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The NCLEX-RN exam is conducted by the National Council of State Boards of Nursing (NCSBN). It is a computer-adaptive test, which means the questions' level of difficulty adapts to the individual's ability to answer them. The exam is designed to test the individual's level of competence, from simple to complex nursing tasks. The test is carried out at various testing centers across the country, and individuals must register for the exam and submit their credentials to the NCSBN.
The NCLEX-RN exam consists of a maximum of 265 questions, and candidates have up to six hours to complete it. The exam is computer-adaptive, which means that the difficulty of the questions will vary based on the candidate's performance. The exam covers a range of topics, including patient care, safety, pharmacology, health promotion, and disease prevention.
The NCLEX-RN (National Council Licensure Examination for Registered Nurses) Certification Exam is a standardized test that assesses the skills and knowledge of individuals who want to become registered nurses in the United States. The exam is designed to ensure that nurses have the necessary competencies to provide safe and effective patient care. Passing the NCLEX-RN is a requirement for licensure as an RN in all U.S. states and territories.
NEW QUESTION # 208
A 40-year-old client is admitted to the hospital for tests to diagnose cancer. Since his admission, he has become dependent and demanding to the nursing staff. The nurse identifies this behavior as which defense mechanism?
- A. Regression
- B. Projection
- C. Displacement
- D. Denial
Answer: A
Explanation:
Section: Questions Set C
Explanation:
(A) Denial is the disowning of consciously intolerable thoughts. (B) Displacement is the referring of a feeling or emotion from one person, object, or idea to another. (C) Regression is returning to an earlier stage of development. (D) Projection is attributing one's own thoughts, feelings, or impulses to another person.
NEW QUESTION # 209
A client sustained second- and third-degree burns to his face, neck, and upper chest. Which of the following nursing diagnoses would be given the highest priority in the first 8 hours' postburn?
- A. Alteration in sensation secondary to third-degree burn
- B. Alteration in comfort secondary to alteration in skin integrity
- C. Fluid volume deficit secondary to alteration in skin integrity
- D. Alteration in airway integrity secondary to edema of neck and face, which in turn is secondary to alteration in skin integrity
Answer: D
Explanation:
Explanation
(A) Fluid deficit is a high priority not only during the first 8 hours postburn, but also during the first 36 hours postburn. (B) Alteration in comfort is a high priority during the entire length of the client's hospitalization and on discharge. (C) Alteration in sensation is a high priority during the first 48-72 hours postburn. Lack of sensation may be indicative of lack of circulation. (D) Alteration in airway integrity is the highest priority for this client in the first 8 hours postburn. Failure to continually assess this client's airway status could result in poor ventilation and oxygenation, in addition to an inability to intubate the client secondary to excessive edema formation in the neck.
NEW QUESTION # 210
A young child has been placed in a spica cast. The chief concern of the nurse during the first few hours is:
- A. Prevention of loss of muscle tone
- B. Prevention of neurovascular complications
- C. Using heated fans to dry the cast
- D. Immobilization of the affected limb
Answer: B
Explanation:
Explanation
(A) Because the extremity may continue to swell and the cast could constrict circulation, the nurse should elevate the limb and observe for capillary refill, warmth, mobility of toes and circulation. (B) Although muscle tone may diminish over time in the affected limb, this is not the immediate concern. (C) The limb has been immobilized already by the cast, and therefore immobilization is not a concern. (D) Heated fans and dryers are discouraged because the outside cast will dry quickly, yet the area beneath the cast remains wet and could cause burns.
NEW QUESTION # 211
A schizophrenic client has made sexual overtures toward her physician on numerous occasions. During lunch, the client tells the nurse, "My doctor is in love with me and wants to marry me." This client is using which of the following defense mechanisms?
- A. Displacement
- B. Projection
- C. Suppression
- D. Reaction formation
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Displacement involves transferring feelings to a more acceptable object. (B) Projection involves attributing one's thoughts or feelings to another person. (C) Reaction formation involves transforming an unacceptable impulse into the opposite behavior. (D) Suppression involves the intentional exclusion of unpleasant thoughts or experiences.
NEW QUESTION # 212
A client who has gout is most likely to form which type of renal calculi?
- A. Struvite stones
- B. Calcium stones
- C. Uric acid stones
- D. Staghorn calculi
Answer: C
Explanation:
(A)
The presence of urinary tract infection is a factor in the formation of struvite stones. (B) Staghorn calculi is the other name for struvite stones associated with urinary tract infection.
