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NCLEX-RN Exam Practice Materials Collection
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NCLEX-RN Exam Study guide
There is a brief overview for the NCLEX-RN Exam
The NCLEX-RN® exam is the licensure examination administered by the National League for Nursing (NLN) for the purpose of determining the competency of nursing personnel. The test is based on the national core curriculum standards for nursing and requires a knowledge and application of basic nursing principles. The exam consists of three parts: Part 1: Multiple choice questions, Part 2: Essay, and Part 3: Clinical skills. The multiple-choice questions cover the four major categories: assessing, planning, implementing, and evaluating care; nursing diagnoses and evaluation; health promotion, maintenance, and illness prevention; and health assessment, planning, implementation, and evaluation. You'll need to know the difference between a nursing diagnosis and problem list, and why it's important to identify problems and interventions. NCLEX-RN Dumps are the preferred study tools for any nurse looking to pass the test.
NEW QUESTION # 268
A male client is undergoing cardiac tests. He has been instructed to wear a Holter monitor. The nurse knows she has included the appropriate information in her teaching when the client tells her:
- A. "He should remove the electrodes for bathing."
- B. "He is to keep a record of everything he does during the day."
- C. "Damage to his heart muscle will be recorded by the monitor."
- D. "He is to refrain from activities that cause chest pain."
Answer: B
Explanation:
(A) The client should leave the electrodes in place during the entire time the test is ordered. He should not even remove the electrodes for bathing. (B) The Holter monitor will record cardiac electrical activity but will not record damage to his myocardium. (C) The client should keep a record of all of his activities so the physician can correlate the ECG findings with his activities. (D) The client should continue doing his regular activities. The purpose of the Holter monitor is to record heart activity during routine activities.
NEW QUESTION # 269
A child is admitted with severe headache, fever, vomiting, photophobia, drowsiness, and stiff neck associated with viral meningitis. She will be more comfortable if the nurse:
- A. Dims the lights in her room
- B. Encourages her to breathe slowly and deeply
- C. Places a large, soft pillow under her head
- D. Offers sips of warm liquids
Answer: A
Explanation:
Section: Questions Set G
Explanation:
(A) The discomfort of photophobia is alleviated by dimming the lights. (B) Helping the child to breathe slowly and deeply may help to reduce anxiety, but it will not alleviate other discomforts of viral meningitis. (C) It is important to maintain fluid balance, but sips of warm liquids do not alleviate the discomforts of meningitis. (D) A large, soft pillow under her head causing neck flexion is likely to increase her discomfort owing to stretching of the meninges.
NEW QUESTION # 270
A measurable outcome criterion in the nursing care of an adolescent with anorexia nervosa would be:
- A. Verbalizing realistic feelings about her body
- B. Exhibiting increased self-esteem
- C. Having an improved perception of her body image
- D. Accepting her present body image
Answer: A
Explanation:
(A) This outcome criterion is inadequate because the term "accepts" is not directly measurable. (B) This outcome criterion is directly measurable because specific goal-related verbalizations can be heard and verified by the nurse. (C) "Improved perception of body image" is not directly measurable and is therefore open to many interpretations. (D) Although long-term goals for the anorexic client should focus on increased self-esteem, this outcome criterion (as stated) does not include specific indicators or behaviors for which to observe.
NEW QUESTION # 271
A 10-year-old has been diagnosed with acute poststreptococcal glomerulonephritis. The clinical findings were proteinuria, moderately elevated blood pressure, and periorbital edema. Which dietary plan is most appropriate for this client?
- A. Low-protein diet
- B. Increased fluid intake
- C. High-cholesterol diet
- D. Low-sodium diet
Answer: D
Explanation:
(A) A high-protein diet is usually indicated because protein is excreted in urine. Protein restriction is usually prescribed with severe azotemia. (B) The kidneys usually enlarge in these children, and sodium and water are retained. (C) Fluid restriction may be ordered to help reduce edema; however, monitoring for dehydration is indicated. (D) A high-cholesterol diet would not be indicated for any child, especially one with elevated blood pressure.
NEW QUESTION # 272
A diagnosis of hepatitis C is confirmed by a male client's physician. The nurse should be knowledgeable of the differences between hepatitis A, B, and C.
Which of the following are characteristics of hepatitis C?
- A. The potential for chronic liver disease is minimal.
- B. The incubation period is 2-26 weeks.
- C. The onset of symptoms is abrupt.
- D. There is an effective vaccine for hepatitis B, but not for hepatitis C.
