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NCLEX-RN EXAM PACK SET 7 QUESTIONS AND ANSWERS -2023, Exams of Health, psychology
Welcome to our collection of NCLEX Exam questions to help you achieve success on your NCLEX-RN exam! This updated guide for 2023 includes practice questions, a primer on the NCLEX-RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies
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NCLEX-RN EXAM PACK SET 7
QUESTIONS AND ANSWERS
UPDATED 2022 \2023)
1. 1. Question
The nurse is providing discharge teaching for the client withleukemia. The client should be told to avoid:
o A. Using oil- orcream-based soaps
o B. Flossing between the teeth
o C. The intake of salt
o D. Using an electric razor
- Question The nurse is changing the ties of the client with a tracheostomy.The safest method of changing the tracheostomy ties is to:
o A. Apply the new tie before removing the old one.
o B. Have a helper present.
o C. Hold the tracheostomy with the nondominant handwhile removing the old tie.
o D. Ask the doctor to suture the tracheostomy in place.
- Question The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse shouldgive priority to:
o A. Turning the client to the left side
o B. Milking the tube to ensure patency
o C. Slowing the intravenous infusion
o D. Notifying the physician
- Question The infant is admitted to the unit with tetralogy of fallot. Thenurse would anticipate an order for which medication?
o A. Digoxin
o B. Epinephrine
o C. Aminophylline
o D. Atropine
- Question The nurse is educating the lady’s club in a self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence. On the diagram below, select where the Tail of Spence is.
o A
o B
o C
o D
- Question The toddler is admitted with a cardiac anomaly. The nurse isaware that the infant with a ventricular septal defect will:
o A. Tire easily
o B. Grow normally
o C. Need more calories
o D. Be more susceptible to viral infections
Correct Answer: A.
The Tail of Spence is located in the upper outer quadrant of the
breast.
o Option B: Option B is the areola, a dark area of skin
surrounding the nipple.
- Question The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to:
o A. Determine lung maturity
o B. Measure the fetal activity
o C. Show the effect of contractions on fetal heart rate
o D. Measure the wellbeing of the fetus
- Question The nurse is evaluating the client who was admitted 8 hours agofor induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse?
Correct Answer: A. Tire easily
The toddler with a ventricular septal defect will tire easily. The
hole (defect) occurs in the wall (septum) that separates the
heart’s lower chambers (ventricles) and allows blood to pass from
the left to the right side of the heart. The oxygen-rich blood then
gets pumped back to the lungs instead of out to the body,
causing the heart to work harder.
o Options B and C: He will not grow normally but will
not need more calories.
o Option D: He will be susceptible to bacterial infection,
but he will be no more susceptible to viral infections
than other children.
o A. Instruct the client to push
o B. Perform a vaginal exam
o C. Turn off the Pitocin infusion
o D. Place the client in a semi-Fowler’s position
- Question The nurse notes the following on the ECG monitor. The nursewould evaluate the cardiac arrhythmia as:
o A. Atrial flutter
o B. A sinus rhythm
o C. Ventricular tachycardia
o D. Atrial fibrillation
- Question A client with clotting disorder has an order to continue lovenox (Enoxaparin) injections after discharge. The nurse should teach the client that lovenox injections should:
o A. Be injected into the deltoid muscle
o B. Be injected into the abdomen
o C. Aspirate after the injection
o D. Clear the air from the syringe before injections
Correct Answer: C. Ventricular tachycardia
The graph indicates ventricular tachycardia.
o Options A, B, D: The answers in A, B, and D are not
noted on the ECG strip.
Correct Answer: B. Be injected into the abdomen
- Question The nurse has a preop order to administer valium (Diazepam) 10mg and phenergan (Promethazine) 25mg. The correct methodof administering these medications is to:
o A. Administer the medications together in one syringe
o B. Administer the medication separately
o C. Administer the Valium, wait 5 minutes, and then injectthe Phenergan
o D. Question the order because they cannot be given atthe same time
- Question A client with frequent urinary tract infections asks the nurse how she can prevent the recurrence. The nurse should teach the clientto:
o A. Douche after intercourse
o B. Void every 3 hours
o Option A: Lovenox injections should be given in the
abdomen, not in the deltoid muscle.
o Options C and D: The client should not aspirate
after, but before, the injection or clear the air from the
syringe before injection.
o C. Obtain a urinalysis monthly
o D. Wipe from back to front after voiding
- Question Which task should be assigned to the nursing assistant?
o A. Placing the client in seclusion
o B. Emptying the Foley catheter of the preeclamptic client
o C. Feeding the client with dementia
o D. Ambulating the client with a fractured hip
- Question The client has recently returned from having a thyroidectomy.The nurse should keep which of the following at the bedside?
o A. A tracheostomy set
o B. A padded tongue blade
o C. An endotracheal tube
o D. An airway
- Question The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by:
o A. Cats
o B. Dogs
o C. Turtles
o D. Birds
- Question What’s the first intervention for a patient experiencing chestpain and a p02 of 89%?
