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Understand the objectives of the NCLEX-RN exam.
The objective of the NCLEX-RN® certification is to test your ability to use critical thinking skills to make nursing judgments. This is a much different type of testing than what you have done in nursing school. Nursing schools test your knowledge of the nursing process. They want to know if you have learned all the nursing terms. On the NCLEX-RN® exam, they want to see if you have learned to apply the nursing knowledge you learned in school to the nursing process. Improvement of knowledge and retention of information on the NCLEX-RN exam is based on how well you answered questions. NCLEX-RN Dumps tests your knowledge and understanding. Aid material helps you learn new concepts and retain information that you learned in school. Knowledge like textbooks are no longer used for this test. It's not enough to memorize the answer to every question.
You must understand the concept behind the question and know the answers to all questions. That is what you are tested on the NCLEX-RN exam. Pool of questions is important because it means that there are questions you have not seen before. Links between topics are also important. Questions in one topic might be related to questions in another topic. Training your brain to recognize this can help you identify those questions and prepare for them. Exam cram is not as important as knowing what to study for. You must know the content of the exam.
To be licensed as a registered nurse in the United States, you must meet the following requirements:
Have passed the NCLEX exam.
Be a citizen of the U.S.
Be in good health.
Have been registered to practice as an entry-level nurse.
NEW QUESTION # 87
The client has been in active labor for the last 12 hours. During the last 3 hours, labor has been augmented with oxytocin because of hypoactive uterine contractions. Her physician assesses her cervix as 95% effaced, 8 cm dilated, and the fetus is at 0 station. Her oral temperature is 100.2°F at this time. The physician orders that she be prepared for a cesarean delivery. In preparing the client for the cesarean delivery, which one of the following physician's orders should the RN question?
- A. Prepare abdominal area from below the nipples to below the symphysis pubis area.
- B. Discontinue the oxytocin infusion.
- C. Administer meperidine (Demerol) 100 mg IM 1 hour prior to the delivery.
- D. Insert an indwelling Foley catheter prior to delivery.
Answer: C
Explanation:
Section: Questions Set C
Explanation:
(A) Meperidine is a narcotic analgesic medication that crosses the placental barrier and reaches the fetus, causing respiratory depression in the fetus. A narcotic medication should never be included in the preoperative order for a cesarean delivery. (B) Oxytocin infusion would be discontinued if client is being prepared for a cesarean delivery because the medication would not be needed. (C) The bladder is always emptied prior to and during the surgical intervention to prevent the urinary bladder from accidentally being incised while the uterine incision is made. (D) The abdominal area is always prepared to rid the area of hair before the abdominal incision is made. Abdominal hair cannot be sterilized and could become a source for postoperative incisional infection.
NEW QUESTION # 88
A female client at 36 weeks' gestation has been treated successfully for premature labor for 4 weeks. She has begun having uterine contractions today and has been admitted to the labor and delivery suite. Her amniocentesis results reveal a lecithin/sphingomyelin (L/S) ratio of 2 and positive phosphatidylglycerol (PG).
These lab values indicate:
- A. Cord compression
- B. Placental maturity
- C. Fetal lung maturity
- D. Suspected chronic asphyxia
Answer: C
Explanation:
Explanation
(A) Placental maturity is assessed by a biophysical profile. (B) L/S ratio and presence of phosphatidylglycerol are not used to determine fetal asphyxia. A biophysical profile score of6 may indicate this condition. (C) Cord compression is not reflected by the L/S ratio or presence of phosphatidylglycerol. Variable decelerations observed through electronic fetal monitoring could reflect umbilical cord compression. (D) An L/S ratio>2 and the presence of phosphatidylglycerol in amniotic fluid indicate fetal lung maturity.
NEW QUESTION # 89
A client delivered a term infant 1 hour ago. Her uterus on assessment is boggy and is U +1 in contrast to the previous assessment of U _2. The immediate nursing response is to:
- A. Administer methergine IM
- B. Remove the retained placental fragments
- C. Assist the client to the bathroom and provide cues to stimulate urination
- D. Massage the fundus until firm
Answer: D
Explanation:
Explanation
(A) Methergine is given following placental delivery to promote uterine contractions and prevent hemorrhage.