Answer: B
Explanation:
Explanation
(A) Hepatitis C and B may result in chronic liver disease. Hepatitis A has a low potential for chronic liver disease. (B) Hepatitis C and B have insidious onsets. Hepatitis A has an abrupt onset. (C) Incubation periods are as follows: hepatitis C is 2-26 weeks, hepatitis B is 6-20 weeks, and hepatitis A is 2-6 weeks. (D) Only hepatitis B has an effective vaccine.
NEW QUESTION # 273
A client had abdominal surgery this morning. The nurse notices that there is a small amount of bloody drainage on his surgical dressing. The nurse would document this as what type of drainage?
- A. Sanguinous
- B. Serosanguinous
- C. Catarrhal
- D. Purulent
Answer: A
Explanation:
(A)
Drainage from a surgical incision usually proceeds from sanguinous to serosanguinous.
(B)
Purulent drainage usually indicates infection and should not be seen initially from a surgical incision. (C) Drainage from a surgical incision is initially sanguinous, proceeding to serosanguinous, and then to serous. (D) Catarrhal is a type of exudate seen in upper respiratory infections, not in surgical incisions.
NEW QUESTION # 274
In performing the initial nursing assessment on a client at the prenatal clinic, the nurse will know that which of the following alterations is abnormal during pregnancy?
- A. Dysuria
- B. Chloasma
- C. Striae gravidarum
- D. Colostrum
Answer: A
Explanation:
Section: Questions Set B
Explanation:
(A) Striae gravidarum are the normal stretch marks that frequently occur on the breasts, abdomen, and thighs as pregnancy progresses. (B) Chloasma is the "mask of pregnancy" that normally occurs in many pregnant women. (C) Dysuria is an abnormal danger sign during pregnancy and may indicate a urinary tract infection.
(D) Colostrum is a yellow breast secretion that is normally present during the last trimester of pregnancy.
NEW QUESTION # 275
A 4-year-old child is being discharged from the hospital after being treated for severe croup. Which one of the following instructions should the nurse give to the child's mother for the home treatment of croup?
- A. Give him a dose of antihistamine.
- B. Take him in the bathroom, turn on the hot water, and close the door.
- C. Place him near a cool mist vaporizer and encourage crying.
- D. Give large amounts of clear liquids if drooling occurs.
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Initial home treatment of croup includes placing the child in an environment of high humidity to liquefy and mobilize secretions. (B) Antihistamines should be avoided because they can cause thickening of secretions. (C) Drooling is a characteristic sign of airway obstruction and the child should be taken directly to the emergency room. (D) Crying increases respiratory distress and hypoxia in the child with croup. The nurse should promote methods that will calm the child.
NEW QUESTION # 276
A laboring client presents with a prolapsed cord. The nurse should immediately place the client in what position?
- A. Trendelenburg
- B. Reverse Trendelenburg
- C. Fowler's
- D. Sims'
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Reverse Trendelenburg position increases pressure on the perineum. This position will not relieve cord pressure. (B) Fowler's position increases perineal pressure. Cord pressure would not be relieved. (C) Trendelenburg position will decrease perineal pressure. Cord compression will be decreased and increase in fetal blood flow occurs. (D) Sims' position does not relieve pressure on cord or perineum.
NEW QUESTION # 277
A male client received a heart-lung transplant 1 month ago at a local transplant center. While visiting the nursing center to have his blood pressure taken, he complains of recent weakness and fatigue. He also tells the nurse that he is considering stopping his cyclosporine because it is expensive and is causing his face to become round. He fears he will catch viruses and be more susceptible to infections. The nurse responds to this last statement by explaining that cyclosporine:
- A. Is available at discount pharmacies for a reduced price
- B. May initially cause weakness, dizziness, and fatigue, but these side effects will gradually resolve themselves
- C. Is usually not necessary after the first year following transplantation
- D. Is given to prevent rejection and makes him less susceptible to infection than other oral corticosteroids
Answer: D
Explanation:
(A) Cyclosporine is the immunosuppressive drug of choice. It provides immunosuppression but does not lower the white blood cell count; therefore, the client is less susceptible to infection. (B) Cyclosporine is available at discount pharmacies. The cost may be absorbed by health insurance, or Medicare, if the client is eligible. However, this statement does not address the entire problem verbalized by the client. (C) Immunosuppressive agents will be taken for the client's entire life because rejection can occur at any time. (D) These side effects do not necessarily resolve in time; however, the client may adapt.
NEW QUESTION # 278
A 24-year-old graduate student recognizes that he has a phobia. He suffers severe anxiety when he is in darkness. It has altered his lifestyle because he is unable to go to a movie theater, concert, and other events that may require absence of light. The client is seeking assistance because he is no longer able to socialize with friends due to his phobia. The psychologist working with him is using desensitization. He has asked the nursing staff to assist the client in muscle relaxation techniques. What result would indicate client education has been successful?
