[Jan-2025] The Best NCLEX Certification NCLEX-RN Professional Exam Questions
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NEW QUESTION # 454
Which of the following activities would be most appropriate during occupational therapy for a client with bipolar disorder?
- A. Working crossword puzzles
- B. Playing tennis with a staff member
- C. Playing cards with other clients
- D. Sewing beads on a leather belt
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) This activity is too competitive, and the manic client might become abusive toward the other clients. (B) During mania, the client's attention span is too short to accomplish this task. (C) This activity uses gross motor skills, eases tension, and expands excess energy. A staff member is better equipped to interact therapeutically with clients. (D) This activity requires the use of fine motor skills and is very tedious.
NEW QUESTION # 455
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. 132/78 to 124/76
- B. 136/88 to 144/93
- C. 140/90 to 148/98
- 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 # 456
A female client has been treated since childhood for mitral valve prolapse. The antibiotic of choice for her during pregnancy would be:
- A. Hydralazine
- B. Tetracycline
- C. Erythromycin
- D. Sulfa
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Sulfa is a teratogen and will cause kernicterus. (B) Tetracycline is a teratogen and will effect tooth development. (C) Hydralazine is not an antibiotic but a calcium channel blocker. (D) Erythromycin is safe during pregnancy and can be used when the client is allergic to penicillin.
NEW QUESTION # 457
Clients receiving antipsychotic drug therapy will often exhibit extrapyramidal side effects that are reversible with which of the following agents ordered by the physician?
- A. Anti-Parkinsonian drugs
- B. Anticholinergics
- C. Phenothiazines
- D. Tricyclic agents
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) This answer is incorrect. Phenothiazines are antipsychotic drugs and produce the symptoms. (B) This answer is correct. Anticholinergic agents are often used prophylactically for extrapyramidal symptoms.
They balance cholinergic activity in the basal ganglia of the brain. (C) This answer is incorrect. Anti- Parkinsonian drugs would increase the symptoms. (D) This answer is incorrect. Tricyclic agents are used for symptoms of depression.
NEW QUESTION # 458
A client has ascites, which is caused by:
- A. Decreased renal function
- B. Decreased plasma proteins
- C. Portal hypertension
- D. Electrolyte imbalance
Answer: B
Explanation:
(A) A decrease in plasma proteins causes a decrease in intravascular osmotic pressure resulting in leakage of fluid into peritoneal cavity. (B) Fluid and electrolyte imbalance may occur as a result of the ascites. (C) Ascites is a result of hepatic malfunction, not renal malfunction. (D) Portal hypertension causes esophageal varices, not ascites.
NEW QUESTION # 459
An 8-year-old boy has been diagnosed with hemophilia. Which of the following diagnostic blood studies is characteristically abnormal in this disorder?
- A. Platelet count
- B. Partial thromboplastin time
- C. Bleeding time
- D. Complete blood count
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Partial thromboplastic time measures activity of thromboplastin, which depends on the intrinsic clotting factors deficient in children who are hemophiliacs. (B) Platelet counts are normal in hemophilia. (C) Hemophilia does not affect the complete blood count. (D) Bleeding times are normal in hemophiliacs. They measure the time interval for the bleeding from small superficial wounds to cease.
NEW QUESTION # 460
When interviewing parents who are suspected of child abuse, the nurse would use which of the following interview techniques?
- A. After the interview, call child protective services.
- B. Approach them in the emergency room as soon as you suspect abuse to "clear the air" right away.
- C. Ask the parents what they could have done differently to prevent this from happening to the child.
- D. Be direct, honest, and attentive.
Answer: D
Explanation:
(A)
The nurse must be honest, direct, professional, and attentive in her interview to gain the parent's trust. (B) The nurse should approach the parents in private, away from the child.
(C)
Asking them to relive and evaluate the situation may be looked at as placing blame on the parents for the child's "accident." At this point, the parents may get defensive and stop communicating. (D) Although you may call child protective services, the nurse should inform the parents of their responsibility to do this and explain the process to them.
NEW QUESTION # 461
When teaching a sex education class, the nurse identifies the most common STDs in the United States as:
- A. Chlamydia
- B. Herpes genitalis
- C. Gonorrhea
- D. Syphilis
Answer: A
Explanation:
Section: Questions Set A
Explanation:
(A) Chlamydia trachomatis infection is the most common STD in the United States. The Centers for Disease Control and Prevention recommend screening of all high-risk women, such as adolescents and women with multiple sex partners. (B) Herpes simplex genitalia is estimated to be found in 5-20 million people in the United States and is rising in occurrence yearly. (C) Syphilis is a chronic infection caused by Treponema pallidum.