Methergine may be administered in this clinical situation, but fundal massage would be the first response. (B) Removal of retained placental fragments is done by the physician and is not the first response. (C) If the fundus rises and is deviated, particularly to theright, the nurse should suspect bladder distention secondary to bladder and urethral trauma associated with birth and decreased bladder tone following delivery. Therefore, women have a diminished sensation to void. (D) A boggy fundus rises and is indicative of blood pooling, predisposing the woman to clot formation. Massage the uterus until firm. Too vigorous massage will result in atonia. Clots may be expelled by a kneading motion of the uterus by the nurse.
NEW QUESTION # 90
Parents should be taught not to prop the bottle when feeding their infants. In addition to the risk of choking, it puts the infant at risk for:
- A. Otitis media
- B. Asthma
- C. Conjunctivitis
- D. Tonsillitis
Answer: A
Explanation:
(A)
Because the eustachian tube is short and straight in the infant, formula that pools in the back of the throat attacks bacteria which can enter the middle ear and cause an infection.
(B)
Asthma is not associated with propping the bottle. (C) Conjunctivitis is an eye infection and not associated with propping the bottle. (D) Tonsillitis is usually a result of pharyngitis and not propping the bottle.
NEW QUESTION # 91
The physician prescribes a medical regimen of isoniazid, rifampin, and vitamin B6 for a tuberculosis client. The nurse instructs the client that B6 is given because it:
- A. Improves nutritional status
- B. Increases activity of isoniazid
- C. Increases activity of rifampin
- D. Reduces peripheral neuropathy
Answer: D
Explanation:
(A) Vitamin B6does not enhance the activity of isoniazid. (B) Vitamin B6does not enhance the activity of rifampin. (C) A vitamin alone does not improve nutritional status. (D) Isoniazid leads to Vitamin B6deficiency, which is manifested as peripheral neuropathy.
NEW QUESTION # 92
An 82-year-old former restaurant owner walks to the nursing station and states, "I have to go. The restaurant opens at 11 am." Which response by the nurse is the most appropriate?
- A. "It is snowing outside. The restaurant is closed."
- B. "You once owned a restaurant. Tell me about it."
- C. "You are in the hospital now. Calm down."
- D. "Go back to your room. You do not own a restaurant."
Answer: B
Explanation:
Explanation
(A) This response cuts off communication with the client. It does not address her feelings. (B) Reality orientation frequently does not work alone. Feelings must be addressed. Telling a client to calm down is frequently ineffective. (C) Reminiscence is used here to reorient and recall past pleasant events. Talking about the restaurant will allay anxiety. (D) This response may confirm to the client that she indeed does still own a restaurant, buying into her confusion. Her feelings and anxiety require nursing intervention.
NEW QUESTION # 93
A male client is started on IV anticoagulant therapy with heparin. Which of the following laboratory studies will be ordered to monitor the therapeutic effects of heparin?
- A. Red blood cell (RBC) count
- B. Prothrombin time
- C. Hemoglobin
- D. Partial thromboplastin time
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Partial thromboplastin time is used to monitor the effects of heparin, and dosage is adjusted depending on test results. It is a screening test used to detect deficiencies in all plasma clotting factors except factors VII and XIII and platelets. (B) Hemoglobin is the main component of RBCs. Its main function is to carry O2from the lungs to the body tissues and to transport CO2back to the lungs. (C) RBC count is the determination of the number of RBCs found in each cubic millimeter of whole blood. (D) PT is used to monitor the effects of oral anticoagulants, e.g., coumarintype anticoagulants.
NEW QUESTION # 94
At her monthly prenatal visit, a client reports experiencing heartburn. Which nursing measure should be included in her plan of care to help alleviate it?
- A. Eat small, frequent bland meals.
- B. Use Alka-Seltzer as necessary.
- C. Lie down after eating.
- D. Restrict fluid intake.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) At least eight glasses of fluid per day are encouraged to help dilute stomach contents, thereby decreasing irritation. (B) Alka Seltzer contains aspirin, which is irritating to gastric mucosa, and therefore should be avoided. (C) Small, frequent bland meals help to decrease gastric pressure and to prevent reflux. (D) Lying down after meals may cause gastric reflux and prevents optimal gastric emptying.
NEW QUESTION # 95
A dose of theophylline may need to be altered if a client with COPD:
- A. Is allergic to morphine
- B. Is concurrently on cimetidine for ulcers
- C. Operates machinery
- D. Has a history of arthritis
Answer: B
Explanation:
Explanation
(A) The effects of morphine or an allergic response to the drug will not affect theophylline clearance. (B) Xanthines are used cautiously in clients with severe cardiac disease, liver disease, cor pulmonale, hypertension, or hyperthyroidism. Arthritis does not influence the dosage of theophylline. (C) Theophylline does not cause sedation or drowsiness. Conversely, its side effects may be exhibited by central nervous system stimulation. (D) Cimetidine decreases theophylline clearance from the system and increases theophylline levels in the blood, thus increasing the risk of toxicity.