o A. Administer morphine
o B. Administer oxygen
o C. Administer sublingual nitroglycerin
o D. Obtain an electrocardiogram (ECC)
- Question Which of the following signs and symptoms usually signifies rapidexpansion and impending rupture of an abdominal aortic aneurysm?
o A. Abdominal pain
o B. Absent pedal pulses
o C. Chest pain
o D. Lower back pain
- Question In which of the following types of cardiomyopathy does cardiacoutput remain normal?
o A. Obliterative
o B. Restrictive
o C. Dilated
o D. Hypertrophic
Correct Answer: D. Hypertrophic Hypertrophic cardiomyopathy (HCM) is a condition in which there is a severe ventricular hypertrophy and poor diastolic filling. It is an autosomal dominant condition wherein the heart muscles asymmetrically increases in size and mass along the septum. Theincrease in the thickness of heart muscles reduces the size of thecavities of the ventricles causing them to take a longer time to relax after systole. Cardiac output isn’t affected by hypertrophic cardiomyopathy because the size of the ventricle remains relatively unchanged.
o Options A and B: Restrictive cardiomyopathy (RCM)is wherein the walls of the
heart are rigid causing arestrictive stretching and filling of blood properly. Restrictive and obliterative cardiomyopathy are the same.
o Option C: Dilated cardiomyopathy (DCM) is a condition in which the left ventricle is
enlarged and weakened causing a decrease in the ability to pump blood (decreased cardiac output). It is the most common type of cardiomyopathy and commonly leadsto progressive heart failure. The cause of DCM canbe idiopathic or it can result from inflammatory processeslike myocarditis, or from cytotoxic agents like alcohol and certain neoplastic drugs.
- Question Which of the following interventions should be your first prioritywhen treating a patient experiencing chest pain while walking?
o A. Have the patient sit down.
o B. Get the patient back to bed.
o C. Obtain an ECG.
o D. Administer sublingual nitroglycerin.
- Question Which of the following positions would best aid breathing for apatient with acute pulmonary edema?
o A. Lying flat in bed
o B. Left side-lying position
o C. High Fowler’s position
o D. Semi-Fowler’s position
- Question A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks’ gestation. She’s at risk forwhich of the following blood dyscrasias?
o A. Heparin-associated thrombosis and thrombocytopenia(HATT)
o B. Idiopathic thrombocytopenic purpura (ITP)
o C. Thrombocytopenia
o D. Disseminated intravascular coagulation (DIC)
- Question A 16-year-old patient involved in a motor vehicle accident arrivesin the ED unconscious and severely hypotensive. He’s suspected to have several fractures of his pelvis and legs. Which of the following parenteral fluids is the best choice for his current condition?
o A. Packed red blood cells
o B. 0.9% sodium chloride solution
o C. Lactated Ringer’s solution
o D. Fresh frozen plasma
- Question Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress?
o A. Cushing syndrome
o B. Pain receptors
o C. Immune response
o D. Neural transmission
- Question A patient infected with human immunodeficiency virus (HIV)begins zidovudine therapy. Which of the following statements best describes this drug’s action?
o A. It stimulates the immune system.
o B. It destroys the outer wall of the virus and kills it.
o C. It interferes with viral replication
o D. It promotes excretion of viral antibodies.
Correct Answer: C. Immune response
Corticosteroids suppress eosinophils, lymphocytes, and natural
killer cells, inhibiting the natural inflammatory process in an
infected or injured part of the body. This helps resolve
inflammation, stabilizes lysosomal membranes, decreases
capillary permeability, and depresses phagocytosis of tissues by
white blood cells, thus blocking the release of more inflammatory
materials.
o Option A: Excessive corticosteroid therapy can lead
to Cushing’s syndrome.
o Option B: Analgesics suppress pain receptors.
o Option D: Opioids and heroin may suppress neural
transmission if taken in unregulated amounts.
Correct Answer: C. It interferes with viral replication.
- Question A 20 - year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. Whatcould you tell him to help him reduce his discomfort?
o A. "Hold your cough as much as possible."
o B. "Place the head of your bed flat to help withcoughing."
o C. "Restrict fluids to help decrease the amount ofsputum."
o D. "Splint your chest wall with a pillow forcomfort."
- Question A 19 - year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions shouldyou take first?
o A. Take a full medical history.
Zidovudine inhibits DNA synthesis in HIV, thus interfering with
viral replication. The drug doesn’t destroy the viral wall, stimulate
the immune system, or promote HIV antibody excretion.
o Options A, B, D: These options are not functions of
Zidovudine.
o B. Give a bronchodilator by nebulizer.
o C. Apply a cardiac monitor to the patient.
o D. Provide emotional support for the patient.
