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NCLEX-RN (National Council Licensure Examination) is a certification exam that is required for individuals who wish to become licensed registered nurses (RNs). NCLEX-RN exam is designed to test the knowledge, skills, and abilities that are necessary to perform the duties of an entry-level RN. The NCLEX-RN exam is administered by the National Council of State Boards of Nursing (NCSBN) and is taken by nursing graduates who have completed an accredited nursing program.
Find out about the path of the NCLEX-RN exam.
The following is the certification path for the NCLEX-RN exam. This is also known as the passing pathway. There are several different certification levels in the NCLEX-RN exam.
These include:
- Master's of Science in Nursing (MSN)
- Registered Nurse (RN)
- Licensed Practical Nurse (LPN)
NEW QUESTION # 338
The following medications were noted on review of the client's home medication profile. Which of the medications would most likely potentiate or elevate serum digoxin levels?
- A. KCl
- B. Quinidine
- C. Theophylline
- D. Thyroid agents
Answer: B
Explanation:
Explanation
(A) Hypokalemia can cause digoxin toxicity. Administration of KCl would prevent this. (B) Thyroid agents decrease digoxin levels. (C) Quinidine increases digoxin levels dramatically. (D) Theophylline is not noted to have an effect on digoxin levels.
NEW QUESTION # 339
Cystic fibrosis is transmitted as an autosomal recessive trait. This means that:
- A. Mothers carry the gene and pass it to their sons
- B. Both parents must have the disease for a child to have the disease
- C. Fathers carry the gene and pass it to their daughters
- D. Both parents must be carriers for a child to have the disease
Answer: D
Explanation:
(A) Cystic fibrosis is not an X-linked or sex-linked disease. (B) The only characteristic on the Y chromosome is the trait for hairy ears. (C) Both parents do not need to have the disease but must be carriers. (D) If a trait is recessive, two genes (one from each parent) are necessary to produce an affected child.
NEW QUESTION # 340
A 6-year-old girl has been diagnosed with a urinary tract infection secondary to vesicoureteral reflux. Which statement by her mother indicates a need for further teaching?
- A. "She enjoys wearing nylon panties, but I make her change them everyday."
- B. "She tries to empty her bladder completely after she urinates, like I told her."
- C. "I have taught her to wipe from front to back after urinating."
- D. "I make sure she drinks plenty of fluids every day."
Answer: A
Explanation:
(A) Wiping from front to back is wiping from an area of lesser contamination (urethra) to an area of greater contamination (rectum). (B) Generous fluid intake reduces the concentration of urine. (C) Cotton is a natural, absorbent fabric. Nylon often predisposes the client to urinary tract infections. Dark, warm, moist areas are excellent media for bacterial growth. (D) With vesicoureteral reflux, urine refluxes into the ureter(s) during voiding and then returns to the bladder (residual), which becomes a source for future infection.
NEW QUESTION # 341
As a postoperative cholecystectomy client completes tomorrow's dinner menu, the nurse knows that one of the following meal choices will best provide the essential vitamin(s) necessary for proper tissue healing?
- A. Chicken breast fillet in tomato sauce, potatoes, mustard greens, orange and strawberry slices
- B. Fish fillet, carrots, mashed potatoes, butterscotch pudding
- C. Roast chicken, gelatin with sliced fruit
- D. Liver, white rice, spinach, tossed salad, custard pudding
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) This meal choice provides more of the vitamins A, D, and K than of vitamin C (B) This meal choice provides more of the vitamins A, B12, and D than of vitamin C (C) This meal choice provides more of the vitamins A, B1 (thiamine), niacin, and microminerals than of vitamin C. (D) This meal choice provides foods rich in vitamin C, which are essential in tissue healing.
NEW QUESTION # 342
A client is a victim of domestic violence. She is now receiving assistance at a shelter for battered women.
She tells the nurse about the cycle of violence that she has been experiencing in her relationship with her husband of 5 years. In the "tension-building phase," the nurse might expect the client to describe which of the following?
