NCLEX Questions

Because we could all use the practice, yeah? New day, new question.

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The nurse is developing a teaching plan for a client who must undergo an above-the-knee amputation of the left leg. After a leg amputation, exercise of the remaining limb:

a) isn't necessary.

b) should begin immediately postoperatively.

c) should begin the day after surgery.

d) begins at a rehabilitation center.

Exercise should begin the day after surgery. Exercise is necessary to maintain the muscle tone of the remaining limb. Immediately after surgery, the client usually isn't alert enough to participate and may be in too much pain. Exercise needs to begin before discharge to a rehabilitation center.

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A client has been receiving an I.V. solution. What is an appropriate expected outcome for this client?

a) "Monitor fluid intake and output every 4 hours."

b) "The client remains free of signs and symptoms of phlebitis."

c) "Edema and warmth are noted at I.V. insertion site."

d)  "There is a risk for infection related to I.V. insertion."

"The client remains free of signs and symptoms of phlebitis" is an appropriate expected outcome for this client. Monitoring fluid intake and output is a nursing intervention. Edema and warmth are objective assessment findings. Option d is a nursing diagnosis.

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The nurse formulates a nursing diagnosis of impaired social interaction related to disorganized thinking for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention takes highest priority?

a) Helping the client to participate in social interactions

b) Establishing a one-on-one relationship with the client

c) Exploring the effects of the client's behavior on social interactions 

d) Developing a schedule for the client's participation in social interactions

By establishing a one-on-one relationship, the nurse helps the client learn how to interact with people in new situations. The other options are appropriate but should take place only after the nurse-client relationship is established.

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The nurse is providing care for a client who has a sacral pressure ulcer with a wet-to-dry dressing. Which guideline is appropriate for a wet-to-dry dressing?

a) The wound should remain moist from the dressing.

b) The wet-to-dry dressing should be tightly packed into the wound.

c) The dressing should be allowed to dry out before removal.

d) A plastic sheet-type dressing should cover the wet dressing.

A wet-to-dry saline dressing should always keep the wound moist. Tight or dry packing can cause tissue damage and pain. A dry gauze dressing — not a plastic sheet-type dressing — should cover the wet dressing.

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Touching other people without their permission, reading someone else's mail, and using personal possessions without asking permission are all examples of:

a) antisocial behavior.

b) manipulation.

c) poor boundaries.

d) passive-aggressive behavior.

The described behaviors indicate poor personal boundaries, which is the inability to differentiate between self and others. Poor boundaries are symptoms of antisocial and passive-aggressive behavior. Manipulation is an attempt to control another person. 

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The physician is treating a client in the cardiac care unit for atrial arrhythmia and prescribes propranolol (Inderal), 10 mg P.O. three times a day. Propranolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?

a) Uterus

b) Blood vessels

c) Bronchi

d) Heart

Beta1-receptor sites are mainly located in the heart. Beta2-receptor sites are located in the uterus, blood vessels, and bronchi.

[even-more-nclex-questions]

The neonate of a client with type 1 diabetes mellitus is at high risk for hypoglycemia. An initial sign the nurse should recognize as indicating hypoglycemia in a neonate is:

a) peripheral acrocyanosis

b) bradycardia.

c) lethargy.

d) jaundice.

Lethargy in the neonate may be seen with hypoglycemia because of a lack of glucose in the nerve cells. Peripheral acrocyanosis is normal in the neonate because of immature capillary function. Tachycardia — not bradycardia — is seen with hypoglycemia. Jaundice isn't a sign of hypoglycemia.

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A client with chronic obstructive pulmonary disease (COPD) is being evaluated for a lung transplant. The nurse performs the initial physical assessment. Which signs and symptoms should the nurse expect to find?

SELECT ALL THAT APPLY

a) Decreased respiratory rate

b) Dyspnea on exertion

c) Barrel chest

d) Shortened expiratory phase

e) Clubbed fingers and toes

f) Fever

Typical findings in clients with COPD include dyspnea on exertion, a barrel chest, and clubbed fingers and toes. Clients with COPD are usually tachypneic with a prolonged expiratory phase. Fever isn't associated with COPD unless an infection is also present.

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Y'all. I finished nursing school. It is indeed possible. 

In case you were wondering how it feels, this is me a few weeks ago, doing senior pictures, kicking butt in ICU, gettin' that Summa Cum Laude, etc:

And this is me now:

I may even leave my house later, but only because I'm craving fudge.

There are no more ATIs to study for, no more nursing policy papers to write, no teaching plans to turn in, and no more introducing myself as "your student nurse today." Just pinning, graduation, and The Big Test in the Sky (as one professor calls NCLEX).

It's a beautiful day. 