Over the last several years the number of people infected has begun to increase. (D) Gonorrhea is a bacterial infection caused by the organism Neisseria gonorrhoeae. Although gonorrhea is common, chlamydia is still the most common STD.
NEW QUESTION # 462
A 48-hour-old male infant is ordered to have phototherapy. When his mother questions the nurse about its purpose, the nurse explains that phototherapy:
- A. Prevents the development of ophthalmia neonatorum
- B. Assists the baby's clotting mechanism
- C. Increases levels of unconjugated bilirubin, thereby preventing kernicterus (brain damage)
- D. Breaks down bilirubin in the skin into substances that can be excreted in stool or urine
Answer: D
Explanation:
Explanation
(A) The instillation of erythromycin ophthalmic preparation, not phototherapy, prevents ophthalmia neonatorum. (B) The administration of vitamin K (AquaMEPHYTON) assists the infant's clotting mechanism.
(C) Excessive bilirubin accumulates when the infant's liver cannothandle the increased load caused by the breakdown of red blood cells postnatally. This excessive bilirubin seeps out of the blood and into the tissues, staining them yellow. Phototherapy accelerates the removal of bilirubin from the skin by breaking it down into substances that can be excreted in stool or urine. (D) Phototherapy decreases levels of unconjugated bilirubin, thereby preventing kernicterus.
NEW QUESTION # 463
A client on the infectious disease unit is discussing transmission of human immunodeficiency virus (HIV).
The nurse would need to provide more client education based on which client statement?
- A. "HIV can be transmitted to an unborn infant."
- B. "HIV is a virus transmitted by sexual contact."
- C. "Condoms reduce the transmission of HIV."
- D. "HIV is a virus that is easily transmitted by casual contact."
Answer: D
Explanation:
Explanation
(A) HIV is transmitted through unprotected sexual contact. (B) Condoms are an effective barrier to prevent HIV transmission. (C) HIV is not easily transmitted by casual contact. (D) HIV can be transmitted intrauterinely at the time of delivery, and by breast-feeding.
NEW QUESTION # 464
A 13-year-old hemophiliac is hospitalized for hemarthrosis of his right knee. To relieve the pain, the nurse should:
- A. Administer aspirin for pain
- B. Place on bed rest; elevate and splint the right knee
- C. Encourage active range of motion to right knee
- D. Apply moist heat to the right knee
Answer: B
Explanation:
Explanation
(A) Immobilization, splinting, and bed rest will reduce the bleeding. Once bleeding is reduced or stopped, the pain will subside. (B) Moist heat causes vasodilation and bleeding. Ice or cold compresses should be applied.
(C) Aspirin decreases platelet aggregation, which causes bleeding. (D) Active range of motion aggravates bleeding and damages the synovial sac during bleeding episodes.
NEW QUESTION # 465
A client was admitted to the hospital for a TURP. Within 48 hours of admission and 12 hours postoperatively, both the blood pressure and pulse increased. He became agitated, thought snakes were crawling on his arms and legs, and generally became unmanageable. He pulled out his IV and urinary catheter in attempt to rid himself of the snakes. He was sweating profusely. The admission nurse's notes indicated that the client admitted to "having a few drinks now and then." He is probably experiencing which of the following?
- A. Adjustment disorder with mixed features
- B. Generalized anxiety disorder
- C. Major psychotic depression
- D. Delirium tremens
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Symptoms of psychotic depression must exist for at least 2 weeks, and the symptoms must represent a change from previous functioning. (B) Delirium tremens occur approximately on the second or third day following cessation or reduction of alcohol intake. Symptoms would be all those described in the situation.
(C) Symptoms exhibited by this client are not exhibited in clients with anxiety disorders, who manifest excessive or unrealistic worry about life circumstances for at least 6 months. (D) Symptoms for adjustment disorders with mixed emotional features (e.g., depression and anxiety) are different from those exhibited by the client in this situation.
NEW QUESTION # 466
A client has been admitted to the labor and delivery unit in active labor. After assessing her, the RN notes that the client's fetus position is left occipital posterior. Which of the following statements best describes what this means to the labor process:
- A. Decreases the time of the client's first stage of labor
- B. Prolongs the client's third stage of labor
- C. Prolongs the client's first stage of labor
- D. Decreases the overall time of the labor process
Answer: C
Explanation:
Explanation
(A) Posterior position causes a larger diameter of the fetal head to enter the pelvis than an anterior position.
