2024 Easy Success NCLEX NCLEX-RN Exam in First Try
Best NCLEX-RN Exam Dumps for the Preparation of Latest Exam Questions
NEW QUESTION # 267
Pregnant women with diabetes often have problems related to the effectiveness of insulin in controlling their glucose levels during their second half of pregnancy. The nurse teaches the client that this is due to:
- A. Decreased progesterone levels
- B. Decreased estrogen levels
- C. Decreased glomerular filtration and increased tubular absorption
- D. Increased human placental lactogen levels
Answer: D
Explanation:
(A) There is a rise in glomerular filtration rate in the kidneys in conjunction with decreased tubular glucose reabsorption, resulting in glycosuria. (B) Insulin is inhibited by increased levels of estrogen. (C) Insulin is inhibited by increased levels of progesterone. (D) Human placental lactogen levels increase later in pregnancy. This hormonal antagonist reduces
insulin's effectiveness, stimulates lipolysis, and increases the circulation of free fatty acids.
NEW QUESTION # 268
Assessment of a client reveals a 30% loss of preillness weight, lanugo, and cessation of menses for 3 months.
Her vital signs are BP 90/50, P 96 bpm, respirations 30, and temperature 97 F. She admits to the nurse that she has induced vomiting 3 times this morning, but she had to continue exercising to lose "just 5 more lb." Her symptoms are consistent with:
- A. Gastritis
- B. Pregnancy
- C. Anorexia nervosa
- D. Bulimia
Answer: C
Explanation:
Explanation
(A) Presenting behaviors collectively are inconsistent with depression. (B) A preillness weight loss of 30%, lanugo, and cessation of menses are inconsistent with bulimia. (C) Symptoms and vital signs do not indicate the presence of infection. (D) All symptoms and vital signs are consistent with anorexia nervosa.
NEW QUESTION # 269
On admission to the inpatient unit, a 34-year-old client is able to follow simple directions, but with great difficulty.
He is worried about how he can keep clean in such a public place and repeatedly dusts his bureau, straightens his bed, and adjusts the clothes in his closet. The client is experiencing a severe level of anxiety. Which response by the nurse would be most therapeutic in initially attempting to reduce his anxiety?
- A. "I've inspected this room and it is perfectly clean."
- B. "I can see how uncomfortable you are, but I would like you to walk with me so I can show you around the unit."
- C. "You will not be allowed to remain in your room if you continue to bother things."
- D. "Tell me why your room needs to be so clean."
Answer: B
Explanation:
(A) This statement is punitive. (B) Acknowledging the anxiety and channeling it into some positive activity is therapeutic. (C) The client cannot say "why"; this statement puts the client on the defensive. (D) A rational approach, especially a judgmental one, is nontherapeutic.
NEW QUESTION # 270
A mother called the physician's office to ask if it would help relieve her small daughter's abdominal pain if she gave an enema and placed a heating pad on the abdomen. Her daughter has a fever and has vomited twice.
The nurse's response is based on the knowledge that:
- A. Both heat and enemas stimulate intestinal motility and could increase the risk of perforation
- B. The symptoms could easily have been caused by constipation, which an enema would relieve
- C. Heat would help to relax the abdominal muscles and relieve her pain
- D. Complaints of stomach ache are common in young children and are generally best ignored
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A) Constipation does not cause fever or vomiting but may cause anorexia. Risk of perforation outweighs the possible benefits of an enema. (B) Heat will not relieve her symptoms but will increase intestinal motility and increase the risk of perforation. (C) Heat and enemas are contraindicated where severe abdominal pain is suspected because they increase intestinal motility and the risk of perforation. (D) Complaints accompanied by physical symptoms such as pain, anorexia, and fever should never be ignored.
NEW QUESTION # 271
Succinylcholine chloride (Anectine) is ordered prior to electroconvulsive therapy treatment for depressed clients. The nurse explains that the purpose of the drug is to:
- A. Act as an anesthetic
- B. Reduce secretions
- C. Relieve anxiety
- D. Relax muscles
Answer: D
Explanation:
(A) Succinylcholine chloride relaxes muscles and decreases the intensity of the seizure. (B) Succinylcholine chloride does not relieve anxiety. (C) Atropine is given to reduce secretions. (D) Thiamylal sodium (Surital) or other phenobarbital preparations are used as brief anesthetics.
NEW QUESTION # 272
A 43-year-old client is admitted to the hospital with a diagnosis of peripheral vascular disorder. She arrives in her room via stretcher and requires assistance to move to her bed. The nurse notes that her left leg is cold to touch.