(C)
Clients who have gout form uric acid stones. (D) Clients who have increased urinary excretion of calcium form calcium stones.
NEW QUESTION # 213
On morning rounds, the nurse found a manic-depressive client who is taking lithium in a confused mental state, vomiting, twitching, and exhibiting a coarse hand tremor. Which one of the following nursing actions is essential at this time?
- A. Withhold her lithium, and report her symptoms to the physician.
- B. Administer her next dosage of lithium, and then call the physician.
- C. Contact the lab and request a lithium level in 30 minutes, and call the physician.
- D. Place her on NPO to decrease the excretion of lithium from her body, and call the physician.
Answer: A
Explanation:
Explanation
(A) The client has lithium toxicity, and the nurse must withhold further dosages. (B) Because of her level of toxicity, further lithium could cause coma and death. The nurse needs further orders from the physician to stabilize the client's lithium level. (C) Ensuring adequate intake of sodium chloride will promote excretion of lithium and will assist in managing the client's lithiumtoxicity. (D) A lithium blood level must be drawn immediately to determine the seriousness of the toxicity and to provide the physician with data for medical orders.
NEW QUESTION # 214
A successful executive left her job and became a housewife after her marriage to a plastic surgeon. She started doing volunteer work for a charity organization. She developed pain in her legs that advanced to the point of paralysis. Her physicians can find no organic basis for the paralysis. The client's behavior can be described as:
- A. Housework phobia
- B. Agoraphobia
- C. Malingering
- D. Conversion reaction
Answer: D
Explanation:
Explanation
(A) A typical phobia does not result in physical symptoms (i.e., paralysis). (B) Malingering is pretending to be ill. This person has a true paralysis. (C) A conversion reaction is a physical expression of an emotional conflict. It has no organic basis. (D) Agoraphobia is fear of public places.
NEW QUESTION # 215
A baby who was diagnosed with pyloric stenosis has continued to have projectile vomiting. With prolonged vomiting, the infant is prone to:
- A. Respiratory alkalosis
- B. Metabolic alkalosis
- C. Metabolic acidosis
- D. Respiratory acidosis
Answer: B
Explanation:
Explanation
(A) Respiratory acidosis is the result of problematic ventilation. Plasma pH decreases, while plasma PCO2 and plasma HCO3 increase. (B) Respiratory alkalosis results from increased respiratory rate and depth. Plasma pH increases, while plasma PCO2 and plasma HCO3 decrease. (C) Metabolic acidosis occurs when there is strong acid gain in the body. Plasma pH, PCO2, and HCO3 decrease. (D) Increased risk for metabolic alkalosis is due to a loss of hydrogen ions; depletion of potassium, sodium, and chloride when vomiting occurs. Plasma pH and plasma PCO2 increase; plasma HCO3 may decrease and then increase to compensate.
NEW QUESTION # 216
A primipara is assessed on arrival to the postpartum unit. The nurse finds her uterus to be boggy. The nurse's first action should be to:
- A. Call the physician
- B. Massage her fundus
- C. Give the prescribed oxytocic drug
- D. Assess her vital signs
Answer: B
Explanation:
Section: Questions Set E
Explanation:
(A) The nurse should first implement independent and dependent measures to achieve uterine tone before calling the physician. (B) Assessment of vital signs will not help to restore uterine atony, which is the priority need. (C) Giving a prescribed oxytocic drug would be necessary ifthe uterus did not maintain tone with massage. (D) Fundal massage generally restores uterine tone within a few moments and should be attempted first.
NEW QUESTION # 217
A male infant is to be discharged home this morning. Which instruction related to his cord care should be included in his mother's discharge teaching plan?
- A. Keep the umbilical area covered at all times with the diaper.
- B. Clean the umbilical cord with alcohol at each diaper change.
- C. Keep the umbilical area moist with Vaseline until the stump falls off.
- D. Clean the umbilical cord daily with soap and water during the bath.
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) The umbilical area should be kept dry for healing to occur. Moisture is conducive to bacterial growth and therefore could lead to infection at the site. (B) The diaper should be folded below the cord to allow the cord stump to be exposed to the air for healing. (C) The umbilical cord should be swabbed with alcohol at each diaper change to remove urine and stool and to facilitate the desiccation process through drying. (D) Soap and water should not be used to clean the umbilical area because the area could retain moisture, thus making it susceptible to bacterial growth and infection.
