[Nov 23, 2021] Valid NCLEX-RN Test Answers & NCLEX NCLEX-RN Exam PDF
Realistic NCLEX-RN Exam Dumps with Accurate & Updated Questions
NEW QUESTION 519
After a 10-year-old child with insulin-dependent diabetes mellitus receives her dinner tray, she tells the nurse that she hates broccoli and wants some corn on the cob. The nurse's appropriate response is:
- A. "No vegetable exchanges are allowed."
- B. "Yes, but only one-half ear is allowed."
- C. "Yes, you may exchange any vegetable for any other vegetable."
- D. "Corn and other starchy vegetables are considered to be bread exchanges."
Answer: D
Explanation:
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 injectionfacilitates 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 520
A client is diagnosed with diabetic ketoacidosis. The nurse should be prepared to administer which of the following IV solutions?
- A. 0.9 normal saline
- B. D5in lactated Ringer's
- C. D5W
- D. D5in normal saline
Answer: A
Explanation:
(A) D5in normal saline would increase serum glucose. (B) D5W would increase serum glucose. (C) A concentration of 0.9 NS is used to correct extracellular fluid depletion. (D) D5in Ringer's lactate would increase serum glucose.
NEW QUESTION 521
A 5-year-old child cries continually in her bed. Her parents have been unsuccessful in assisting her in expressing her feelings. Which activity should the nurse provide the child to assist her in expressing her feelings?
- A. Books with colorful pictures
- B. Music
- C. Puppets
- D. Riding toys
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) Books increase cognition, assist with fine motor skills, and augment language development. (B) Music provides auditory stimulation and large-muscle activity. (C) Riding toys provide large-muscle activity. (D) Puppets allow expression of feelings and fears that otherwise could not be directly communicated.
NEW QUESTION 522
A client had a hemicolectomy performed 2 days ago. Today, when the nurse assesses the incision, a small part of the abdominal viscera is seen protruding through the incision. This complication of wound healing is known as:
- A. Excoriation
- B. Evisceration
- C. Decortication
- D. Dehiscence
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Excoriation is abrasion of the epidermis or of the coating of any organ of the body by trauma, chemicals, burns, or other causes. (B) Dehiscence is a partial or complete separation of the wound edges with no protrusion of abdominal tissue. (C) Decortication is removal of the surface layer of an organ or structure. It is a type of surgery, such as removing the fibrinous peel from the visceral pleura in thoracic surgery. (D) Evisceration occurs when the incision separates and the contents of the cavity spill out.
NEW QUESTION 523
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. Encourage the client to attend all structured activities on the unit, whether she wants to or not.
- B. Give the client two or three choices to decide what she wants to do.
- 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:
(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 524
Due to his prolonged history of alcohol abuse, an alcoholic client will most likely have deficiencies of which of the following nutrients?
- A. Vitamin C and zinc
- B. Vitamin A and biotin
- C. Thiamine and pyroxidine
- D. Folic acid and niacin
Answer: C
Explanation:
Explanation
(A) Chronic alcoholism can lead to deficiencies of B complex vitamins including thiamine and pyroxidine. (B) Chronic alcoholism can lead to deficiencies of vitamins A, D, K, and B complex. (C) Chronic alcoholism can lead to deficiencies of vitamins A, D, K, and B complex. (D) Vitamins A, D, K, and B require bile salts to be absorbed from the gastrointestinal tract. A damaged liver does not form bile salts.
NEW QUESTION 525
When a client is receiving vasoactive therapy IV, such as dopamine (Intropin), and extravasation occurs, the nurse should be prepared to administer which of the following medications directly into the site?
- A. Sodium bicarbonate
- B. Phenylephrine (Neo-Synephrine)
- C. Phentolamine (Regitine)
- D. Epinephrine
Answer: C
Explanation:
Explanation
(A) Phentolamine is given to counteract the-adrenergic effects that cause ischemia and necrosis of local tissue.
