Latest [Dec 01, 2021] NCLEX NCLEX-RN Real Exam Dumps PDF
NCLEX-RN Practice Test Questions Updated 865 Questions
NEW QUESTION 442
Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?
- A. Mediastinal tissue and organ shifting
- B. Hypoxemia and respiratory acidosis
- C. Ventilation-perfusion (V./Q.) mismatch
- D. Decreased tidal volume and tachypnea
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A, B, D) These occur in both tension pneumothorax and open pneumothorax. (C) The tension pneumothorax acts like a one- way valve so that the pneumothorax increases with each breath. Eventually, it occupies enough space to shift mediastinal tissue toward the unaffected side away from the midline.
Tracheal deviation, movement of point of maximum impulse, and decreased cardiac output will occur. The other three options will occur in both types of pneumothorax.
NEW QUESTION 443
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 glomerular filtration and increased tubular absorption
- B. Decreased estrogen levels
- C. Increased human placental lactogen levels
- D. Decreased progesterone levels
Answer: C
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 444
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. Major psychotic depression
- C. Delirium tremens
- D. Generalized anxiety disorder
Answer: C
Explanation:
Section: Questions Set D
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 445
The physician recommends immediate hospital admission for a client with PIH. She says to the nurse, "It's not so easy for me to just go right to the hospital like that." After acknowledging her feelings, which of these approaches by the nurse would probably be best?
- A. Explore with the client her perceptions of why she is unable to go to the hospital.
- B. Stress to the client that her husband would want her to do what is best for her health.
- C. Explain to the client that she is ultimately responsible for her own welfare and that of her baby.
- D. Repeat the physician's reasons for advising immediate hospitalization.
Answer: A
Explanation:
Explanation
(A) This answer does not hold the client accountable for her own health. (B) The nurse should explore potential reasons for the client's anxiety: are there small children at home, is the husband out of town? The nurse should aid the client in seeking support or interventions to decrease the anxiety of hospitalization. (C) Repeating the physician's reason for recommending hospitalization may not aid the client in dealing with her reasons for anxiety. (D) The concern for self and welfare of baby may be secondary to a woman who is in a crisis situation. The nurse should explore the client's potential reasons for anxiety. For example, is there another child in the home who is ill, or is there a husband who is overseas and not able to return on short notice?
NEW QUESTION 446
The nurse will be alert to the most potentially lifethreatening side effect associated with the administration of monoamine oxidase (MAO) inhibitor. This is:
- A. Oculogyric crisis
- B. Tardive dyskinesia
- C. Orthostatic hypotension
- D. Hypertensive crisis
Answer: D
Explanation:
Explanation
(A) Oculogyric crisis, involuntary upward deviation and fixation of the eyeballs, is usually associated with either postencephalitic parkinsonian or drug-induced extrapyramidal symptoms (EPS). (B) Hypertensive crisis is a potentially life-threatening side effect. This may occur if the client ingests foods, beverages, or medications containing tyramine. (C) Orthostatic hypotension, a drop in blood pressure resulting from a rapid change of body position, can occur with the administration of antidepressants. (D) Tardive dyskinesia, characterized by slow, rhythmical, automatic or stereotyped muscular movements, usually is associated with the administration of certain antipsychotic medications.
NEW QUESTION 447
Which of the following findings would necessitate discontinuing an IV potassium infusion in an adult with ketoacidosis?
- A. Serum potassium level of 3.7
- B. Urine output 22 mL/hr for 2 hours
- C. Serum glucose level of 180
- D. Small T wave of ECG
Answer: B
Explanation:
(A) Adequate renal flow of 30 mL/hr is a necessity with potassium infusions because potassium is excreted renally. (B) Because potassium level will decrease during correction of diabetic ketoacidosis, potassium will be infused even if plasma levels of potassium are normal. (C) A small T wave is normal and desired on the electrocardiogram. A tall, peaked T-wave could indicate overinfusion of potassium and hyperkalemia. (D) Glucose levels of <200 are desirable.
NEW QUESTION 448
The nurse caring for a client who has pneumonia, which is caused by a gram-positive bacteria, inspects her sputum. Because the client's pneumonia is caused by a gram-positive bacteria, the nurse experts to find the sputum to be:
- A. Green colored
- B. Rust colored
- C. Bright red with streaks
- D. Pink-tinged and frothy
Answer: B
Explanation:
Explanation
(A) Bright red sputum with streaks is associated with pneumonia caused by gram-negative bacteria, such asKlebsiellapneumonia. (B) Pneumococcal pneumonia, caused by gram-positive bacteria, has a characteristic productive cough with green or rust-colored sputum. (C) Green-colored sputum is more characteristic ofPseudomonasthan of gram-positive bacterial pneumonia. (D) Pink-tinged and frothy sputum is more characteristic of pulmonary edema than of gram-positive bacterial pneumonia.
NEW QUESTION 449
A 3-year-old child is admitted with a diagnosis of possible noncommunicating hydrocephalus. What is the first symptom that indicates increased intracranial pressure?
- A. Ataxia
- B. Bulging fontanelles
- C. Seizure
- D. Headache
Answer: D
Explanation:
Section: Questions Set C
Explanation:
(A) Bulging fontanelles are a symptom of increased intracranial pressure in infants. (B) Seizure is a late sign of increased intracranial pressure. (C) Headache is a very early symptom of increased intracranial pressure in the child. (D) Ataxia is a late sign of increased intracranial pressure.