NEW QUESTION # 96
The nurse recognizes that a client with the diagnosis of cholecystitis and cholelithiasis would expect to have stools that are:
- A. Watery and loose
- B. Clay or gray colored
- C. Black
- D. Bright-red streaked
Answer: B
Explanation:
Explanation
(A) Clients who have obstruction in the biliary tract so that bile is not released into the duodenum experience a change in stools from brown to gray or clay colored. (B) This type of stool can occur with other GI problems, such as bacterial or viral infections, and other disease problems, and is not a common finding with biliary obstructions such as cholecystitis and cholelithiasis. (C) This type of stool is usually associated with a GI or bowel problem, such as lower GI bleeding, rather than with biliary obstructions. (D) This type of stool is usually associated with a GI or bowel problem, such as upper GI bleeding, rather than with biliary obstructions.
NEW QUESTION # 97
Assessment of a client reveals a 30% loss of preillness weight, lanugo, and cessation of menses for 3 months.
Her vital signs are BP 90/50, P 96 bpm, respirations 30, and temperature 97 οF. She admits to the nurse that she has induced vomiting 3 times this morning, but she had to continue exercising to lose "just 5 more lb." Her symptoms are consistent with:
- A. Anorexia nervosa
- B. Bulimia
- C. Gastritis
- D. Pregnancy
Answer: A
Explanation:
Section: Questions Set F
Explanation:
(A) Presenting behaviors collectively are inconsistent with depression. (B) A preillness weight loss of 30%, lanugo, and cessation of menses are inconsistent with bulimia. (C) Symptoms and vital signs do not indicate the presence of infection. (D) All symptoms and vital signs are consistent with anorexia nervosa.
NEW QUESTION # 98
A client has been in labor 10 hours and is becoming very tired. She has dilated to 7 cm and is at 0 station with the fetus in a right occipitoposterior position. She is complaining of severe backache with each contraction.
One comfort measure the nurse can employ is to:
- A. Apply strong sacral pressure during the contraction
- B. Have her push with each contraction
- C. Place her in knee-chest position during the contraction
- D. Use effleurage during the contraction
Answer: A
Explanation:
Section: Questions Set F
Explanation:
(A) This measure is inappropriate. The knee-chest position is employed to take pressure off the cord. (B) Effleurage is a comfort measure but not the one that will contribute most to the relief of backache caused by a posterior position. (C) Sacral pressure will counteract the pressure created by the position of the fetal head. (D) The client is not completely dilated. Pushing is contraindicated until the second stage of labor.
NEW QUESTION # 99
A 23-year-old college student seeks medical attention at the college infirmary for complaints of severe fatigue. Her skin is pale, and she reports exertional dyspnea. She is admitted to the hospital with possible aplastic anemia. Laboratory values reflect anemia, and the client is prepared for a bone marrow biopsy. She refuses to sign the biopsy consent and states, "Can't you just get the doctor to give me a transfusion and let me go. This weekend begins spring break, and I have plans to go to Florida." At this time the nurse's greatest concern is that:
- A. The client does not grasp the full impact of her illness
- B. The client may require transfusion before leaving for spring break
- C. The causative agent be identified and treatment begun
- D. The client may contract an infection as a result of being exposed to large crowds at spring break
Answer: A
Explanation:
(A)
The client could contract an infection, but at this point it is not the most pertinent issue.
(B)
The client's statement indicates that she does not grasp the full impact of her illness. Further client education must be given, along with allowing her to express her feelings regarding her illness. (C) The client may require a transfusion, but this is a temporary measure because the causative agent has not been identified. Her feelings regarding her illness must be addressed in order for care to continue. (D) A bone marrow is done first to make a definitive diagnosis; then treatment may begin.
NEW QUESTION # 100
A client is admitted to the hospital with a diagnosis of aplastic anemia and placed on isolation. The nurse notices a family member entering the room without applying the appropriate apparel. The nurse will approach the family member using the following information as a basis for discussion:
- A. Adherence to the guidelines are the latest Centers for Disease Control and Prevention recommendations on use of protective apparel.
- B. Hospital regulations mandate that everyone in the facility adhere to appropriate codes.
- C. The risks of exposure of the visitor to infectious organisms is great.