(B) Epinephrine is an endogenous catecholamine that produces vasoconstriction and increases heart rate and contractility. (C) Phenylephrine causes constriction of arterioles of skin, mucous membranes, and viscera, which in turn can cause ischemia and necrosis. (D) Sodium bicarbonate is an alkalinizing agent that is incompatible with dopamine.
NEW QUESTION 526
A 45-year-old client diagnosed with major depression is scheduled for electroconvulsive therapy (ECT) in the morning. Which of the following medications are routinely administered either before or during ECT?
- A. Atropine, sodium brevitol, and succinylcholine chloride (Anectine)
- B. Thioridazine (Mellaril), lithium, and benztropine
- C. Carbamazepine (Tegretol), haloperidol, and trihexyphenidyl (Artane)
- D. Sodium, potassium, and magnesium
Answer: A
Explanation:
(A) Thioridazine (an antipsychotic drug), lithium (an antimanic drug), and benztropine (an antiparkinsonism agent) are generally administered to treat schizophrenic and bipolar disorders. (B) Atropine (a cholinergic blocker), sodium brevitol (a shortacting anesthetic), and succinylcholine (a neuromuscular blocker) are administered either before or during ECT to coun teract bradycardia and to provide anesthesia and total muscle relaxation. (C) These are electrolyte substances administered to correct fluid and electrolyte imbalances in the body. (D) Carbamazepine (an anticonvulsant), haldoperidol (an antipsychotic), and trihexyphenydyl (an antiparkinsonism agent) are usually administered in psychiatric settings to control problems associated with psychotic behavior.
NEW QUESTION 527
A 27-year-old male client is admitted to the acute care mental health unit for observation. He has recently lost his job, and his wife told him yesterday that she wants a divorce. The client is placed on suicide precautions. In assessing suicide potential, the nurse should pay close attention to the client's:
- A. Level of insight
- B. Mood and affect
- C. Abstracting abilities
- D. Thought processes
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Assessing the client's level of insight is an important part of the mental status exam (MSE), but it does not reflect suicide potential. (B) Assessing the client's thought processes is an important part of the MSE, but it does not reflect suicide potential. (C) Assessing the client's mood and affect is an important part of the MSE, and it can be a very valuable indicator of suicide potential. Frequently a client who has decided to proceed with suicide plans will exhibit a suddenly improved mood and affect. (D) Assessing a client's abstracting abilities is an important part of the MSE, but it does not reflect suicide potential.
NEW QUESTION 528
The physician of an alcoholic client places him on a low-protein, high-carbohydrate diet. When choosing his menu, the client's best choice from the items below would be:
- A. Baked chicken, baked potato with bacon bits, milk
- B. Cheese omelette with ham and mushrooms, milk
- C. Waffles with butter and honey, orange juice
- D. Liver and onions, macaroni and cheese, tea with sugar
Answer: C
Explanation:
Section: Questions Set F
Explanation:
(A, B, D) These foods are high in protein, which needs to be restricted. (C) Serum ammonia levels can be decreased by restricting dietary protein intake. Waffles, honey, and orange juice are high in carbohydrate and low or completely lacking in protein. Butter, a concentrated fat, will provide extra calories.
NEW QUESTION 529
A 2-day-old infant boy has been diagnosed with an atrial septal defect due to a persistent patent foramen ovale.
When explaining the diagnosis to the mother, the nurse includes in the discussion the function of the foramen ovale. In fetal circulation, the foramen ovale allows a portion of the blood to bypass the:
- A. Superior vena cava
- B. Liver
- C. Pulmonary system
- D. Left ventricle
Answer: C
Explanation:
(A)
The foramen ovale permits a percentage of the blood to shunt from the right atrium to the left atrium. The blood then goes to the left ventricle, permitting systemic fetal circulation with blood containing a higher O2 saturation. (B) As the blood shunts from the right atrium to the left atrium, the pulmonary system is bypassed. The fetus receives O2 from the maternal circulation, thereby permitting the partial bypass of the pulmonary system. (C) The foramen ovale is locatedin the atrial septum of the heart and does not affect the liver.
