (C) Vital signs are a high priority when working with selfdestructive clients.
(D)
Room assignment is of low priority.
NEW QUESTION 39
A 29-year-old client is admitted for a hysterectomy. She has repeatedly told the nurses that she is worried about having this surgery, has not slept well lately, and is afraid that her husband will not find her desirable after the surgery. Shortly into the preoperative teaching, she complains of a tightness in her chest, a feeling of suffocation, lightheadedness, and tingling in her hands. Her respirations are rapid and deep. Assessment reveals that the client is:
- A. Wanting attention from the nurses
- B. Having a heart attack
- C. Hyperventilating
- D. Suffering from complete upper airway obstruction
Answer: C
Explanation:
(A) Classic symptoms of a heart attack include heaviness or squeezing pain in the chest, pain spreading to the jaw, neck, and arm. Nausea and vomiting, sweating, and shortness of breath may be present. The client does not exhibit these symptoms. (B) Clients suffering from anxiety or fear prior to surgical procedures may develop hyperventilation. This client is not seeking attention. (C) Symptoms of complete airway obstruction include not being able to speak, and no airflow between the nose and mouth. Breath sounds are absent. (D) Tightness in the chest; a feeling of suffocation; lightheadedness; tingling in the hands; and rapid, deep respirations are signs and symptoms of hyperventilation. This is almost always a manifestation of anxiety.
NEW QUESTION 40
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. Chills shortly after delivery
- C. Pulse rate of 60 bpm in morning on first postdelivery day
- D. Urinary output of 3000 mL on the second day after delivery
Answer: A
Explanation:
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 41
A pregnant client is having a nonstress test (NST). It is noted that the fetal heart beat rises 20 bpm, lasting 20 seconds, every time the fetus moves. The nurse explains that:
- A. The fetus is distressed
- B. The test is normal and the fetus is reacting appropriately
- C. The test is inconclusive and should be repeated
- D. Further testing is needed
Answer: B
Explanation:
(A)
The test results were normal, so there would be no need to repeat to determine results.
(B)
There are no data to indicate further tests are needed, because the result of the NST was normal. (C) An NST is reported as reactive if there are two to three increases in the fetal heart rate of 15 bpm, lasting at least 15 seconds during a 15-minute period. (D) The NST results were normal, so there was no fetal distress.
NEW QUESTION 42
The nurse is caring for a client who has diabetes insipidus. The nurse would describe this client's urine output pattern as:
- A. Anuria
- B. Dysuria
- C. Oliguria
- D. Polyuria
Answer: D
Explanation:
Explanation
(A)Anuriais defined as absence of urine output, which is not indicative of the urinary pattern of diabetes insipidus. (B)Oliguriais defined as <500 mL of urine per day, which is not a urinary output pattern associated with diabetes insipidus. (C)Dysuriais defined as difficult urination. Clients with diabetes insipidus do not have dysuria as a symptom of their disease. (D) Polyuria is a primary symptom of diabetes insipidus. These clients have decreased or absent vasopressin secretion, which causes water loss in the urine and sodium increases.
NEW QUESTION 43
Which of the following physician's orders would the nurse question on a client with chronic arterial insufficiency?
- A. No smoking
- B. Neurovascular checks every 2 hours
- C. Elevate legs on pillows
- D. Arteriogram in the morning
Answer: C
Explanation:
(A) Neurovascular checks are a routine part of assessment with clients having this diagnosis. (B) Elevation of the legs is contraindicated because it reduces blood flow to areas already compromised. (C) Arteriogram is a routine diagnostic order. (D) Smoking is highly correlated with this disorder.
NEW QUESTION 44
A postpartum client complains of rectal pressure and severe pain in her perineum; this may be indicative of:
- A. Constipation
- B. A hematoma of the vagina or vulva
- C. Afterbirth pains
- D. Cystitis
Answer: B
Explanation:
Explanation
(A) Afterbirth pains are a common complaint in the postpartum client, but they are located in the uterus. (B) Constipation may cause rectal pressure but is not usually associated with "severe pain." (C) Cystitis may cause pain, but the location is different. (D) Hematomas are frequently associated with severe pain and pressure.
Further assessments are indicated for this client.
NEW QUESTION 45
A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:
- A. Hang Ringer's lactate as the companion fluid
- B. Use microdrip tubing for the blood administration
- C. Take a baseline set of vital signs
- D. Have the registered nurse in charge assume responsibility for verifying the client and blood product information
Answer: C
Explanation:
(A) A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. (B) The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringer's lactate can cause clotting. (C) Only a blood administration set should be used. A microdrip tube would cause lysis of the red blood cells. (D) Proper identification of the recipient and the blood product must be validated by at least two people.
