Prepare for the Actual NCLEX Certification NCLEX-RN Exam Practice Materials Collection
NCLEX Certification Certified Official Practice Test NCLEX-RN - Dec-2024
NCLEX-RN exam is an essential test for anyone wishing to practice as a registered nurse in the United States. It is a comprehensive assessment of a candidate's nursing knowledge and skills and is designed to test their ability to apply critical thinking and problem-solving skills to real-world situations. Passing the NCLEX-RN exam is a crucial step in obtaining licensure and beginning a career as a registered nurse.
NEW QUESTION # 450
A 25-year-old client believes she may be pregnant with her first child. She schedules an obstetric examination with the nurse practitioner to determine the status of her possible pregnancy. Her last menstrual period began May 20, and her estimated date of confinement using Nägele's rule is:
- A. February 1
- B. February 27
- C. March 27
- D. January 3
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A)March 27 is a miscalculation. (B) February 1 is a miscalculation. (C) February 27 is the correct answer.
To calculate the estimated date of confinement using Nagele's rule, subtract 3 months from the date that the last menstrual cycle began and then add 7 days to the result. (D) January 3 is a miscalculation.
NEW QUESTION # 451
The primary reason that an increase in heart rate (100 bpm) detrimental to the client with a myocardial infarction (MI) is that:
- A. Stroke volume and blood pressure will drop proportionately
- B. Decreased contractile strength will occur due to decreased filling time
- C. Decreased coronary artery perfusion due to decreased diastolic filling time will occur, which will increase ischemic damage to the myocardium
- D. Systolic ejection time will decrease, thereby decreasing cardiac output
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Decreased stroke volume and blood pressure will occur secondary to decreased diastolic filling. (B) Tachycardia primarily decreases diastole; systolic time changes very little. (C) Contractility decreases owing to the decreased filling time and decreased time for fiber lengthening. (D) Decreased O2 supply due to decreased time for filling of the coronary arteriesincreases ischemia and infarct size. Tachycardia primarily robs the heart of diastolic time, which is the primary time for coronary artery filling.
NEW QUESTION # 452
A 74-year-old obese man who has undergone open reduction and internal fixation of the right hip is 8 days postoperative. He has a history of arthritis and atrial fibrillation. He admits to right lower leg pain, described as "a cramp in my leg." An appropriate nursing action is to:
- A. Assess for pain with plantiflexion
- B. Instruct him to rub the cramp out of his leg
- C. Elevate right lower extremity with pillows propped under the knee
- D. Assess for edema and heat of the right leg
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Calf pain with dorsiflexion of the foot (Homans' sign) can be a sign of a deep venous thrombosis; however, it is not diagnostic of the condition. (B) Swelling and warmth along the affected vein are commonly observed clinical manifestations of a deep venous thrombosis as a result of inflammation of the vessel wall. (C) Rubbing or massaging of the affected leg is contraindicated because of the risk of the clot breaking loose and becoming an embolus. (D) A pillow behind the knee can be constricting and further impair blood flow.
NEW QUESTION # 453
A client with cirrhosis of the liver becomes comatose and is started on neomycin 300 mg q6h via nasogastric tube. The rationale for this therapy is to:
- A. Prevent systemic infection
- B. Promote diuresis
- C. Acidify the small bowel
- D. Decrease ammonia formation
Answer: D
Explanation:
(A) Neomycin is an antibiotic, but this is not the Rationale for administering it to a client in hepatic coma. (B) Diuretics and salt-free albumin are used to promote diuresis in clients with cirrhosis of the liver. (C) Neomycin destroys the bacteria in the intestines. It is the bacteria in the bowel that break down protein into ammonia. (D) Lactulose is administered to create an acid environment in the bowel. Ammonia leaves the blood and migrates to this acidic environment where it is trapped and excreted.
NEW QUESTION # 454
A mother brings her 3-year-old child who is unconscious but breathing to the ER with an apparent drug overdose. The mother found an empty bottle of aspirin next to her child in the bathroom. Which nursing action is the most appropriate?
- A. Place child on respiratory assistance.
- B. Put in a nasogastric tube and lavage the child's stomach.
- C. Teach mother poison prevention techniques.
- D. Monitor muscular status.
Answer: B
Explanation:
Section: Questions Set B
Explanation:
(A) The immediate treatment for drug overdose is removal of the drug from the stomach by either forced emesis or gastric lavage. The child's unconscious state prohibits forced emesis. (B) Toxic amounts of salicylates directly affect the respiratory system, which could lead to respiratory failure. (C) The mother's anxiety is probably so high that preventive guidance will be ineffective. (D) Respiratory assistance is not needed if the child's respiratory function is unaltered.
NEW QUESTION # 455
Respiratory function is altered in a 16-year-old asthmatic. Which of the following is the cause of this alteration?
