[Jan 07, 2025] Pass NCLEX NCLEX-RN Exam Info and Free Practice Test
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NEW QUESTION # 47
A common complication of cirrhosis of the liver is prolonged bleeding. The nurse should be prepared to administer?
- A. Vitamin E
- B. Vitamin K
- C. Vitamin A
- D. Vitamin C
Answer: B
Explanation:
Section: Questions Set D
Explanation:
(A) Vitamin C does not directly affect clotting. (B) Vitamin K is a fat-soluble vitamin that depends on liver function for absorption. Vitamin K is essential for clotting. (C) Vitamin E does not directly affect clotting. (D) Vitamin A does not directly affect clotting.
NEW QUESTION # 48
When a client arrives on the labor and delivery unit, she informs the nurse that she has been having contractions for the last 5 hours. Now the pain is constant and not cyclical as it was earlier. The nurse considers the possibility of uterine rupture. Which of the following symptoms would be consistent with a uterine rupture?
- A. Systolic hypertension
- B. A large gush of clear fluid from the vagina
- C. Increased fetal movements
- D. Abdominal rigidity
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) This symptom would indicate a rupture of the membranes, which would be expected during labor.
There would be no cause for alarm if the fluid were clear. (B) With uterine rupture and the risk of maternal shock secondary to blood loss, the most likely sign would be hypotension indicating hypovolemic shock.
(C) In the event of a uterine rupture, an abdominal examination would likely reveal rigidity or tenderness.
(D) The most likely finding would be a decrease in fetal movement related to fetal distress due to impaired uteroplacental blood flow. Maintaining the client on her left side would help to maximize uterine blood flow.
NEW QUESTION # 49
A client decided early in her pregnancy to breast-feed her first baby. She gave birth to a normal, full-term girl and is now progressing toward the establishment of successful lactation. To remove the baby from her breast, she should be instructed to:
- A. Gently pull the infant away
- B. Insert a clean finger into the baby's mouth beside the nipple
- C. Withdraw the breast from the infant's mouth
- D. Compress the areolar tissue until the infant drops the nipple from her mouth
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) In pulling the infant away from the breast without breaking suction, nipple trauma is likely to occur. (B) In pulling the breast away from the infant without breaking suction, nipple trauma is likely to occur. (C) Compressing the maternal tissue does not break the suction of the infant on the breast and can cause nipple trauma. (D) By inserting a finger into the infant's mouth beside the nipple, the lactating mother can break the suction and the nipple can be removed without trauma.
NEW QUESTION # 50
An elective saline abortion has been performed on a 3- week primigravida. Following the procedure, the nurse should be alert for which early side effect?
- A. Water satiety
- B. Thirst
- C. Edema
- D. Diabetes insipidus
Answer: B
Explanation:
Explanation
(A) If the client is experiencing water satiety, there is no more desire for water. (B) Absorption of saline into circulation rather than into amniotic sac increases serum sodium and desire for water. (C) Edema can be a late side effect caused by water intoxication. (D) Diabetes insipidus occurs as a result of deficient antidiuretic hormone.
NEW QUESTION # 51
The nurse is caring for a client who has diabetes insipidus. The nurse would describe this client's urine output pattern as:
- A. Dysuria
- B. Anuria
- C. Polyuria
- D. Oliguria
Answer: C
Explanation:
Section: Questions Set 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 # 52
The nurse is in the hallway and one of the visitors faints. The nurse should:
- A. Sit the victim up and place the head between the knees
- B. Elevate the victim's legs
- C. Sit the victim up and lightly slap his face
- D. Apply a cool cloth to the victim's neck and forehead until he recovers
Answer: B
Explanation:
(A) Sitting the client up defeats the goal of re-establishing cerebral blood flow. (B) Elevating the legs anatomically redirects blood flow to the cerebral area. (C) This strategy is a nice general comfort measure after the victim has regained consciousness. (D) This strategy is not as effective a strategy in helping the client to regain consciousness as elevating the legs.
NEW QUESTION # 53
Proper positioning for the child who is in Bryant's traction is:
- A. Both hips and knees maintained at a 90-degree flexion angle, and the back flat on the bed
- B. Both legs extended, and the hips are not flexed
- C. The affected leg extended with slight hip flexion
- D. Both hips flexed at a 90-degree angle with the knees extended and the buttocks elevated off the bed
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) The child's weight supplies the countertraction for Bryant's traction; the buttocks are slightly elevated off the bed, and the hips are flexed at a 90-degree angle. Both legs are suspended by skin traction. (B) The child in Buck's extension traction maintains the legs extended and parallel to the bed. (C) The child in Russell traction maintains hip flexion of the affected leg at the prescribed angle with the leg extended. (D) The child in "90-90" traction maintains both hips and knees at a 90-degree flexion angle and the back is flat on the bed.