NEW QUESTION 46
A client suspects that she is pregnant. She reports two missed menstrual periods. The first day of her last menstrual period was August 3. Her estimated date of confinement would be:
- A. November 10
- B. May 10
- C. May 7
- D. November 7
Answer: B
Explanation:
(A)
Wrong calculation (B) Wrong calculation (C) Wrong calculation
(D)
Nagele's rule is: Expected Date of Confinement = Last Menstrual Period - 3 months + 7 days + 1 year
NEW QUESTION 47
When assessing a female child for Turner's syndrome, the nurse observes for which of the following symptoms?
- A. Secondary sex characteristics
- B. Gynecomastia
- C. Amenorrhea
- D. Tall stature
Answer: C
Explanation:
Explanation
(A) This syndrome is caused by absence of one of the X chromosomes. These children are short in stature. (B) Amenorrhea is a symptom of Turner's syndrome, which appears at puberty. (C) Sexual infantilism is characteristic of this syndrome. (D) Gynecomastia is a symptom in Klinefelter's syndrome.
NEW QUESTION 48
A client on the infectious disease unit is discussing transmission of human immunodeficiency virus (HIV).
The nurse would need to provide more client education based on which client statement?
- A. "HIV is a virus transmitted by sexual contact."
- B. "HIV is a virus that is easily transmitted by casual contact."
- C. "Condoms reduce the transmission of HIV."
- D. "HIV can be transmitted to an unborn infant."
Answer: B
Explanation:
Section: Questions Set D
Explanation:
(A) HIV is transmitted through unprotected sexual contact. (B) Condoms are an effective barrier to prevent HIV transmission. (C) HIV is not easily transmitted by casual contact. (D) HIV can be transmitted intrauterinely at the time of delivery, and by breast-feeding.
NEW QUESTION 49
On admission to the inpatient unit, a 34-year-old client is able to follow simple directions, but with great difficulty.
He is worried about how he can keep clean in such a public place and repeatedly dusts his bureau, straightens his bed, and adjusts the clothes in his closet. The client is experiencing a severe level of anxiety. Which response by the nurse would be most therapeutic in initially attempting to reduce his anxiety?
- A. "I've inspected this room and it is perfectly clean."
- B. "Tell me why your room needs to be so clean."
- C. "I can see how uncomfortable you are, but I would like you to walk with me so I can show you around the unit."
- D. "You will not be allowed to remain in your room if you continue to bother things."
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) This statement is punitive. (B) Acknowledging the anxiety and channeling it into some positive activity is therapeutic. (C) The client cannot say "why"; this statement puts the client on the defensive. (D) A rational approach, especially a judgmental one, is non-therapeutic.
NEW QUESTION 50
Prenatal clients are routinely monitored for early signs of pregnancy-induced hypertension (PIH). For the prenatal client, which of the following blood pressure changes from baseline would be most significant for the nurse to report as indicative of PIH?
- A. 136/88 to 144/93
- B. 114/70 to 140/88
- C. 140/90 to 148/98
- D. 132/78 to 124/76
Answer: B
Explanation:
(A) These blood pressure changes reflect only an 8 mm Hg systolic and a 5 mm Hg diastolic increase, which is insufficient for blood pressure changes indicating PIH. (B) These blood pressure changes reflect a decrease in systolic pressure of 8 mm Hg and diastolic pressure of 2 mm Hg; these values are not indicative of blood pressure increases reflecting PIH. (C) The definition of PIH is an increase in systolic blood pressure of 30 mm Hg and/or diastolic blood pressure of 15 mm Hg. These blood pressures reflect a change of 26 mm Hg systolically and 18mm Hg diastolically. (D) These blood pressures reflect a change of only 8 mm Hg systolically and 8 mm Hg diastolically, which is insufficient for blood pressure changes indicating PIH.
NEW QUESTION 51
A six-month-old infant is receiving ribavirin for the treatment of respiratory syncytial virus. Ribavirin is administered via which one of the following routes?