Pressure on the sacral nerves is increased, and it takes the fetus a longer time to enter the pelvic inlet. (B) This position will prolong the first stage of labor. When the larger diameter of the fetal head enters the pelvis first, it will have a more difficult time accommodating to the pelvis; therefore, it will take a longer time for the fetus to move through the pelvis. (C) It will increase the time of labor because the larger diameter of the fetal head will have a more difficult time accommodating to the pelvic inlet and thus will move through the pelvis slower. (D) In the third stage of labor the placenta is delivered; therefore, the infant has been delivered.
NEW QUESTION # 467
A 65-year-old client who has a new colostomy is preparing for discharge from the hospital. As part of the instructions on colostomy care, the nurse explains to the client that to regulate the bowel, colostomy irrigation should be performed at the same time each day. The best time is:
- A. Before meals
- B. At bedtime
- C. After meals
- D. Every 2 hours
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Bowel movements should be regulated at a specific time each day to prevent "accidents." Irrigating after meals takes advantage of the gastrocolic reflex and time of increased peristalsis, so better results may be produced. After meals is the normal time that peristalsis begins in most persons and evacuation of feces occurs. (B) Irrigating before meals may cause poor results because of decreased gastrocolic reflex and decreased peristalsis. (C) Irrigating a colostomy every 2 hours may produce hyperactivity of the bowel, leading to irritation and diarrhea. This would not aid in regulation of the bowel. (D) If irrigation of a colostomy were done at bedtime, there is greater chance of having an "accident" during sleep. This would not be an advantageous practice of bowel regulation.
NEW QUESTION # 468
Parents of children receiving chemotherapy should be warned that alopecia is a side effect and that:
- A. The parents will soon get used to seeing their children without hair, and it will no longer bother them
- B. Children seldom show concern about losing their hair
- C. It is best for girls to choose a wig similar to their hair style and color before the hair falls out
- D. The hair will come out gradually, and the loss will not be noticeable for some time
Answer: C
Explanation:
Section: Questions Set D
Explanation:
(A) Children may become depressed with a changed appearance and not want to look at themselves or have others see them. (B) The hair will fall out in clumps, causing patchy baldness that is quite noticeable and traumatic to children and their families. (C) Having a wig that looks like a girl's own hair can be a psychological boost to children and is helpful in fostering later adjustments to hair loss. (D) Families may become accustomed to seeing their children without hair, but the loss is traumatic to them and will continue to bother them.
NEW QUESTION # 469
A 52-year-old client who underwent an exploratory laparotomy for a bowel obstruction begins to complain of hunger on the third postoperative day. His nasogastric (NG) tube was removed this morning, and he has an IV of D5W with 0.45% normal saline running at 125 mL/hr. He asks when he can get rid of his IV and start eating. The nurse recognizes that he will be able to begin taking oral fluids and nourishment when:
- A. The nurse can detect bowel sounds in all four quadrants
- B. He is able to eat a full meal without evidence of nausea or vomiting
- C. It is determined that he has no signs of wound infection
- D. His blood pressure returns to its preoperative baseline level or greater
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) The absence of wound infection is related to his surgical wound and not to postoperative GI functioning and return of peristalsis. (B) Routine postoperative protocol involves detection of bowel sounds and return of peristalsis before introduction of clear liquids, followed by progression of full liquids and a regular diet versus a full regular meal first. (C) Routine postoperative protocol for bowel obstruction is to assess for the return of bowel sounds within 72 hours after major surgery, because that is when bowel sounds normally return. If unable to detect bowel sounds, the surgeon should be notified immediately and have the client remain NPO. (D) Routine postoperative protocol for bowel obstruction and other major surgeries involves frequent monitoring of vital signs in the immediate postoperative period (in recovery room) and then every
4 hours, or more frequently if the client is unstable, on the nursing unit. This includes assessing for signs of hypovolemic shock. Vital signs usually stabilize within the first 24 hours postoperatively.
NEW QUESTION # 470
A male client is admitted to the medical-surgical unit from the emergency room with a diagnosis of acute pancreatitis. The nurse performs the admission nursing assessment. He is NPO with IV fluids infusing at
100 mL/hour. He is experiencing excruciating abdominal pain. Based on an analysis of these data, which nursing diagnosis would receive the highest priority?
- A. Knowledge deficit related to treatment regimen
- B. Fluid volume deficit related to vomiting and nasogastric tube drainage
- C. Pain related to stimulation of nerve endings associated with obstruction of the pancreatic tract
- D. Altered nutrition: less than body requirements, related to inadequate intake associated with current anorexia, nausea, vomiting, and digestive enzyme loss
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Relief of pain is the primary goal of nursing intervention because this client is experiencing acute pain.
(B) Fluid volume deficit is being treated with IV fluid replacement. (C) Knowledge deficit will not be addressed at this time because a client in acute pain is not ready to learn. (D) Alteration in nutrition is the third priority after relief of pain and fluid volume deficit.