- A. Promises of gifts that her husband made to her
- B. A period of tenderness between the couple
- C. Minor battering incidents, such as the throwing of food or dishes at her
- D. Acute battering of the client, characterized by his volatile discharge of tension
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) This description is characteristic of the "honeymoon" or "respite" phase. (B) This description is characteristic of the "battering" phase. (C) This description is characteristic of the "tension- building" phase prior to the volatile discharge of tension found in the battering phase. (D) This description is characteristic of the "honeymoon" or "respite" phase.
NEW QUESTION # 343
The physician orders medication for a client's unpleasant side effects from the haloperidol. The most appropriate drug at this time is:
- A. Benztropine
- B. Triazolam (Halcion)
- C. Lorazepam
- D. Thiothixene
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Lorazepam is a benzodiazepine, or antianxiety agent, that potentiates the effects of _-aminobutyric acid in the CNS, which is not the CNS neurotransmitter EPS. (B) Triazolam is a benzodiazepine sedative- hypnotic whose action is mediated in the limbic, thalamic, and hypothalamic levels of the CNS by ў- aminobutyric acid. (C) Benztropine is an anticholinergic agent, and the drug of choice for blocking CNS synaptic response, which causes EPS. (D) Thiothixene is an antipsychotic and neuroleptic drug that blocks dopamine neurotransmission at the CNS synapses, thereby causing EPS.
NEW QUESTION # 344
An 80-year-old male client with a history of arteriosclerosis is experiencing severe pain in his left leg that started approximately 20 minutes ago. When performing the admission assessment, the nurse would expect to observe which of the following:
- A. Decreased or absent pedal pulse in the left leg
- B. The left leg warmer to touch than the right leg
- C. Both lower extremities warm to touch with 2_pedal pulses
- D. Both lower extremities cyanotic when placed in a dependent position
Answer: A
Explanation:
Section: Questions Set G
Explanation:
(A) This statement describes a normal assessment finding of the lower extremities. (B) This assessment finding reflects problems caused by venous insufficiency. (C) Decreased or absentpedal pulses reflect a problem caused by arterial insufficiency. (D) The leg that is experiencing arterial insufficiency would be cool to touch due to the decreased circulation.
NEW QUESTION # 345
A postpartum client complains of rectal pressure and severe pain in her perineum; this may be indicative of:
- A. Constipation
- B. A hematoma of the vagina or vulva
- C. Afterbirth pains
- D. Cystitis
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Afterbirth pains are a common complaint in the postpartum client, but they are located in the uterus. (B) Constipation may cause rectal pressure but is not usually associated with "severe pain." (C) Cystitis may cause pain, but the location is different. (D) Hematomas are frequently associated with severe pain and pressure. Further assessments are indicated for this client.
NEW QUESTION # 346
A newborn girl's father expresses concern that the newborn does not have good control of her hands and arms. It is important for the father to realize certain neurological patterns that characterize the newborn:
- A. Function progresses in a head-to-toe, proximal-distal fashion.
- B. Asymmetrical movement of the extremities is not unusual and will disappear with maturation of the central nervous system.
- C. Purposeless, uncoordinated movements of the arms are indicative of neurological dysfunction.
- D. Mild hypotonia is expected in the upper extremities.
Answer: A
Explanation:
(A) Term neonates are predominantly in a flexed position with strong active muscle tone that increases. Newborns are slightly hypertonic. (B) Neonatal movements may be jerky and uncoordinated as the neonate works against gravity in contrast to the buoyancy of the amniotic fluid. Jerky movements must be differentiated from the tremors of hypoglycemia, hypocalcemia, and neurological dysfunction. (C) Growth of the newborn progresses in a cephalocaudal, proximal-distal fashion. Knowledge regarding infant development may facilitate parental involvement and infant stimulation. (D) Asymmetrical movements of the extremities are indicative of neurological dysfunction.
NEW QUESTION # 347
A female client has experienced varying degrees of depression throughout her life. Now that she is postmenopausal, her depression has increased. She is unable to motivate herself to clean her house or even to get out of bed and get dressed in the morning. The client was begun on fluoxetine (Prozac) therapy. When educating her about fluoxetine, what might the nurse caution her about?