- A. IM
- B. Aerosol
- C. IV
- D. Oral
Answer: B
Explanation:
Section: Questions Set B
Explanation:
(A) Ribavirin is not supplied in an oral form. (B) Ribavirin is administered by aerosol in order to decrease the duration of viral shedding within the infected tissue. (C) Ribavirin is not approved for IV use to treat respiratory syncytial virus. (D) Ribavirin is a synthetic antiviral agent supplied as a crystalline powder that is reconstituted with sterile water. A Small Aerosol Particle Generator unit aerosolizes the medication for delivery by oxygen hood, croup tent, or aerosol mask.
NEW QUESTION 52
A 48-year-old female client is going to have a cholecystectomy in the morning. In planning for her postoperative care, the nurse is aware that a priority nursing diagnosis for her will be high risk for:
- A. Urinary retention
- B. Ineffective breathing pattern
- C. Knowledge deficit
- D. Impaired physical mobility
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) The client may have a knowledge deficit, but reducing the risk for knowledge deficit is not a priority nursing diagnosis postoperatively. (B) The client will have a Foley catheter for a day or two after surgery.
Urinary retention is usually not a problem once the Foley catheter is removed. (C) A client having a cholecystectomy should not be physically impaired. In fact, the client is encouraged to begin ambulating soon after surgery. (D) Because of the location of the incision, the client having a cholecystectomy is reluctant to breathe deeply and is at risk for developing pneumonia. These clients have to be reminded and encouraged to take deep breaths.
NEW QUESTION 53
In cleansing the perineal area around the site of catheter insertion, the nurse would:
- A. Wipe the catheter away from the urinary meatus
- B. Gently insert the catheter another 12 inch after cleansing to prevent irritation from the balloon
- C. Apply a small amount of talcum powder after drying the perineal area
- D. Wipe the catheter toward the urinary meatus
Answer: A
Explanation:
Explanation
(A) Wiping toward the urinary meatus would transport microorganisms from the external tubing to the urethra, thereby increasing the risk of bladder infection. (B) Wiping away from the urinary meatus would remove microorganisms from the point of insertion of the catheter, thereby decreasing the risk of bladder infection. (C) Talcum powder should not be applied following catheter care, because powders contribute to moisture retention and infection likelihood. (D) The catheter should never be inserted further into the urethra, because this would serve no useful purpose and would increase the risk of infection.
NEW QUESTION 54
A client is started on prednisone 2.5 mg po bid. Which of the following instructions should be included in her discharge teaching specific to this medication?
- A. Avoid contact with people who have contagious illnesses.
- B. Brush your teeth at least 4 times a day with a firm toothbrush.
- C. Increase your oral intake of fluids to at least 4000 mL every day.
- D. Immediately stop taking the prednisone if you feel depressed.
Answer: A
Explanation:
Explanation
(A) Fluid retention is a side effect of prednisone. The nurse should teach clients to weigh themselves daily and to observe for signs of edema. If these signs of fluid retention occur, they should notify the physician. (B) Prednisone, a glucocorticoid, suppresses the normal immune response making the client more susceptible to infections. (C) An increase in bleeding tendencies is a side effect of prednisone therapy. The nurse should teach clients to use preventive measures (i.e., electric razors and soft toothbrushes). (D) Depression and personality changes are side effects of prednisone therapy. Prednisone should never be discontinued abruptly.
NEW QUESTION 55
A physician's order reads: Administer furosemide oral solution 0.5 mL stat. The furosemide bottle dosage is 10 mg/mL. What dosage of furosemide should the nurse give to this infant?
- A. 20 mg
- B. 0.5 mg
- C. 5 mg
- D. 0.05 mg
Answer: C
Explanation:
(A) 1 mg = 0.1 mL, then 0.5 mL X= 55 mg. (B) Thisanswer is a miscalculation. (C) This answer is a miscalculation. (D) This answer is a miscalculation.
NEW QUESTION 56
......
Discuss the key features of the exam.
There are several key features of the exam:
Essay Test: The essay test is an important component of the NCLEX-RN exam. The question is designed to test your ability to analyze situations and determine the best course of action. This is similar to the way you were trained during nursing school.
You are tested on how you would use critical thinking skills.
The test includes a clinical scenario.
Written test: The written test is two hours long. This means that you will have four-and-a-half hours to complete the exam.
It tests if you understand the basics of the nursing process.
It tests your ability to apply the knowledge you learned in nursing school to the nursing process.
It also tests your ability to make nursing judgments.
The Exam: There is a maximum number of questions you can answer in the NCLEX-RN exam. It is a multiple-choice test.
It is organized according to the nursing framework Meeting Client Needs.
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