- Question A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He developed severe hypoxia48 hours after the incident, requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed?
o A. Atelectasis
o B. Pneumonia
o C. Bronchitis
o D. Acute respiratory distress syndrome (ARDS)
Correct Answer: D. Acute respiratory distress syndrome
(ARDS).
Severe hypoxia after smoke inhalation typically is related to
ARDS. The other choices aren’t typically associated with smoke
inhalation.
o Option A: Atelectasis is a complete or partial collapse
of the entire lung or area (lobe) of the lung. It occurs
when the tiny air sacs (alveoli) within the lung become
deflated or possibly filled with alveolar fluid.
- Question Which of the following measures best determines that a patientwho had a pneumothorax no longer needs a chest tube?
o A. You see a lot of drainage from the chest tube.
o B. Arterial blood gas (ABG) levels are normal.
o C. The chest X-ray continues to show the lung is 35 %deflated.
o D. The water-seal chamber doesn’t fluctuate whenno suction is applied.
- Question Which of the following nursing interventions should you use to prevent footdrop and contractures in a patient recovering from asubdural hematoma?
o A. High-top sneakers
Atelectasis is one of the most common breathing
(respiratory) complications after surgery.
o Option B: Pneumonia is an infection that inflames the
air sacs in one or both lungs.
o Option C: Bronchitis is an inflammation of the lining
of your bronchial tubes, which carry air to and from
your lungs.
o B. Low-dose heparin therapy
o C. Physical therapy consultation
o D. Sequential compressive device
- Question Which of the following signs of increased intracranial pressure(ICP) would appear first after head trauma?
o A. Bradycardia
o B. Large amounts of very dilute urine
o C. Restlessness and confusion
o D. Widened pulse pressure
- Question When giving intravenous (I.V.) phenytoin, which of the followingmethods should you use?
o A. Use an in-line filter.
o B. Withhold other anticonvulsants.
o C. Mix the drug with saline solution only.
o D. Flush the I.V. catheter with dextrose solution.
- Question After surgical repair of a hip, which of the following positions isbest for the patient’s legs and hips?
o A. Abduction
o B. Adduction
o C. Prone
o D. Subluxated
- Question Which of the following factors should be the primary focus ofnursing management in a patient with acute pancreatitis?
o A. Nutrition management
o B. Fluid and electrolyte balance
o C. Management of hypoglycemia
o D. Pain control
- Question After a liver biopsy, place the patient in which of the followingpositions?
o A. Left side-lying, with the bed flat
o B. Right side-lying, with the bed flat
o C. Left side-lying, with the bed in semi-Fowler’s position
o D. Right side-lying, with the bed in semi-Fowler’sposition
o Option D: A subluxation is a partial dislocation of a
joint. It’s often the result of acute injury or repetitive
motions, but it can also occur because of medical
conditions where the ligaments are loose.
Correct Answer: B. Fluid and electrolyte balance
Acute pancreatitis is commonly associated with fluid isolation and
accumulation in the bowel secondary to ileus or peripancreatic
edema. Fluid and electrolyte loss from vomiting is a major
concern. Therefore, your priority is to manage hypovolemia and
restore electrolyte balance.
o Options A and D: Pain control and nutrition also are
important, but not priority.
o Option C: Patients are at risk for hyperglycemia, not
hypoglycemia.
- Question Which of the following potentially serious complications couldoccur with therapy for hypothyroidism?
o A. Acute hemolytic reaction
o B. Angina or cardiac arrhythmia
o C. Retinopathy
o D. Thrombocytopenia
- Question Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes?
o A. Diabetes mellitus
o B. Diabetes insipidus
o C. Diabetic ketoacidosis
Correct Answer: B. Right side-lying, with the bed flat.
Positioning the patient on his right side with the bed flat will splint
the biopsy site and minimize bleeding.
o Options A, C, D: The other positions won’t do this
and may cause more bleeding at the site or internally.
o D. Syndrome of inappropriate antidiuretic hormonesecretion (SIADH)
- Question Patients with Type 1 diabetes mellitus may require which of thefollowing changes to their daily routine during periods of infection?
o A. No changes
o B. Less insulin
o C. More insulin
o D. Oral diabetic agents
- Question On a follow-up visit after having a vaginal hysterectomy, a 32 - year-old patient has a decreased hematocrit level. Which of thefollowing complications does this suggest?
o A. Hematoma
o B. Hypovolemia
o C. Infection
o D. Pulmonary embolus (PE)
- Question A patient has partial-thickness burns to both legs and portions ofhis trunk. Which of the following I.V. fluids are given first?
o A. Albumin
o B. D5W
o C. Lactated Ringer’s solution
o D. 0. 9 % sodium chloride solution with 2 mEq ofpotassium per 100 ml
Correct Answer: C. Lactated Ringer’s solution
Lactated Ringer’s solution replaces lost sodium and corrects
metabolic acidosis, both of which commonly occur following a
burn.
- Question Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site?