- D. The client is at extreme risk of acquiring infections.
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Although clients with a compromised immune system may acquire infections, the primary emphasis is on protecting the client. (B, D) Most people are aware of the guidelines once they see posted signs, so quoting regulations is not likely to result in consistent adherence to regulations. (C) Clients with aplastic anemia have white cell counts of 2000 or lower, making them more vulnerable to infections from others.
NEW QUESTION # 101
A 3-year-old female client is brought into the pediatric clinic because she limps. She has not been to the clinic since she was 9 months old. The nurse practitioner describes the limp as a "Trendelenburg gait." This gait is characteristic of:
- A. Dislocated hip
- B. Fractured pelvis
- C. Fractured femur
- D. Scoliosis
Answer: A
Explanation:
(A, C, D) A Trendelenburg gait is not characteristic of any of these disorders. (B) The downward slant of one hip is a positive sign of dislocation in the weight-bearing hip. If one hip is dislocated, the child walks with a characteristic limp known as the Trendelenburg gait.
NEW QUESTION # 102
In a client with chest trauma, the nurse needs to evaluate mediastinal position. This can best be done by:
- A. Auscultating heart sounds
- B. Auscultating bilateral breath sounds
- C. Palpating for presence of crepitus
- D. Palpating for trachial deviation
Answer: D
Explanation:
Explanation
(A) No change in the breath sounds occurs as a direct result of the mediastinal shift. (B) Crepitus can occur owing to the primary disorder, not to the mediastinal shift. (C) Mediastinal shift occurs primarily with tension pneumothorax, but it can occur with very large hemothorax or pneumothorax. Mediastinal shift causes trachial deviation and deviation of the heart's point of maximum impulse. (D) No change in the heart sounds occurs as a result of the mediastinal shift.
NEW QUESTION # 103
The nurse is admitting a client with folic acid deficiency anemia. Which of the following questions is most important for the nurse to ask the client?
- A. "Have your stools been normal?"
- B. "Do you drink alcohol on a regular basis?"
- C. "Do you eat red meat?"
- D. "Do you take aspirin on a regular basis?"
Answer: B
Explanation:
Explanation
(A) Aspirin does not affect folic acid absorption. (B) Folic acid deficiency is strongly associated with alcohol abuse. (C) Because folic acid is a coenzyme for single carbon transfer purines, calves liver or other purines are the meat sources. (D) Folic acid does not affect stool character.
NEW QUESTION # 104
A postoperative TURP client is ordered continuous bladder irrigations. Later in the evening on the first postoperative day, he complains of increasing suprapubic pain. When assessing the client, the nurse notes diminished flow of bloody urine and several large blood clots in the drainage tubing. Which one of the following should be the initial nursing intervention?
- A. Irrigate the Foley catheter.
- B. Change the Foley catheter.
- C. Administer a prescribed narcotic analgesic.
- D. Call the physician about the problem.
Answer: A
Explanation:
(A) The physician should be notified as problems arise, but in this case, the nurse can attempt to irrigate the Foley catheter first and call the physician if irrigation is unsuccessful. Notifying the physician of problems is a subsequent nursing intervention. (B) This answer is correct. Assessing catheter patency and irrigating as prescribed are the initial priorities to maintain continuous bladder irrigation. Manual irrigation will dislodge blood clots that have blocked the catheter and prevent problems of bladder distention, pain, and possibly fresh bleeding. (C) The Foley catheter would not be changed as an initial nursing intervention, but irrigation of the catheter should be done as ordered to dislodge clots that interfere with patency. (D) Even though the client complains of increasing suprapubic pain, administration of a prescribed narcotic analgesic is not the initial priority. The effect of the medication may mask the symptoms of a distended bladder and lead to more serious complications.
NEW QUESTION # 105
Which of the following would indicate the need for further teaching for the client with COPD? The client verbalizes the need to:
- A. Eliminate intake of milk and milk products
- B. Eat small, frequent meals
- C. Eat high-calorie, high-protein foods
- D. Take vitamin supplementation
Answer: A
Explanation:
(A) Protein is vital for the maintenance of muscle to aid in breathing. A high-calorie diet using higher fat than carbohydrate content is given because clients are unable to breathe off the excess CO2that is an end product of carbohydrate metabolism. (B) Inadequate nutritional status, in particular, deficiencies in vitamins A and C, decreases resistance to infection. (C) Milk does not make mucus thicker. It may coat the back of the throat and make it feel thicker. Rinsing the mouth with water after drinking milk will prevent this problem. (D) Small, frequent meals minimize a fullness sensation and reduce pressure on the diaphragm. The work of breathing and SOB are also reduced.