- A. He enters a movie theater, sits in his chair, and replaces anxiety with relaxation as the theater darkens.
- B. He takes a part-time job as a photographic assistant. His job necessitates his working in a darkroom.
- C. He enters a concert, but as the lights dim, he does not experience anxiety.
- D. He states that he no longer fears dark places.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) This situation provides specific evidence that the client is able to integrate muscle relaxation technique into his lifestyle to alleviate anxiety. (B) The client may not experience anxiety at the concert, but there is no evidence regarding the technique that he used to alleviate anxiety. (C) The client may state he no longer experiences anxiety, but there is no evidence demonstrating this. He may be denying anxiety to discontinue therapy prematurely. (D) Does he experience anxiety in the darkroom? He may have taken this job to force himself to deal with the phobia directly.
NEW QUESTION # 279
A 27-year-old primigravida stated that she got up from the chair to fix dinner and bright red blood was running down her legs. She denies any pain previously or currently. The client is very concerned about whether her baby will be all right. Her vital signs include P 120 bpm, respirations 26 breaths/min, BP
104/58 mm Hg, temperature 98.2_F, and fetal heart rate 146 bpm. Laboratory findings revealed hemoglobin 9.0 g/dL, hematocrit 26%, and coagulation studies within normal range. On admission, the peripad she wore was noted to be half saturated with bright red blood. A medical diagnosis of placenta previa is made. The priority nursing diagnosis for this client would be:
- A. Alteration in parenting related to potential fetal injury
- B. Potential for fluid volume excess related to fluid resuscitation
- C. Anxiety related to threat to self
- D. Decreased cardiac output related to excessive bleeding
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Based on the client's history, presence of bright red vaginal bleeding, and hemoglobin value on admission, the priority nursing diagnosis would be decreased cardiac output related to excessive bleeding.
(B) This nursing diagnosis is a potential problem that does not exist at the present time, and therefore is not the priority problem. (C) The client's expressed anxiety is for her child. The fetus will remain physiologically safe if the decreased cardiac output is resolved. (D) Initial spontaneous bleeding with placenta previa is rarely life threatening to the mother or the fetus. Delivery of the fetus will be postponed until fetal maturity is achieved and survival is likely.
NEW QUESTION # 280
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 to describe how things were at gymnastics before she started refusing to go
- B. Tell her that it is OK to be afraid of this activity
- C. Ask her why she doesn't like gymnastics anymore
- D. Reassure her that things will get better once she begins the classes again
Answer: A
Explanation:
Section: Questions Set D
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 # 281
The mother of a client is apprehensive about taking home her 2 year old who was diagnosed with asthma after being admitted to the emergency room with difficulty breathing and cyanosis. She asks the nurse what symptoms she should look for so that this problem will not happen again. The nurse instructs her to watch for the following early symptoms:
- A. Fatigue, dark circles under the eyes, changes in breathing pattern, glassy eyes, and moodiness
- B. Fever, runny nose, and hyperactivity
- C. Changes in breathing pattern, moodiness, fatigue, and edema of eyes
- D. Fever, cough, paleness, and wheezing
Answer: A
Explanation:
(A) The child with asthma may not have fever unless there is an underlying infection. (B) Edema of the eyes will not be present because the child with asthma is more likely to have dehydration related to excessive water loss during the work of breathing. (C) All of these symptoms indicate decreased oxygenation and are early symptoms of asthma. (D) Coughing and wheezing are not early signs of difficulty.
NEW QUESTION # 282
A 44-year-old client had an emergency cholecystectomy 3 days ago for a ruptured gallbladder. She complains of severe abdominal pain. Assessment reveals abdominal rigidity and distention, increased temperature, and tachycardia. Diagnostic testing reveals an elevated WBC count. The nurse suspects that the client has developed:
- A. Peritonitis
- B. Pulmonary embolism
- C. Evisceration
- D. Gastritis
Answer: A
Explanation:
Explanation
(A) Assessment findings for gastritis would reveal anorexia, nausea and vomiting, epigastric fullness and tenderness, and discomfort. (B) Evisceration is the extrusion of abdominal viscera as a result of trauma or sutures failing in a surgical incision. (C) Peritonitis, inflammation of the peritoneum, can occur when an abdominal organ, such as the gallbladder, perforates and leaks blood and fluid into the abdominal cavity. This causes infection and irritation. (D) Assessment findings of pulmonary embolism would reveal severe substernal chest pain, tachycardia, tachypnea, shortness of breath, anxiety or panic, and wheezing and coughing often accompanied by blood-tinged sputum.