- A. Fluoxetine is not sedating; therefore, restrictions on driving and other hazardous activities are not necessary.
- B. Rashes or pruritus usually occur early in the therapy and are treatable without discontinuing the medication.
- C. It is safe to take over-the-counter or other prescription medications with fluoxetine.
- D. A daily dose of fluoxetine may be taken in the morning or evening.
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) A daily dose of fluoxetine should be taken in the morning. Afternoon doses may cause nervousness and insomnia. (B) Although fluoxetine is less sedating than other antidepressants, it may still cause dizziness or drowsiness in some clients. The nurse should caution clients to avoid driving or hazardous activities until the central nervous system effects of the drug are demonstrated. (C) Rashes or pruritus do commonly occur early in therapy and respond to antihistamines or topical corticosteroids. (D) Advise the client not to take over-the-counter or other prescription drugs without consulting with the physician.
Fluoxetine does interact with other common drugs such as monoamine oxidase inhibitors, diazepam, insulin, oral antidiabetic agents, tricyclic antidepressants, and tryptophan.
NEW QUESTION # 348
A 4 days postpartum client who is gravida 3, para 3, isexamined by the home health nurse during her first postpartum home visit. The nurse notes that she has a pink vaginal discharge with a serosanguineous consistency. The nurse would most accurately chart the client's lochia as:
- A. Serosa
- B. Rosa
- C. Rubra
- D. Alba
Answer: A
Explanation:
Section: Questions Set E
Explanation:
(A) Lochia rubra is bloody with clots and occurs 1-3 days postpartum. (B) There is no such term as lochia rosa.
(C) Lochia serosa is a pink-brown discharge with a serosanguineous consistency that occurs 4-9 days postpartum. (D) Lochia alba is yellow to white in color and occurs approximately 10 days postpartum.
NEW QUESTION # 349
A postoperative TURP client returns from the recovery room to the general surgery unit and is in stable condition. One hour later the nurse assesses him and finds him to be confused and disoriented. She recognizes that this is most likely caused by:
- A. Hypovolemic shock
- B. Hypernatremia
- C. Hypokalemia
- D. Hyponatremia
Answer: D
Explanation:
Explanation
(A) Early signs of hypovolemic shock include hypotension, tachycardia, tachypnea, pallor, and diaphoresis.
(B) Early signs of potassium depletion include muscular weakness or paralysis, tetany, postural hypotension, weak pulse, shallow respirations, apathy, weak voice, and electrocardiographic changes. (C) Early signs of an elevated sodium level include dry oral mucous membranes, marked thirst, hypertension, tachycardia, oliguria or anuria, anxiety, and agitation. (D) This answer is correct. Important early clinical findings of a decreased sodium concentration include confusion and disorientation. Hyponatremia can occur after a TURP because absorption during surgery through the prostate veins can increase circulating blood volume and decrease sodium concentration.
NEW QUESTION # 350
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 οF. 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. Bulimia
- B. Pregnancy
- C. Anorexia nervosa
- D. Gastritis
Answer: C
Explanation:
Explanation/Reference:
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 # 351
What is the most effective method to identify early breast cancer lumps?
- A. Ultrasounds every 3 years
- B. Mammograms every 3 years
- C. Yearly checkups performed by physician
- D. Monthly breast self-examination
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Mammograms are less effective than breast self-examination for the diagnosis of abnormalities in younger women, who have denser breast tissue. They are more effective forwomen older than 40. (B) Up to 15% of early-stage breast cancers are detected by physical examination; however, 95% are detected by women doing breast self-examination. (C) Ultrasound is used primarily to determine the location of cysts and to distinguish cysts from solid masses. (D) Monthly breast self-examination has been shown to be the most effective method for early detection of breast cancer. Approximately 95% of lumps are detected by women themselves.
NEW QUESTION # 352
A client is to be discharged from the hospital and is to continue taking warfarin 2.5 mg po bid. Which of the following should be included in her discharge teaching concerning the warfarin therapy?
- A. "Carry a medications alert card with you at all times."
- B. "You should take aspirin instead of acetaminophen (Tylenol) for headaches."