(D)
The superior vena cava returns blood to the heart, bringing blood to the location of the foramen ovale.
NEW QUESTION 530
A violent client remains in restraints for several hours. Which of the following interventions is most appropriate while he is in restraints?
- A. Give fluids if the client requests them.
- B. Measure vital signs at least every 4 hours.
- C. Release restraints every 2 hours for client to exercise.
- D. Assess skin integrity and circulation of extremities before applying restraints and as they are removed.
Answer: C
Explanation:
Explanation
(A) Fluids (nourishment) should be offered at regular intervals whether the client requests (or refuses) them or not. (B) Skin integrity and circulation of the extremities should be checked regularly while the client is restrained, not only before restraints are applied and after they are removed. (C) Vital signs should be checked at least every 2 hours. If the client remains agitated in restraints, vital signs should be monitored even more closely, perhaps every 1-2 hours. (D) Restraints should be released every 2 hours for exercise, one extremity at a time, to maintain muscle tone, skin and joint integrity, and circulation.
NEW QUESTION 531
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. Hospital regulations mandate that everyone in the facility adhere to appropriate codes.
- B. The client is at extreme risk of acquiring infections.
- C. The risks of exposure of the visitor to infectious organisms is great.
- D. Adherence to the guidelines are the latest Centers for Disease Control and Prevention recommendations on use of protective apparel.
Answer: B
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 532
A 35-year-old client is admitted to the hospital for elective tubal ligation. While the nurse is doing preoperative teaching, the client says, "The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?" The best explanation for the nurse to give the client would be that balanced anesthesia:
- A. Is a type of regional anesthesia
- B. Is a combination of several anesthetic agents or drugs producing a smooth induction and minimal complications
- C. Uses equal amounts of inhalation agents and liquid agents
- D. Does not depress the central nervous system
Answer: B
Explanation:
(A) Regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. (B) Varying amounts of anesthetic agents are used when employing balanced anesthesia. Amounts depend on age, weight, condition of the client, and surgical procedure. (C) General anesthesia is a drug-induced depression of the central nervous system that produces loss of consciousness and decreased muscle activity. (D) Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.
NEW QUESTION 533
The mother of a 7-year-old mental health center client reports that the client has refused to attend gymnastics for the past 2 weeks. Prior to that time, the child liked going to this class and was attending 3 times a week. In talking with the client, the nurse would:
- A. Ask her why she doesn't like gymnastics anymore
- B. Tell her that it is OK to be afraid of this activity
- C. Ask her to describe how things were at gymnastics before she started refusing to go
- D. Reassure her that things will get better once she begins the classes again
Answer: C
Explanation:
(A) The child has not said that she dislikes gymnastics. (B) The nurse will be able to obtain information on what events occurred at gymnastics prior to her refusal to attend. The nurse will also gain information about the child's perception of the problem. (C) The child has not said she is afraid to go to gymnastics. (D) False reassurance is inappropriate.
NEW QUESTION 534
After 7 hours in restraints and a total of 30-mg haloperidol in divided doses, a client complains of stiffness in his neck and his tongue "pulling to one side." These extrapyramidal symptoms (EPS) will most likely be relieved by the administration of:
- A. Flurazepan (Dalmane)
- B. Thiothixene (Navane)
- C. Lorazepam (Ativan)
- D. Benztropine (Cogentin)
Answer: D
Explanation:
(A) Lorazepam is an antianxiety agent that produces muscle relaxation and inhibits cortical and limbic arousal. It has no action in the basal ganglia of the brain. (B) Benztropine acts to reduce EPS by blocking excess CNS cholinergic activity associated with dopamine deficiency in the basal ganglia by displacing acetylcholine at the receptor site. (C) Thiothixene is an antipsychotic known to block dopamine in the limbic system, thereby causing EPS. (D) Flurazepan is a hypnotic that acts in the limbic system, thalamus, and hypothalamus of the CNS to produce sleep. It has no known action in the vasal ganglia.