NEW QUESTION # 283
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. Suction for a maximum of 20 seconds
- C. Suction for a maximum of 30 seconds
- D. Hyperoxygenate before and after suctioning
Answer: D
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 # 284
Two weeks after a client's admission for depression, the physician orders a consult for electroconvulsive therapy (ECT). Which of the following conditions, if present, would be a contraindication for ECT?
- A. History of mitral valve prolapse
- B. Surgically repaired herniated lumbar disk
- C. Brain tumor or other space-occupying lesion
- D. History of frequent urinary tract infections
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) A contraindication for ECT is a space-occupying lesion such as a brain tumor. During ECT, intracranial pressure increases. Therefore, ECT would not be prescribed for a client whose intracranial pressure is already elevated. (B) Any cardiac dysrhythmias or complications that arise during ECT are usually attributed to the IV anesthetics used, not to preexisting cardiac structural conditions. (C) Musculoskeletal injuries during ECT are extremely rare because of the IV use of centrally acting muscle relaxers. (D) A history of any kind of infection would not contraindicate the use of ECT. In fact, concurrent treatment of infections with ECT is not uncommon.
NEW QUESTION # 285
A 26-year-old client has no children. She has had an abdominal hysterectomy. In the first 24 hours postoperatively, the nurse would be concerned if the client:
- A. Cries easily and says she is having abdominal pain
- B. Develops a temperature of 102_F
- C. Has a urine output of 200 mL for 4 hours
- D. Has no bowel sounds
Answer: B
Explanation:
Explanation
(A) The client may be more tearful than normal due to the stress of the surgery and its implications for her future life. She would be expected to have pain following surgery. (B) A temperature of 102_F indicates an infectious process. This is not a normal sequence to surgery and indicates a need for further assessment. (C) The client is expected to have no bowel soundsfor 24-48 hours after surgery because of the trauma to the bowel. (D) Normal urine output is 30 mL/hr. This represents an output of 50 mL/hr, which is greater than normal.
NEW QUESTION # 286
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. 140/90 to 148/98
- B. 136/88 to 144/93
- C. 132/78 to 124/76
- D. 114/70 to 140/88
Answer: D
Explanation:
Explanation/Reference:
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 # 287
A 56-year-old psychiatric inpatient has had recurring episodes of depression and chronic low self-esteem. She feels that her family does not want her around, experiences a sense of helplessness, and has a negative view of herself. To assist the client in focusing on her strengths and positive traits, a strategy used by the nurse would be to:
- A. Increase the client's self-esteem by asking that she make all decisions regarding attendance in group activities
- B. Tell the client to attend all structured activities on the unit
- C. Not allow any dependent behaviors by the client because she must learn independence and will have to ask for any assistance from staff
- D. Encourage or direct client to attend activities that offer simple methods to attain success
Answer: D
Explanation:
(A) The nurse should encourage activities gradually, as client's energy level and tolerance for shared activities improve. (B) Activities that focus on strengths and accomplishments, with uncomplicated tasks, minimize failure and increase self-worth. (C) Asking a client to set a goal to make all decisions about attending group activities is unrealistic, and such decisions are not always under the client's control; this sets up the client for further failure and possibly decreased self-worth. (D) Encouragement toward independence does promote increased feelings of selfworth; however, clients may need assistance with decision making and problem solving for various situations and on an individual basis.
NEW QUESTION # 288
A 42-year-old male client has been treated at an alcoholic rehabilitation center for physiological alcohol dependence. The nurse will be able to determine that he is preparing for discharge and is effectively coping with his problem when he shares with her the following information:
- A. "It really wasn't my fault that I had to come here. If my wife hadn't left, I wouldn't have needed those drinks."
- B. "I really wasn't addicted to alcohol when I came here, I just needed some help dealing with my divorce."
- C. "I know that I will not ever be able to socially drink alcohol again and will need the support of the AA group."
- D. "I know that I can only drink one or two drinks at social gatherings in the future, but at least I don't have to continue AA."
Answer: C
Explanation:
(A) The client has insight into the severity of his alcohol addiction and has chosen one of the most effective treatment strategies to support him-Alcoholics Anonymous. (B) The client is still using denial and is not dealing with his alcohol addiction. (C) The client is exhibiting denial about his alcohol addiction and projecting blame on his divorce. (D) The client is projecting blame onto his wife for being in the hospital while still denying his alcohol addiction.
NEW QUESTION # 289
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The National Council Licensure Examination (NCLEX-RN) is a standardized test that assesses the competency of registered nurses (RNs) in the United States of America. NCLEX-RN exam is developed and administered by the National Council of State Boards of Nursing (NCSBN). It is designed to evaluate the knowledge, skills, and abilities of entry-level RNs to ensure they are competent and safe to practice nursing.
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