She complains of having recently experienced muscle spasms in that leg. To determine if these muscle spasms are indicative of intermittent claudication, the nurse would begin her assessment with the following question:
- A. "Do you experience swelling at the end of the day in the affected and unaffected leg?"
- B. "Would you describe the intensity, duration, and symptoms associated with your pain?"
- C. "Have you had any lesions of the affected leg that have been difficult to heal?"
- D. "Do your muscle spasms occur following rest, walking, or exercising?"
Answer: D
Explanation:
Explanation
(A) Describing pain is an important aspect of the assessment; however, assessing activity preceding muscle spasms is equally important. (B) Edema may occur with peripheral vascular disease, but it is not of particular importance in assessing intermittent claudication. (C) Lesions may be present with peripheral vascular disease, but they are not an indication of intermittent claudication. (D) With intermittent claudication, muscle spasms occur intermittently, mainly with walking and after exercising. Rest may relieve muscle spasms.
NEW QUESTION # 273
Following a vaginal delivery, the postpartum nurse should observe for:
- A. Dystocia, kraurosis
- B. Hemorrhage and infection
- C. Fatigue, hemorrhoids
- D. Chadwick's sign
Answer: B
Explanation:
(A) Dystocia is difficult labor. The delivery has occurred. Kraurosis is atrophy and dryness of skin and any mucous membrane (vulva). (B) Chadwick's sign is a bluish color of vaginal mucosa suggestive of pregnancy. (C) Fatigue is a common symptom in the postpartal period. Hemorrhoids may occur with pregnancy. (D) Hemorrhage and infection are potential complications of vaginal delivery. Hemorrhage may result from retained placental fragments or soft uterus. Infection may occur from the introduction of organisms into the uterus during the delivery.
NEW QUESTION # 274
A 3-year-old female client is brought into the pediatric clinic because she limps. She has not been to the clinic since she was 9 months old. The nurse practitioner describes the limp as a "Trendelenburg gait." This gait is characteristic of:
- A. Fractured femur
- B. Fractured pelvis
- C. Dislocated hip
- D. Scoliosis
Answer: C
Explanation:
(A, C, D) A Trendelenburg gait is not characteristic of any of these disorders. (B) The downward slant of one hip is a positive sign of dislocation in the weight-bearing hip. If one hip is dislocated, the child walks with a characteristic limp known as the Trendelenburg gait.
NEW QUESTION # 275
A male client is experiencing extreme distress. He begins to pace up and down the corridor. What nursing intervention is appropriate when communicating with the pacing client?
- A. Help him to recognize his anxiety.
- B. Increase the level of his supervision.
- C. Walk with him as he paces.
- D. Ask him to sit down. Speak slowly and use short, simple sentences.
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) The nurse should not ask him to sit down. Pacing is the activity he has chosen to deal with his anxiety.
The nurse dealing with this client should speak slowly and with short, simplesentences. (B) The client may already recognize the anxiety and is attempting to deal with it. (C) Walk with the client as he paces. This gives support while he uses anxiety-generated energy. (D) Increasing the level of supervision may be appropriate after he stops pacing. It would minimize self-injury and/or loss of control.
NEW QUESTION # 276
A 52-year-old client's abdominal aortic aneurysm ruptured. She received rapid massive blood transfusions for bleeding. One potential complication of blood administration for which she is especially at risk is:
- A. Hypocalcemia
- B. Circulatory overload
- C. Air embolus
- D. Hypokalemia
Answer: A
Explanation:
Explanation
(A) Air embolism is a potential complication of blood administration, but it is fairly rare and can be prevented by using good IV technique. (B) Circulatory overload is a potential complication of blood administration, but because this client is actively bleeding, she is not at high risk for overload. (C) Hypocalcemia is a potential complication of blood administration that occurs in situations where massive transfusion has occurred over a short period of time. It occurs because the citrate in stored blood binds with the client's calcium. Another potential complication for which this client is especially at risk is hypothermia, which can be prevented by using a blood warmer to administer the blood. (D) Hypokalemia is not a complication of blood administration.
NEW QUESTION # 277
A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would expect which of the following to be present in relation to his blood sugar level?