NEW QUESTION 535
Following TURP, which of the following instructions would be appropriate to prevent or alleviate anxiety concerning the client's sexual functioning?
- A. "Check with your doctor about resuming sexual activity."
- B. "You may resume sexual intercourse in 2 weeks."
- C. "Many men experience impotence following TURP."
- D. "A transurethral resection does not usually cause impotence."
Answer: D
Explanation:
Section: Questions Set F
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 536
A client has received preoperative teaching for the vertical partial laryngectomy that he is scheduled to have in the morning. The nurse determines that the teaching has been effective when the client states:
- A. "The quality of my voice will be excellent after surgery."
- B. "I may also have to have a radical neck dissection done."
- C. "I will have very little difficulty swallowing after surgery."
- D. "I know I will need special swallowing training after my surgery."
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) A client with a supraglottic (horizontal partial) laryngectomy would require special swallowing training, not a vertical partial laryngectomy. (B) The quality of the client's voice will be altered but adequate for communication. (C) The client will have minimal difficulty swallowing. (D) A radical neck dissection may be done with a total laryngectomy, but not with a partial laryngectomy.
NEW QUESTION 537
Loss of appetite for a child with leukemia is a major recurrent problem. The plan of care should be designed to:
- A. Increase his appetite
- B. Help the child gain weight
- C. Make mealtimes pleasant
- D. Reinforce attempts to eat
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Ignoring refusals to eat and rewarding eating attempts are the most successful means of increasing intake. (B) This goal is not specific enough or related to the loss of appetite. (C) This goal is not possible at this time based on his illness. (D) This goal is helpful, but alone will not address his loss of appetite.
NEW QUESTION 538
A client is diagnosed with Mycobacterium tuberculosis. He is placed in respiratory isolation, intubated, and receives mechanical ventilation. When performing suctioning, the nurse should:
- A. Maintain clean technique during suctioning
- B. Hyperoxygenate before and after suctioning
- C. Suction for a maximum of 30 seconds
- D. Suction for a maximum of 20 seconds
Answer: B
Explanation:
Section: Questions Set D
Explanation:
(A) The maximum time for suctioning is 10-15 seconds. (B) Supplemental O2should be administered before and after suctioning to reduce hypoxia. (C) The maximum time for suctioning is 10-15 seconds. (D) Strict sterile technique should be used during suctioning.
NEW QUESTION 539
A client's congestive heart failure has been treated, and he will soon be discharged. Discharge teaching should include instruction to call the physician if he notices a 2-lb weight gain in a 24-hour period.
Increased weight gain may indicate:
- A. Development of diabetes insipidus
- B. Decreasing renal function
- C. Decreasing cardiac output
- D. A diet too high in calories and saturated fat
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Increased calories may result in weight gain, but there is no indication in this question that this man's diet has changed in a way that would result in increased calories. (B) Decreasing cardiac output stimulates the renin-angiotensin-aldosterone cycle and results in fluid retention, which is reflected by weight gain. (C) Decreasing renal function may result in fluid retention, but this question gives no indication that this man has any renal problems. (D) Profound diuresis occurs with diabetes insipidus, which results in weight loss.
NEW QUESTION 540
A 16-year-old diabetic girl has been selected as a cheerleader at her school. She asks the nurse whether she should increase her insulin when she is planning to attend cheerleading practice sessions lasting from 8 to 11 AM. The most appropriate answer would be:
- A. "You should ask your doctor about this."
- B. "No, do not increase your insulin, but eating a snack prior to practice exercise will make insulin more effective and move more glucose into the cells."
- C. "Yes, increase your insulin by 1 U for each hour of practice because exercise causes the body to need more insulin."
- D. "No, do not increase your insulin. Exercise will not affect your insulin needs."
Answer: B
Explanation:
(A) A nurse can give this information to a client. (B) Exercise makes insulin more efficient in moving more glucose into the cells. No more insulin is needed. (C) Exercise makes insulin more efficient unless the diabetes is poorly controlled. (D) Exercise makes insulin more efficient in moving more glucose into the cells.
NEW QUESTION 541
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