NEW QUESTION # 54
A 52-year-old female client is admitted to the hospital in acute renal failure. She has been on hemodialysis for the past 2 years. Stat arterial blood gases are drawn on the client yielding the following results: pH 7.30, PCO2 51 mm Hg, HCO3, 18 mEq/L, PaO2, 84 mm Hg. The nurse would interpret these results as:
- A. Respiratory acidosis
- B. Partially compensated metabolic alkalosis
- C. Compensated metabolic alkalosis
- D. Combined respiratory and metabolic acidosis
Answer: D
Explanation:
(A) Compensated metabolic alkalosis would be reflected by the following: pH within normal limit (7.35-7.45), PCO2 > 45 mm Hg, HCO3 >26 mEq/L. (B) Respiratory acidosis would be reflected by the following: pH < 7.35, PCO2 > 45 mm Hg, HCO3 within normal limits (22-26 mEq/L). (C) Partially compensated metabolic alkalosis would be reflected by the following: pH > 7.45, PCO2 > 45 mm Hg, HCO3 > 26 mEq/L. (D) Combined respiratory and metabolicacidosis would be reflected by the following: pH < 7.35, PCO2 > 45 mm Hg, HCO3 < 22 mEq/L.
NEW QUESTION # 55
Following a gastric resection, a 70-year-old client is admitted to the postanesthesia care unit. He was extubated prior to leaving the suite. On arrival at the postanesthesia care unit, the nurse should:
- A. Obtain pulse and blood pressure readings noting rate and quality of pulse
- B. Review physician's orders, administering medications as ordered
- C. Reassure the client that his surgery is over and that he is in the recovery room
- D. Check airway, feeling for amount of air exchange noting rate, depth, and quality of respirations
Answer: D
Explanation:
(A) Adequate air exchange and tissue oxygenation depend on competent respiratory function. Checking the airway is the nurse's priority action. (B) Obtaining the vital signs is an important action, but it is secondary to airway management. (C) Reorienting a client to time, place, and person after surgery is important, but it is secondary to airway and vital signs. (D) Airway management takes precedence over physician's orders unless they specifically relate to airway management.
NEW QUESTION # 56
MgSO4 blood levels are monitored and the nurse would be prepared to administer the following antidote for MgSO4 side effects or toxicity:
- A. Naloxone (Narcan)
- B. Calcium gluconate
- C. Magnesium oxide
- D. Calcium hydroxide
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A, B) These drugs are not antidotes for MgSO4. (C) This drug is the standard antidote and should always be readily available when MgSO4is being administered. (D) This drug is an antidote for narcotics, not MgSO4.
NEW QUESTION # 57
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. "OK. I'll ask your physician if we can replace the Foley.''
- D. "It is not too much trouble. This is the best way to manage urination.''
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 # 58
A client is placed on lithium therapy for her manicdepressive illness. When monitoring the client, the nurse assesses the laboratory blood values. Toxicity may occur with lithium therapy when the blood level is above:
- A. 0.03 mEq/L
- B. 2.2 mEq/L
- C. 1.0 mEq/L
- D. 1.5 mEq/L
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) This value is a low blood level. (B) This value is a toxic blood level. (C) This value is a low blood level.
(D) This value is the level at which most clients are maintained, and toxicity may occur if the level increases. The client should be monitored closely for symptoms, because some clients become toxic even at this level.
NEW QUESTION # 59
A 14-year-old boy has had diabetes for 7 years. He takes 30 U of NPH insulin and 10 U of regular insulin every morning at 7 AM. He eats breakfast at 7:30 AM and lunch at noon. What time should he expect the greatest risk for hypoglycemia?
- A. 11 AM
- B. 9 AM
- C. 3 PM
- D. 1 PM
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) This time is incorrect because regular insulin would peak after the teenager has eaten breakfast. (B) This time is incorrect because it is after lunch when the NPH peaks. (C) Regular insulin peaks in 2-3 hours and has a duration of 4-6 hours. NPH insulin's onset is 4-6 hours and peaks in 8-16 hours. Blood sugar would peak after meals and be lowest before meals and during the night. (D) This time is incorrect because it is before the NPH and after the regular insulin peak times.