- A. Paradoxical movements of the chest wall
- B. Increased airway resistance
- C. Continuous changes in respiratory rate and depth
- D. Altered surfactant production
Answer: B
Explanation:
Explanation
(A) Altered surfactant production is found in sudden infant death syndrome. (B) Paradoxical breathing occurs when a negative intrathoracic pressure is transmitted to the abdomen by a weakened, poorly functioning diaphragm. (C) Asthma is characterized by spasm and constriction of the airways resulting in increased resistance to airflow. (D) If the pulmonary tree is obstructed for any reason, inspired air has difficulty overcoming the resistance and getting out. The rate of respiration increases in order to compensate, thus increasing air exchange.
NEW QUESTION # 456
During a client's first postpartum day, the nurse assessed that the fundus was located laterally to the umbilicus.
This may be due to:
- A. Fibroid tumor on the uterus
- B. Displacement due to bowel distention
- C. Urine retention or a distended bladder
- D. Endometritis
Answer: C
Explanation:
Explanation
(A, B) Endometritis, urine retention, or bladder distention provide good distractors because they may delay involution but do not usually cause the uterus to be lateral. (C) Bowel distention and constipation are common in the postpartum period but do not displace the uterus laterally. (D) Urine retention or bladder distention commonly displaces the uterus to the right and may delay involution.
NEW QUESTION # 457
Which of the following findings would be abnormal in a postpartal woman?
- A. Urinary output of 3000 mL on the second day after delivery
- B. Pulse rate of 60 bpm in morning on first postdelivery day
- C. An oral temperature of 101F (38.3C) on the third day after delivery
- D. Chills shortly after delivery
Answer: C
Explanation:
(A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a nervous response or to vasomotor changes. If not followed by a fever, it is clinically innocuous. (B) The pulse rate during the immediate postpartal period may be low but presents no cause for alarm. The body attempts to adapt to the decreased pressures intra-abdominally as well as from the reduction of blood flow to the vascular bed. (C) Urinary output increases during the early postpartal period (12-24 hours) owing to diuresis. The kidneys must eliminate an estimated 2000-3000 mL of extracellular fluid associated with a normal pregnancy. (D) A temperature of 100.4F (38C) may occur after delivery as a result of exertion and dehydration of labor. However, any temperature greater than 100.4F needs further investigation to identify any infectious process.
NEW QUESTION # 458
An 18-year-old girl is admitted to the hospital with a depressed skull fracture as a result of a car accident. If the nurse were to observe a rising pulse rate and lowering blood pressure, the nurse would suspect that the client:
- A. Is beginning to experience a dangerously high level of anxiety
- B. Is having intracranial bleeding
- C. Has sustained an internal injury in addition to the head injury
- D. Has a sudden and severe increase in intracranial pressure
Answer: C
Explanation:
(A) Widening pulse pressure (high systolic and low diastolic) with compensatory slowing of pulse rate are late signs of increasing ICP. (B) Rising pulse rate and lowering blood pressure are indicative of hypovolemia due to hemorrhage. (C) High anxiety, in the absence of hemorrhage, would result in a high pulse rate and a high blood pressure. (D) Intracranial bleeding results in increased ICP. A change in level of consciousness is an early sign of increasing ICP, and vital sign changes are late signs of increasing ICP.
NEW QUESTION # 459
Following her surgery, a 5-year-old child will return to the pediatric unit with a long-arm cast. She experienced a supracondylar fracture of the humerus near the elbow. Which
nursing action is most essential during the first
24 hours after surgery and cast application?
- A. Pain management
- B. Assessment of neurovascular status
- C. Mobilization of the child
- D. Discharge teaching
Answer: B
Explanation:
(A) Mobilization is important but not absolutely essential. (B) Discharge teaching should be initiated prior to surgery as well as during the postoperative period. (C) Assessment and management of pain are necessary and high in priority. (D) Neurovascular status of the extremity is of primary importance. The risk of circulatory impairment exists with any cast application. This type of fracture is common in children. A high incidence of neurovascular complications exists with fractures near the elbow.
NEW QUESTION # 460
A client hospitalized with a medical diagnosis of adjustment disorder versus personality disorder states,
"Nobody cares about the clients." The nurse's most effective response would be:
- A. "You will feel differently about us in a few days."
- B. "You seem angry. Tell me more about how you feel."
- C. "What makes you think the nurses don't care?"
- D. "How can you say that I don't care? We just met."
Answer: B
Explanation:
Explanation
(A) This statement is a defensive response that places the nurse in a vulnerable countertransference position, and at the same time, fails to challenge the client's "splitting" behavior. (B) This statement is a defensive response by the nurse. In addition, this type of nontherapeutic statement requests that the client explain the reasons for her behavior, a difficult task for an individual with limited insight. (C) This statement is a nontherapeutic response that both ignores the intensity of the client's emotions and the dynamics underlying
"splitting" behavior. (D) By simultaneously acknowledging the client's emotional intensity and gently challenging her "splitting" behavior, the nurse addresses the client's current distortions and prepares for further interventions with angry or ambivalent feelings.