NEW QUESTION # 106
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. Further testing is needed
- B. The test is inconclusive and should be repeated
- C. The test is normal and the fetus is reacting appropriately
- D. The fetus is distressed
Answer: C
Explanation:
Explanation/Reference:
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 # 107
Which of the following would have the physiological effect of decreasing intracranial pressure (ICP)?
- A. Increased core body temperature
- B. Decreased serum osmolality
- C. Administration of hypo-osmolar fluids
- D. Decreased PaCO2
Answer: D
Explanation:
Explanation
(A) An increase in core body temperature increases metabolism and results in an increase in ICP. (B) Decreased serum osmolality indicates a fluid overload and may result in an increase in ICP. (C) Hypo-osmolar fluids are generally voided in the neurologically compromised. Using IV fluids such as D5W results in the dextrose being metabolized, releasing free water that is absorbed by the brain cells, leading to cerebral edema.
(D) Hypercapnia and hypoventilation, which cause retention of CO2 and lead to respiratory acidosis, both increase ICP. CO2 is the most potent vasodilator known.
NEW QUESTION # 108
A 79-year-old client with Alzheimer's disease is exhibiting significant memory impairment, cognitive impairment, extremely impaired judgment in social situations, and agitation when placed in a new situation or around unfamiliar people. The nurse should include the following strategy in the client's care:
- A. Give the client two or three choices to decide what she wants to do.
- B. Encourage the client to attend all structured activities on the unit, whether she wants to or not.
- C. Maintain routines and usual structure and adhere to schedules.
- D. Ask the client to go to an activity once. If she gives no response right away, change the question around, asking the same thing.
Answer: C
Explanation:
Explanation
(A) Alzheimer's clients cope poorly with changes in routine because of memory deficits. Schedule changes cause confusion and frustration, whereas adhering to schedules is helpful and supports orientation. (B) Insisting that the client go to all unit activities may antagonize her and increase her agitation because of cognitive impairments. It may be better to allow the client time for calming down or distraction rather than to insist that she attend every activity. (C) When repeating a question, allow time first for a response; then use the same words the second time to avoid further confusion. (D) The nurse should avoid giving several choices at once. Cognitively impaired clients will become more frustrated with making decisions.
NEW QUESTION # 109
A client has received digoxin 0.25 mg po daily for 2 weeks. Which of the following digoxin levels indicates toxicity?
- A. 3.0 ng/mL
- B. 1.0 ng/mL
- C. 2.0 ng/mL
- D. 0.5 ng/mL
Answer: A
Explanation:
(A) 0.5 ng/mL of digoxin is a subtherapeutic level, not a toxic one. (B) 1.0 ng/mL is a therapeutic level. (C) 2.0 ng/mL is a therapeutic level. (D) Digoxin's therapeutic level is 0.8-2.0 ng/mL. Digoxin's toxic level is >2.0 ng/mL.
NEW QUESTION # 110
A primigravida is at term. The nurse can recognize the second stage of labor by the client's desire to:
- A. Push during contractions
- B. Walk between contractions
- C. Relax during contractions
- D. Hyperventilate during contractions
Answer: A
Explanation:
Explanation
(A) The second stage of labor is characterized by uterine contractions, which cause the client to bear down.
(B) Slow, deep, rhythmic breathing facilitates the laboring process. Hyperventilation is abnormal breathing resulting from loss of pain control. (C) The client should remain on bed rest during labor. (D) Contractions result in discomfort.
NEW QUESTION # 111
A pregnant client during labor is irritable and feels the urge to vomit. The nurse should recognize this as the:
- A. Fourth stage of labor
- B. Transition stage of labor
- C. Second stage of labor
- D. Third stage of labor
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) The fourth stage begins after expulsion of the placenta. Client symptoms are: fatigue; chills; scant, bloody vaginal discharge; and nausea. (B) The third stage is from birth to expulsion of placenta. Client symptoms are uterine contractions, gush of blood, and perineal pain. (C) The transition stage is characterized by strong uterine contractions and cervical dilation. Clientsymptoms are irritability, restlessness, belching, muscle tremors, nausea, and vomiting. (D) The second stage is characterized by full dilation of cervix. Client symptoms are perineal bulge, pushing with contractions, great irritability, and leg cramps.
NEW QUESTION # 112
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