NEW QUESTION # 60
A term neonate has experienced no distress at birth and has an Apgar score of 9. Her mother has asked to breastfeed her following delivery. Immediately after birth, the neonate was most susceptible to heat loss. The most appropriate intervention to conserve heat loss and promote bonding is to:
- A. Place her on a heated pad
- B. Place her to her mother's breast
- C. Dry her with blankets
- D. Place her under the radiant warmer
Answer: B
Explanation:
Explanation
(A) A radiant warmer maintains an optimal thermal environment by use of a thermal skin sensor taped to the infant. The warmer limits parental attachment, so, although appropriate, it is not an intervention that promotes infant attachment. (B) Warmed blankets prevent heat loss in the neonate by conduction. In addition, tactile stimuli promote crying and lung expansion. This intervention does not promote attachment, however. (C) Skin-to-skin contact is an effective way to conserve heat after delivery and promotes parental attachment following birth in the healthy term infant. The first period of reactivity lasts approximately 30 minutes following birth. A strong sucking reflex and an active, awake newborn characterize this period. (D) Surfaces of objects warmer than the infant promote overheating by conduction, and neonatal hyperthermia may result.
NEW QUESTION # 61
After performing a sterile vaginal exam on a client who has just been admitted to the unit in active labor and placed on an electronic fetal monitor, the RN assesses that the fetal head is at 21 station. She documents this on the monitor strip. Fetal head at 21 station means that the fetal head is located where in the pelvis?
- A. One centimeter above the ischial spines
- B. Located in the pelvic outlet
- C. Has not entered the pelvic inlet yet
- D. One centimeter below the ischial spines
Answer: A
Explanation:
(A) The ischial spines are located on both sides of the midpelvis. These spines mark the
diameter of the narrowest part of the pelvis that the fetus will encounter. They are not sharp protrusions that will harm the fetus. Station refers to the relationship between the ischial spines in the pelvis and the fetus. The ischial spines are designated at 0 station. If the presenting part of the fetus is located above the ischial spines, a negative number is assigned, noting the number of centimeters above the ischial spines. Therefore, 1 centimeter below the ischial spines is designated as +1 station. (B) See explanation in A.
One centimeter above the ischial spines is designated as +1 station. (C) The pelvic inlet is the first part of the pelvis that the fetus enters in routine delivery. The midpelvis is the second part of the pelvis to be entered by the fetus. The ischial spines are located on both sides of the midpelvis. (D) The pelvic outlet is the last part of the pelvis that the fetus will enter. When the fetus reaches this part of the pelvis, birth is near.
NEW QUESTION # 62
A client is pregnant with her second child. Her last menstrual period began on January 15. Her expected date of delivery would be:
- A. October 22
- B. October 8
- C. October 29
- D. October 15
Answer: A
Explanation:
(A) Incorrect application of Nagele's rule: correctly subtracted 3 months but subtracted 7 days rather than added. (B) Incorrect application of Nagele's rule: correctly subtracted 3 months but did not add 7 days. (C) Correct application of Nagele's rule: correctly subtracted 3 months and added 7 days. (D) Incorrect application of Nagele's rule: correctly subtracted 3 months but added 14 days instead of 7 days.
NEW QUESTION # 63
A male client is experiencing extreme distress. He begins to pace up and down the corridor. What nursing intervention is appropriate when communicating with the pacing client?
- A. Ask him to sit down. Speak slowly and use short, simple sentences.
- B. Increase the level of his supervision.
- C. Walk with him as he paces.
- D. Help him to recognize his anxiety.
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) The nurse should not ask him to sit down. Pacing is the activity he has chosen to deal with his anxiety.
The nurse dealing with this client should speak slowly and with short, simplesentences. (B) The client may already recognize the anxiety and is attempting to deal with it. (C) Walk with the client as he paces. This gives support while he uses anxiety-generated energy. (D) Increasing the level of supervision may be appropriate after he stops pacing. It would minimize self-injury and/or loss of control.
NEW QUESTION # 64
A client's behavior is annoying other clients on the unit. He is meddling with their belongings and dominating the group. The best approach by the nurse is to:
- A. Have his medication increased.
- B. Seclude him in his room.
- C. Set limits on his behavior.
- D. Ignore him and tell the other clients that these behaviors are due to his illness and that they should understand.
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) This action by the nurse would be punitive. (B) Consistent limit setting will help the client to know what is acceptable behavior. (C) This action is not within the nurse's scope of practice. (D) This could be dangerous to the client and to others and violates other clients' rights.
NEW QUESTION # 65
A client is being treated for congestive heart failure. His medical regimen consists of digoxin (Lanoxin) 0.25 mg po daily and furosemide 20 mg po bid. Which laboratory test should the nurse monitor?
- A. Intake and output
- B. Potassium
- C. Calcium
- D. Magnesium
Answer: B
Explanation:
(A) Intake and output are not laboratory tests. (B) Serum calcium levels are not affected by digoxin or furosemide. (C) Furosemide is a non-potassium-sparing loop diuretic. Hypokalemia is a common side effect of furosemide and may enhance digoxin toxicity. (D) Serum magnesium levels are not affected by digoxin or furosemide.