NEW QUESTION # 461
A client who is a breast-feeding mother develops mastitis. The clinical signs and symptoms of mastitis include:
- A. Marked engorgement and breast pain
- B. Cracked nipple with complaints of soreness
- C. Elevated temperature and general malaise
- D. Marked engorgement, elevated temperature, chills, and breast pain with an area that is red and hardened
Answer: D
Explanation:
Explanation
(A) Mastitis is a bacterial inflammation of the breast tissue found primarily in breast-feeding mothers. The bacteria usually enter the breast through a cracked nipple, or the infection results from stasis of milk behind a blocked duct. (B) With breast engorgement during breast-feeding, there may be marked breast pain. This is not necessarily a sign of infection. (C) Women may become ill during breast-feeding with other bacterial or viral infections that are not related to mastitis. (D) Improper care of the nipples or improper positioning of the infant during breastfeeding may result in cracked or sore nipples.
NEW QUESTION # 462
A 56-year-old client is admitted to the psychiatric unit in a state of total despair. She feels hopeless and worthless, has a flat affect and very sad appearance, and is unable to feel pleasure from anything. Her husband has been assisting her at home with the housework and cooking; however, she has not been eating much, lies around or sits in a chair most of the day, and is becoming confused and thinks her family does not want her around anymore. In assessing the client, the nurse determines that her behavior is consistent with:
- A. Transient depression
- B. Moderate depression
- C. Mild depression
- D. Severe depression
Answer: D
Explanation:
Explanation
(A) Transient depression manifests as sadness or the "blues" as seen with everyday disappointments and is not necessarily dysfunctional. (B) Mild depression manifests as symptoms seen with grief response, such as denial, sadness, withdrawal, somatic symptoms, and frequent or continuous thoughts of the loss. (C) Moderate depression manifests as feelings of sadness, negativism; low self-esteem; rumination about life's failures; decreased interest in grooming and eating; and possibly sleep disturbances. These symptoms are consistent with dysthymia. (D) Severe depression manifests as feelings of total despair, hopelessness, emptiness, inability to feel pleasure; possibly extreme psychomotor retardation; inattention to hygiene; delusional thinking; confusion; self-blame; and suicidal thoughts. These symptoms are consistent with major depression.
NEW QUESTION # 463
A client has consented to have a central venous catheter placed. The best position in which to place the client is the Trendelenburg position. The reason is that the Trendelenburg position:
- A. Makes the procedure more comfortable for the client
- B. Allows the physician to visualize the subclavian vein
- C. Reduces the possibility of hematoma formation
- D. Reduces the possibility of air embolism
Answer: D
Explanation:
Section: Questions Set C
Explanation:
(A) The subclavian vein is not visible during central line insertion regardless of the client's position. (B) The Trendelenburg position reduces the possibility of air embolism because it places slight positive pressure on the central veins. It also distends the veins, and distention facilitates insertion. (C) This response is untrue; it has no effect on hematoma formation. (D) This position is not necessarily more comfortable for the client, and many clients, especially those who may be short of breath, may find the position uncomfortable and difficult to maintain.
NEW QUESTION # 464
A 74-year-old female client is 3 days postoperative. She has an indwelling catheter and has been progressing well. While the nurse is in the room, the client states, "Oh dear, I feel like I have to urinate again!" Which of the following is the most appropriate initial nursing response?
- A. Instruct her to do Kegel exercises to diminish the urge to void.
- B. Ask her if she has felt this way before.
- C. Assure her that this is most likely the result of bladder spasms.
- D. Check the collection bag and tubing to verify that the catheter is draining properly.
Answer: D
Explanation:
Explanation
(A) Although this may be an appropriate response, the initial response would be to assure the patency of the catheter. (B) The most frequent reason for an urge to void with an indwelling catheter is blocked tubing. This response would be the best initial response. (C) Kegel exercises while a retention catheter is in place would not help to prevent a voiding urge and could irritate the urethral sphincter. (D) Though the nurse would want to ascertain whether the client has felt the same urge to void before, the initial response should be to assure the patency of the catheter.
NEW QUESTION # 465
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NCLEX-RN exam covers a broad range of topics related to nursing practice, including health promotion, disease prevention, patient care management, pharmacology, and more. NCLEX-RN exam consists of multiple-choice questions that assess a nurse's ability to apply knowledge, skills, and critical thinking to real-world situations. The NCLEX-RN is designed to test a nurse's ability to make sound clinical judgments, prioritize patient care needs, and provide safe and effective care.
Get to know about the salary of NCLEX-RN certified professional
The Average salary of different countries of NCLEX-RN Certified professional
- UK - 44352.90 Pounds
- India - 4461870 INR
- United States - 60,000 USD
Ace NCLEX NCLEX-RN Certification with Actual Questions Dec 22, 2024 Updated: https://www.exam-killer.com/NCLEX-RN-valid-questions.html
2024 The Most Effective NCLEX-RN with 865 Questions Answers: https://drive.google.com/open?id=1OVLnLTb2NCFHyDAaMlaW325_4HIILP8R