- A. Fluctuating levels with a predawn increase
- B. An increased blood sugar level
- C. A decreased blood sugar level
- D. A normal blood sugar level
Answer: B
Explanation:
(A) Blood sugar levels increase when the body responds to stress and illness. (B) Blood sugar levels increase when the body responds to stress and illness. (C) Hyperglycemia occurs because glucose is produced as the body responds to the stress and illness of cellulitis. (D) Blood sugar levels remain elevated as long as the body responds to stress and illness.
NEW QUESTION # 278
Which of the following nursing orders has the highest priority for a child with epiglottitis?
- A. Intake and output
- B. Vital signs every shift
- C. Specific gravity every shift
- D. Tracheostomy set at bedside
Answer: D
Explanation:
(A) Because of the possibility of fever or respiratory failure, vital signs should be done more often than every eight hours. (B) If the epiglottitis worsens, the edema and laryngospasm may close the airway and an emergency tracheostomy may be necessary. (C) Although intake and output are a part of the nursing care of a child with epiglottitis, it is not as important as the safety measure of keeping the tracheostomy set at the bedside. (D) Specific gravity will indicate hydration status, but it is not as important as keeping the tracheostomy set at the bedside.
NEW QUESTION # 279
At 32 weeks' gestation, a client is scheduled for a fetal activity test (nonstress test). She calls the clinic and asks the RN, "How do I prepare for the test I am scheduled for?" The RN will most likely inform her of the following instructions to help prepare her for the test:
- A. "Do not eat any food or drink any liquids before the test is started."
- B. "You will need to drink 6 to 8 glasses of water to fill your bladder."
- C. "You will have to remain as still as you possibly can."
- D. "You need to know that an IV is always started before the test."
Answer: C
Explanation:
Explanation
(A) An IV line is not started in a nonstress test, because this test is used as an indicator of fetal well-being.
This test measures fetal activity and heart rate acceleration. (B) The bladder does not have to be full prior to this test. It is not a sonogram test where a full bladder enables other structures to be scanned. (C) It has been proved that eating or drinking liquids prior to the test can assist in increasing fetal activity. (D) Any maternal activity will interfere with the results of the test.
NEW QUESTION # 280
The physician orders fluoxetine (Prozac) for a depressed client. Which of the following should the nurse remember about fluoxetine?
- A. Foods such as aged cheese, yogurt, soy sauce, and bananas should not be eaten with this drug.
- B. The therapeutic effect of the drug occurs 2-4 weeks after treatment is begun.
- C. Fluoxetine may be administered safely in combination with monoamine oxidase (MAO) inhibitors.
- D. Because fluoxetine is a tricyclic antidepressant, it may precipitate a hypertensive crisis.
Answer: B
Explanation:
Explanation
(A) Fluoxetine is not a tricyclic antidepressant. It is an atypical antidepressant. (B) This statement is true. (C) These foods are high in tyramine and should be avoided when the client is taking MAO inhibitors. Fluoxetine is not an MAO inhibitor. (D) Fatal reactions have been reported in clients receiving fluoxetine in combination with MAO inhibitors.
NEW QUESTION # 281
Which of the following statements relevant to a suicidal client is correct?
- A. A client who threatens suicide is just seeking attention and is not likely to attempt suicide.
- B. The more specific a client's plan, the more likely he or she is to attempt suicide.
- C. Nurses who care for a client who has attempted suicide should not make any reference to the word "suicide" in order to protect the client's ego.
- D. A client who is unsuccessful at a first suicide attempt is not likely to make future attempts.
Answer: B
Explanation:
(A)
This is a high-risk factor for potential suicide. (B) A previous suicide attempt is a definite risk factor for subsequent attempts. (C) Every threat of suicide should be taken seriously.
(D)
The client should be asked directly about his or her intent to do bodily harm. The client is never hurt by direct, respectful questions.
NEW QUESTION # 282
A dose of theophylline may need to be altered if a client with COPD:
- A. Has a history of arthritis
- B. Is allergic to morphine
- C. Operates machinery
- D. Is concurrently on cimetidine for ulcers
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) The effects of morphine or an allergic response to the drug will not affect theophylline clearance. (B) Xanthines are used cautiously in clients with severe cardiac disease, liver disease, cor pulmonale, hypertension, or hyperthyroidism. Arthritis does not influence the dosage of theophylline. (C) Theophylline does not cause sedation or drowsiness. Conversely, its side effects may be exhibited by central nervous system stimulation. (D) Cimetidine decreases theophylline clearance from the system and increases theophylline levels in the blood, thus increasing the risk of toxicity.