[even-more-nclex-questions]

A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. Which of the following would be the nurse's best response?

a) "Pregnancy is a human process; you don't have to worry."

b) "You practice good health habits; just follow them and you'll be fine."

c) "There is nothing you can do to have a healthy pregnancy; it's all up to nature."

d) "Folic acid, 400 mcg, improves pregnancy outcomes by preventing certain complications."

When counseling a client who's planning to become pregnant, the nurse should discuss the role of folic acid in preventing neural tube defects. The nurse should provide information but not prescribe the drug. It's the client's responsibility to ask the health care provider about a prescription. Telling the client not to worry ignores the client's needs. Telling the client that it's up to nature is inaccurate. Practicing good health habits is important for any person.

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A client receives morphine, 4 mg I.V., for relief of surgical pain. Thirty minutes later, the nurse asks the client whether the pain is relieved. Which step of the nursing process is the nurse using?

a) Assessment

b) Analysis

c) Implementation

d) Evaluation

Although the nurse is assessing pain relief, this action is considered part of evaluation, not assessment, because the nurse performed an intervention and is evaluating whether the goal has been met. During the nursing analysis (or diagnosis) step of the nursing process, the nurse labels or describes the client's health problems or needs such as pain. During implementation, the nurse performs interventions to meet the client's needs such as administering medication.

[last day of my clinical preceptorship today... last time I introduced myself to a patient as a student nurse... aaaaaaaaaaaaahhh how did this happen?!?!]

[even-more-nclex-questions]

The registered nurse is instructing a new nursing graduate about hemodialysis. Which statement, if made by the new nursing graduate, would indicate an understanding of the procedure for hemodialysis? 

SELECT ALL THAT APPLY

a) "Sterile dialysate must be used."

b) "Dialysate contains metabolic waste products."

c) "Heparin sodium is administered during dialysis."

d) "Dialysis cleanses the blood of accumulated waste products."

e) "Warming the dialysate increases the efficiency of diffusion."

Heparin sodium is used during dialysis, and it inhibits the tendency of blood to clot when it comes in contact with foreign substances. Option 4 is the purpose of dialysis. The dialysate is warmed to approximately 100° F to increase the efficiency of diffusion and to prevent a decrease in the client's blood temperature. Dialysate is made from clear water and chemicals and is free from any metabolic waste products or medications. Bacteria and other microorganisms are too large to pass through the membrane; therefore the dialysate does not need to be sterile.

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What type of immunity is lost when a client develops human immunodeficiency virus (HIV)?

a) Active immunity

b) Passive immunity

c) Humoral immunity

d) Cellular immunity

Cellular immunity, which occurs through the T-cell system, is lost with HIV. Active immunity occurs in response to an infection or vaccines. Passive immunity occurs through an injection of immune serum, or, for an infant, from breastfeeding. Antibodies produced by B cells mediate humoral immunity. 

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A home health nurse has just changed a soiled dressing from an infected wound of a client's. After placing the soiled dressing in a paper bag provided by the client, how should the nurse dispose of it?

a) Place the paper bag inside a plastic bag for disposal.

b) Throw the paper bag into a garbage can.

c) Take the bag home and dispose of it.

d) Ask the client to dispose of the bag.

Placing the paper bag inside a plastic bag for disposal is sufficient for protection. The other answers are inappropriate.

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Quick hiatus for the holiday break, brb - love ya, MWAH! 

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A 3-year-old Vietnamese child with a fever, decreased urine output, wheezing, and coughing is brought to the emergency department. On examination, the nurse discovers red, round, weltlike lesions on the child's upper back and chest. The nurse would interpret these lesions to be caused by which of the following?

a) Shingles

b) Child abuse

c) Allergic reaction

d) Cultural practice

Many Vietnamese perform coining, a cultural practice in which a coin is repeatedly rubbed lengthwise on the oiled skin to rid the body of a disease. Coining can produce weltlike lesions on the child's back or chest, and children subjected to the practice are often thought to have been abused. Interviewing the family and assessing its cultural background help distinguish between abuse and culture practice. Shingles, a form of herpes zoster, is a communicable disease usually affecting immunocompromised individuals and older adults. The disease produces small crusty pustules on the lower back and trunk. The description of the lesions doesn't fit those produced by an allergic reaction. 

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Which of the following drugs may be abused because of tolerance and physiologic dependence.

a) lithium (Lithobid) and divalproex (Depakote).

b) verapamil (Calan) and chlorpromazine (Thorazine)

c) alprazolam (Xanax) and phenobarbital (Luminal)

d) clozapine (Clozaril) and amitriptyline (Elavil)

Both benzodiazepines such as alprazolam and barbiturates such as phenobarbital are addictive, controlled substances. All the other drugs listed aren't addictive substances.