NEW QUESTION # 471
Prior to administering digoxin to a client with congestive heart failure, the nurse needs to assess:
- A. Apical pulse for 1 minute
- B. Radial pulse for 2 minutes
- C. Radial pulse for 1 minute
- D. Respiratory rate for 1 minute
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A) Respiratory rate is not directly affected by digoxin therapy. (B) A radial pulse is not as accurate as an apical pulse. Dysrhythmias may not be detected. (C) A radial pulse is not as accurate as an apical pulse, regardless of assessment time. (D) Apical pulse should be measured for 1-minute prior to digoxin administration. Digoxin decreases the heart rate. Digoxin should be withheld if apical rates are <60 bpm or >120 bpm.
NEW QUESTION # 472
In working with mental health clients who are prescribed medication that must be taken on a routine basis, it is important for education to begin when the drug therapy is initiated. One of the first steps in the teaching process is to:
- A. Explore the client's perception regarding medication therapy
- B. Discuss the danger of overmedication
- C. Distribute written material to supplement verbal instructions
- D. Explain the side effects of the medication
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A, B, C) The nurse must first obtain information regarding the client's perception of the medication regimen.
(D) The first step in the teaching process is to determine the client's perception.
NEW QUESTION # 473
The pediatrician has diagnosed tinea capitis in an 8- year-old girl and has placed her on oral griseofulvin. The nurse should emphasize which of these instructions to the mother and/or child?
- A. May discontinue medication when the child experiences symptomatic relief.
- B. Discontinue drug therapy if food tastes funny.
- C. Observe for headaches, dizziness, and anorexia.
- D. Administer oral griseofulvin on an empty stomach for best results.
Answer: C
Explanation:
Section: Questions Set E
Explanation:
(A) Giving the drug with or after meals may allay gastrointestinal discomfort. Giving the drug with a fatty meal (ice cream or milk) increases absorption rate. (B) Griseofulvin may alter taste sensations and thereby decrease the appetite. Monitoring of food intake is important, and inadequate nutrient intake should be reported to the physician. (C) The child may experience symptomatic relief after 48-96 hours of therapy. It is important to stress continuing the drug therapy to prevent relapse (usually about 6 weeks). (D) The incidence of side effects is low; however, headaches are common. Nausea, vomiting, diarrhea, and anorexia may occur. Dizziness, although uncommon, should be reported to the physician.
NEW QUESTION # 474
A gravida 2 para 1 client is hospitalized with severe preeclampsia. While she receives magnesium sulfate (MgSO4) therapy, the nurse knows it is safe to repeat the dosage if:
- A. Respirations are>16 breaths/min
- B. MgSO4serum levels are>15 mg/dL
- C. Urine output is 20 mL/hr
- D. Deep tendon reflexes are absent
Answer: A
Explanation:
Explanation
(A) MgSO4is a central nervous system depressant. Loss of reflexes is often the first sign of developing toxicity. (B) Urinary output at <25 mL/hr or 100 mL in 4 hours may result in the accumulation of toxic levels of magnesium. (C) The therapeutic serum range for MgSO4is 6-8 mg/dL. Higher levels indicate toxicity. (D) Respirations of>16 breaths/min indicate that toxic levels of magnesium have not been reached. Medication administration would be safe.
NEW QUESTION # 475
A 34-year-old client who is gravida 1, para 0 has a history of infertility and conceived this pregnancy while taking fertility drugs. She is at 32 weeks' gestation and is carrying triplets. She is complaining of low back pain and a feeling of pelvic pressure. Her cervical exam reveals a long, closed cervix. The nurse notes that the client is experiencing mild uterine contractions every 7-8 minutes after the nurse has placed her on the fetal monitor. Her condition should indicate that:
- A. She may be in preterm labor because this is more common with multiple pregnancies
- B. She most likely has a urinary tract infection (UTI) because this is common with pregnancy
- C. The nurse should not be alarmed because mild uterine activity is common at 32 weeks' gestation
- D. Her cervix shows she will likely deliver soon
Answer: A
Explanation:
Explanation
(A) Her cervical exam is normal. There are no cervical changes at this time. (B) Braxton Hicks contractions may be common throughout pregnancy, but they are not regular. (C) Rhythmical contractions in conjunction with low back pain and pelvic pressure at 32 weeks in a woman carrying triplets are of great concern. She may be in preterm labor. (D) UTIs are common in pregnancy due to the enlarging uterus compressing the ureters and the stasis of urine. The woman would be more likely to complain of urinary frequency and urgency, fever or chills, and malodorous urine with a UTI.
NEW QUESTION # 476
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