NEW QUESTION # 218
Because a client is taking an MAO inhibitor, it is necessary to discuss the need for adherence to a low-tyramine diet. Which of the following are foods that she should avoid?
- A. Pickled, aged, smoked, and fermented foods
- B. Fresh vegetables
- C. Broiled fresh fish and fowl
- D. Fresh fruit such as apples and oranges
Answer: A
Explanation:
Explanation
(A) These foods may produce elevation in blood pressure when consumed during MAO inhibition therapy. (B) These foods have not been pickled, fermented, smoked, or aged. They contain very little, if any, tyramine or tryptophan. (C) As long as the meat has not been aged or smoked, it is within the dietary regimen. (D) Fresh fruits can be consumed as desired. However, the consumption of bananas is limited.
NEW QUESTION # 219
An 18-month-old child has been playing in the garage. His mother brings him to a nurse's home complaining of his mouth being sore. His lips and mouth are soapy and white, with small ulcerated areas beginning to form. The child begins to vomit. His pulse is rapid and weak. The nurse suspects that the child has:
- A. Ingested a caustic alkali
- B. Lead poisoning
- C. Inhaled gasoline fumes
- D. Eaten construction chalk
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A, C, D) These agents would not cause ulcerations on mouthand lips. (B) Strong alkali or acids will cause burns and ulcerationson the mucous membranes.
NEW QUESTION # 220
A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy of fluid resuscitation in the burned child?
- A. Serum potassium level
- B. Pulse rate
- C. Blood pressure
- D. Urine output
Answer: D
Explanation:
(A) Blood pressure can remain normotensive even in a state of hypovolemia. (B) Serum potassium is not reliable for determining adequacy of fluid resuscitation. (C) Urine output, alteration in sensorium, and capillary refill are the most reliable indicators for assessing adequacy of fluid resuscitation. (D) Pulse rate may vary for many reasons and is not a reliable indicator for assessing adequacy of fluid resuscitation.
NEW QUESTION # 221
The nurse teaches a male client ways to reduce the risks associated with furosemide therapy. Which of the following indicates that he understands this teaching?
- A. "I'll be sure not to take any more aspirin while I amon this drug."
- B. "I'll be sure to restrict my fluid intake to four or five glasses a day."
- C. "I'll be sure to rise slowly and sit for a few minutes after lying down."
- D. "I'll be sure to walk at least 2-3 blocks every day."
Answer: C
Explanation:
Explanation
(A) This response will help to prevent the occurrence of postural hypotension, a common side effect of this drug and a common reason for falls. (B) Although walking is an excellent exercise, it is not specific to the reduction of risks associated with diuretic therapy. (C) Clients on diuretic therapy are generally taught to ensure that their fluid intake is at least 2000-3000 mL daily, unless contraindicated. (D) Aspirin is a safe drug to take along with furosemide.
NEW QUESTION # 222
A 27-year-old healthy primigravida is brought to the labor and birthing room by her husband at 32 weeks' gestation. She experienced a sudden onset of painless vaginal bleeding. Following an ultrasound examination, the diagnosis of bleeding secondary to complete placenta previa is made. Expected assessment findings concerning the abdomen would include:
- A. Hypertonicity of the uterus
- B. A rigid, boardlike abdomen
- C. A soft relaxed abdomen
- D. Uterine atony
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) A rigid, board like abdomen is an assessment finding indicative of placenta abruptio. (B) A cause of postbirth hemorrhage is uterine atony. With placenta previa, uterine tone is within normal range. (C) The placenta is located directly over the cervical os in complete previa. Blood will escape through the os, resulting in the uterus and abdomen remaining soft and relaxed. (D) In placenta abruptio, hypertonicity of the uterus is caused by the entrapment of blood between the placenta and uterine wall, a retroplacental bleed. This does not exist in placenta previa.
NEW QUESTION # 223
A 50-year-old depressed client has recently lost his job. He has been reluctant to leave his hospital room.
Nursing care would include:
- A. Forcing the client to attend all unit activities
- B. Providing sensory stimulation
- C. Encouraging the client to discuss why he is so sad
- D. Monitoring elimination patterns
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) The client should be encouraged to attend the unit activities. The nurse and client should choose a few activities for the client to attend that will be positive experiences for him. (B) The nurse should encourage the client to discuss his feelings and to begin to deal with the depression. (C) Depressed persons often have little appetite and poor fluid intake. Constipation is common. (D) A calm, consistent level of stimuli is most effective. Sensory deprivation and overstimulation should be avoided.
NEW QUESTION # 224
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