NEW QUESTION # 283
In planning daily care for a client with multiple sclerosis, the nurse would take into consideration that multiple sclerosis:
- A. Responds quickly to antimicrobial therapy
- B. Becomes progressively debilitating without remission
- C. Has unpredictable remissions and exacerbations
- D. Is rapidly fatal
Answer: C
Explanation:
Section: Questions Set G
Explanation:
(A) Multiple sclerosis eventually becomes debilitating, but it is characterized by remission of symptoms. (B) Remissions and exacerbations are unpredictable with multiple sclerosis. The client experiences progressive dysfunction after each exacerbation episode. (C) Multiple sclerosis is usually slowly progressive. (D) Multiple sclerosis is an autoimmune disease. Antimicrobial therapy has no effect on its course.
NEW QUESTION # 284
A 3-year-old child has had symptoms of influenza including fever, productive cough, nausea, vomiting, and sore throat for the past several days. In caring for a young child with symptoms of influenza, the mother must be cautioned about:
- A. The possibility of pneumonia as a complication
- B. Allowing the child to come in contact with other children for 3 days
- C. Giving aspirin and bismuth subsalicylate (Pepto-Bismol) to treat the symptoms
- D. Giving clear liquids too soon
Answer: C
Explanation:
Explanation
(A) Aspirin should never be given to children with influenza because of the possibility of causing Reye's syndrome. Pepto- Bismol is also classified as a salicylate and should be avoided. (B) Depending on the severity of symptoms, the child may be receiving IV therapy or clear liquids. (C) The disease has a 1-3 day incubation period and affected children are most infectious 24 hours before and after the onset of symptoms.
(D) Although viral pneumonia can be a complication of influenza, this would not be an initial priority.
NEW QUESTION # 285
A 9-year-old child was in the garage with his father, who was repairing a lawnmower. Some gasoline ignited and caused an explosion. His father was killed, and the child has split-thickness and full-thickness burns over 40% of his upper body, face, neck, and arms. All of the following nursing diagnoses are included on his care plan. Which of these nursing diagnoses should have top priority during the first 24-48 hours postburn?
- A. Fluid volume deficit related to increased capillary permeability
- B. Potential for infection related to contamination of wounds
- C. Pain related to tissue damage from burns
- D. Potential for impaired gas exchange related to edema of respiratory tract
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A, B, C) These answers are all correct; however, maintenance of airway is the top priority. (D) Persons burned about the face and neck during an explosion are also likely to suffer burns of the respiratory tract, which can lead to edema and respiratory arrest.
NEW QUESTION # 286
When evaluating a client with symptoms of shock, it is important for the nurse to differentiate between neurogenic and hypovolemic shock. The symptoms of neurogenic shock differ from hypovolemic shock in that:
- A. In neurogenic shock, the skin is warm and dry
- B. In hypovolemic shock, capillary refill is less than 2 seconds
- C. In hypovolemic shock, there is a bradycardia
- D. In neurogenic shock, there is delayed capillary refill
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Neurogenic shock is caused by injury to the cervical region, which leads to loss of sympathetic control.
This loss leads to vasodilation of the vascular beds, bradycardia resulting from the lack of sympathetic balance to parasympathetic stimuli from the vagus nerve, and the loss of the ability to sweat below the level of injury. In neurogenic shock, the client is hypotensive but bradycardiac with warm, dry skin. (B) In hypovolemic shock, the client ishypotensive and tachycardiac with cool skin. (C) In hypovolemic shock, the capillary refill would be>5 seconds. (D) In neurogenic shock, there is no capillary delay, the vascular beds are dilated, and peripheral flow is good.
NEW QUESTION # 287
A female client has a chest tube placed. It is accidentally pulled out of the intrapleural space when she is ambulating. The first action the nurse should take is to:
- A. Put on sterile gloves and replace the tube
- B. Auscultate the lung to determine if she needs the tube replaced
- C. Instruct the client to cough deeply to re-expand her lung
- D. Apply a petrolatum dressing over the site
Answer: D
Explanation:
Explanation
(A) This action is inappropriate. Coughing will not re-expand the lung and could result in further harm. (B) This action is a medical procedure, not a nursing procedure. (C) An occlusive dressing will prevent further air leak until the physician institutes further treatment. (D) The decision to reinsert the tube is a medical decision, not a nursing one.
NEW QUESTION # 288
......
NCLEX-RN Study Material, Preparation Guide and PDF Download: https://evedumps.testkingpass.com/NCLEX-RN-testking-dumps.html