NEW QUESTION # 66
A 28-year-old client performs a long, involved ritual in getting up and preparing for the day. He became unable to get to his job before noon. His family, in desperation, has admitted him to the hospital's psychiatric unit. On the unit, he is always late for breakfast, which is served at 8 am. The nurse identifies that the best approach to this problem is to:
- A. Allow him to eat late
- B. Get him up early so that he can complete the ritual before breakfast
- C. Suggest that he do the rituals after breakfast
- D. Ask him to get all the other clients up so that he will forget about his ritual
Answer: B
Explanation:
Explanation
(A) Allowing him to eat late is not a solution to the problem because the ritual affects more than just this meal.
(B) He is helpless to change this behavior because the rituals occur as a result of an irrational effort to control his anxiety. (C) To interfere with the ritual will increase anxiety. Until the basic problem is resolved, and in turn his need for the ritual relieved, arrange the schedule so that essential activities may be included (such as meals with the group). (D) This approach would be very disruptive to the other clients and would not serve to relieve the anxiety of the client.
NEW QUESTION # 67
A client is medically cleared for ECT and is tentatively scheduled for six treatments over a 2-week period.
Her husband asks, "Isn't that a lot?" The nurse's best response is:
- A. "Six to 10 treatments are common. Are you concerned about permanent effects?"
- B. "Don't worry. Some clients have lots more than that."
- C. "Yes, that does seem like a lot."
- D. "You'll have to talk to the doctor about that. The physician knows what's best for the client."
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) This response indicates that the nurse is unsure of herself and not knowledgeable about ECT. It also reinforces the husband's fears. (B) This response is "passing the buck" unnecessarily. The information needed to appropriately answer the husband's question is well within the nurse's knowledge base. (C) The most common range for affective disorders is 6-10 treatments. This response confirms and reinforces the physician's plan for treatment. It also opens communicationwith the husband to identify underlying fears and knowledge deficits. (D) This response offers false reassurance and dismisses the husband's underlying concerns about his wife.
NEW QUESTION # 68
A client has returned to the unit following a left femoral popliteal bypass graft. Six hours later, his dorsalis pedis pulse cannot be palpated, and his foot is cool and dusky. The nurse should:
- A. Notify the physician immediately
- B. Assure the client that his foot is fine
- C. Reposition and reassess the foot
- D. Continue to monitor the foot
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) The client is losing blood supply to his left foot. Continuing to monitor the foot will not help restore the blood supply to the foot. (B) The physician should be notified immediately because the client is losing blood supply to his left foot and is in danger of losing the foot and/or leg. (C) The presenting symptoms are of an emergency nature and require immediate intervention. (D) This action would be giving the client false assurance.
NEW QUESTION # 69
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. Eating a low-carbohydrate diet
- B. Drinking small amounts of liquids with meals
- C. Taking a long walk after meals
- D. Eating three large meals a day
Answer: A
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 # 70
A seventh grader lost consciousness after being hit in the head with a basketball. In the emergency room his vital signs are stable, and he demonstrates no neurologic deficit. He will not be admitted to the hospital. It is most important that you advise his mother to:
- A. Encourage him to drink plenty of fluids
- B. Wake him up every 1-2 hours during the night
- C. Keep him awake for the next 12 hours
- D. Expect him to have nausea with vomiting
Answer: B
Explanation:
(A) Fluid intake should be normal. Fluid intake may be restricted when there is a risk for increased ICP in a hospitalized client. (B) Nausea is possible, but vomiting without nausea is more likely with increased ICP. Neither one should be expected, but the mother should know to notify the physician or hospital if they occur. (C) The child does not need to be kept awake. It is important that he can be aroused from sleep. (D) If the child cannot be awakened from sleep after head injury, it is an indication of serious increase in ICP. The mother should call an ambulance right away.
NEW QUESTION # 71
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NCLEX-RN (National Council Licensure Examination) is a standardized examination that assesses the knowledge, skills, and abilities of registered nurses seeking licensure in the United States and Canada. NCLEX-RN exam is considered a crucial milestone in the journey of becoming a registered nurse. It is designed to test the candidate's ability to apply the nursing knowledge and skills in a clinical setting and ensure that they possess the necessary competency to provide safe and effective patient care.
NCLEX-RN exam covers a broad range of topics related to nursing practice, including health promotion, disease prevention, patient care management, pharmacology, and more. NCLEX-RN exam consists of multiple-choice questions that assess a nurse's ability to apply knowledge, skills, and critical thinking to real-world situations. The NCLEX-RN is designed to test a nurse's ability to make sound clinical judgments, prioritize patient care needs, and provide safe and effective care.
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