- C. "You should use a straight-edge razor when shaving your arms and legs."
- D. "If you forget to take your morning dose, double the night time dose."
Answer: A
Explanation:
Section: Questions Set G
Explanation:
(A) Warfarin must always be taken exactly as directed. Clients should be instructed never to skip or double up on their dosage. (B) Aspirin decreases platelet aggregation, which would potentiate the effects of the coumadin. (C) Healthcare providers need to be aware of persons on warfarin therapy prior to the initiation of any diagnostic tests and/or surgery to help prevent bleeding complications. (D) An electric razor should be used to prevent accidental cutting, which can lead to bleeding.
NEW QUESTION # 353
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. Administer oral griseofulvin on an empty stomach for best results.
- C. Discontinue drug therapy if food tastes funny.
- D. Observe for headaches, dizziness, and anorexia.
Answer: D
Explanation:
Explanation/Reference:
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 # 354
A 67-year-old client will be undergoing a coronary arteriography in the morning. Client teaching about postprocedure nursing care should include that:
- A. Some oozing of blood at the arterial puncture site is normal
- B. Bed rest with bathroom privileges will be ordered
- C. He will be kept NPO for 8-12 hours
- D. The leg used for arterial puncture should be keptstraight for 8-12 hours
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Bed rest will be ordered for 8-12 hours postprocedure. Flexing of the leg at the arterial puncture site will occur if the client gets out of bed, and this is contraindicated after arteriography. (B) The client will be able to eat as soon as he is alert enough to swallow safely and that will depend on what medications areused for sedation during the procedure. (C) Oozing at the arterial puncture site is not normal and should be closely evaluated. (D) The leg where the arterial puncture occurred must be kept straight for 8-
12 hours to minimize the risk of bleeding.
NEW QUESTION # 355
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. Pain related to tissue damage from burns
- C. Potential for impaired gas exchange related to edema of respiratory tract
- D. Potential for infection related to contamination of wounds
Answer: C
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 # 356
A 6-year-old girl is visiting the outpatient clinic because she has a fever and a rash. The doctor diagnoses chickenpox. Her mother asks the nurse how many baby aspirins her daughter can have for fever. The nurse should:
- A. Ask if the client is allergic to aspirin before giving further information
- B. Check the aspirin bottle label to determine milligrams per tablet
- C. Assess the function of the client's cranial nerve VIII
- D. Advise the mother not to give her aspirin
Answer: D
Explanation:
Explanation
(A) Aspirin taken during a viral infection has been implicated as a predisposing factor to Reye's syndrome in children and adolescents. Children and adolescents should not be given aspirin. (B) Allergy to aspirin is not related to Reye's syndrome. (C) Tinnitus, caused by damage to the acoustic nerve, occurs with aspirin toxicity, but this is not related to Reye's syndrome. (D) A 6-year-old child should not be given any baby aspirin.
NEW QUESTION # 357
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. Phenothiazines
- B. Anti-Parkinsonian drugs
- C. Tricyclic agents
- D. Anticholinergics
Answer: D
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 # 358
Nursing care for the parents of a child with a congenital heart defect would include:
- A. Acknowledging the fear and concern surrounding their child's health and assisting the parents through the grieving process as they mourn the loss of their fantasized healthy child
- B. Expressing to the parents after the corrective surgery has been completed successfully that all their grief feelings will resolve
- C. Encouraging the parents not to tell the child about the seriousness of the congenital heart defect, so the child will function as normally as possible
- D. Identifying anger and resentment as destructive emotions that serve no purpose
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) It is important to discuss with parents the need to treat the child as they would any other children, but they must be truthful and honest with the child about the heart defect. As the child grows older, explanations can go into greater depth. (B) Parents of children with congenital heart defects go through a grieving process over the loss of their "healthy" child. The nurse needs to recognize these feelings and give the parents a role in the child's care when they are ready. (C) Anger and resentment are normal feelings that must be dealt with appropriately. (D) Parents may go through a second grieving process after the repair of the cardiac defect. During this grieving period, they mourn the loss of the "defective" child who now may be essentially "normal."
NEW QUESTION # 359
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