NEW QUESTION 450
A client is now pregnant for the second time. Her first child weighed 4536 g at delivery. The client's glucose tolerance test shows elevated blood sugar levels. Because she only shows signs of diabetes when she is pregnant, she is classified as having:
- A. Gestational diabetes mellitus
- B. Type II diabetes mellitus
- C. Type I diabetes mellitus
- D. Insulin-dependent diabetes
Answer: A
Explanation:
Explanation
(A) Insulin-dependent diabetes mellitus, also known as type I diabetes, usually appears before the age of 30 years with an abrupt onset of symptoms requiring insulin for management. It is not related to onset during pregnancy. (B) Non-insulin-dependent diabetes (type II diabetes) usually appears in older adults. It has a slow onset and progression of symptoms. (C) This type of diabetes is the same as insulin-dependent diabetes. (D) Gestational diabetes mellitus has its onset of symptoms during pregnancy and usually disappears after delivery. These symptoms are usually mild and not life threatening, although they are associated with increased fetal morbidity and other fetal complications.
NEW QUESTION 451
A 9-week-old female infant has a diagnosis of bilateral cleft lip and cleft palate. She has been admitted to the pediatric unit after surgical repair of the cleft lip. Which of the following nursing interventions would be appropriate during the first 24 hours?
- A. Clean suture line every shift.
- B. Offer pacifier when she cries.
- C. Maintain elbow restraints in place unless she is being directly supervised.
- D. Position on side or abdomen.
Answer: C
Explanation:
(A) Placing the infant on her abdomen may allow for injury to the suture line. (B) Elbow restraints prevent the infant from touching the suture line and yet leaves hands free. (C) The suture line is cleaned as often as every hour to prevent crusting and scarring. (D) Sucking of a bottle or pacifier places pressure on the suture line and may delay healing and cause scarring.
NEW QUESTION 452
Provide the 1-minute Apgar score for an infant born with the following findings: Heart rate: Above 100 Respiratory effort: Slow, irregular Muscle tone: Some flexion of extremities Reflex irritability: Vigorous cry Color: Body pink, blue extremities
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
Explanation
(A) Seven out of a possible perfect score of 10 is correct. Two points are given for heart rate above 100; 1 point is given for slow, irregular respiratory effort; 1 point is given for some flex- ion of extremities in assessing muscle tone; 2 points are given for vigorous cry in assessing reflex irritability; 1 point is assessed for color when the body is pink with blue extremities (acrocyanosis). (B) For a perfect Apgar score of 10, the infant would have a heart rate over 100 but would also have a good cry, active motion, and be completely pink. (C) For an Apgar score of 8 the respiratory rate, muscle tone, or color would need to fall into the 2-point rather than the 1-point category. (D) For this infant to receive an Apgar score of 9, four of the areas evaluated would need ratings of 2 points and one area, a rating of 1 point.
NEW QUESTION 453
The nurse and prenatal client discuss the effects of cigarette smoking on pregnancy. It would be correct for the nurse to explain that with cigarette smoking there is increased risk that the baby will have:
- A. A low birth weight
- B. Nicotine withdrawal
- C. A birth defect
- D. Anemia
Answer: A
Explanation:
Section: Questions Set F
Explanation:
(A) Women who smoke during pregnancy are at increased risk for miscarriage, preterm labor, and IUGR in the fetus. (B) Although smoking produces harmful effects on the maternal vascular system and the developing fetus, it has not been directly linked to fetal anomalies. (C) Smoking during pregnancy has not been directly linked to anemia in the fetus. (D) Smoking during pregnancy has not been linked to nicotine withdrawal symptoms in the newborn.
NEW QUESTION 454
As a nurse works with an adolescent with cystic fibrosis, the nurse begins to notice that he appears depressed and talks about suicide and feelings of worthlessness. This is an important factor to consider in planning for his care because:
- A. He needs to be confronted with his feelings and forced to work through them
- B. No threat of suicide should be ignored or challenged in any way
- C. He needs to be observed carefully for signs that his depression has been relieved
- D. It may be a bid for attention and an indication that more diversionary activity should be planned for him
Answer: B
Explanation:
(A) Threats of suicide should always be taken seriously. (B) This client has a life-threatening chronic illness. He may be concerned about dying or he may actually be contemplating suicide. (C) Sometimes clients who have made the decision to commit suicide appear to be less depressed. (D) Forcing him to look at his feelings may cause him to build a defense against the depression with behavioral or psychosomatic disturbances.
NEW QUESTION 455
The nurse is in the hallway and one of the visitors faints. The nurse should:
- A. Elevate the victim's legs
- B. Sit the victim up and place the head between the knees
- C. Sit the victim up and lightly slap his face
- D. Apply a cool cloth to the victim's neck and forehead until he recovers
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Sitting the client up defeats the goal of re-establishing cerebral blood flow. (B) Elevating the legs anatomically redirects blood flow to the cerebral area. (C) This strategy is a nice general comfort measure after the victim has regained consciousness. (D) This strategy is not as effective a strategy in helping the client to regain consciousness as elevating the legs.
NEW QUESTION 456
The FHR pattern in a laboring client begins to show early decelerations. The nurse would best respond by:
- A. Administering O2 at 8 L/min via face mask
- B. Changing the client to the left lateral position
- C. Continuing to monitor the FHR closely
- D. Notifying the physician
Answer: C
Explanation:
(A) Early decelerations are reassuring and do not warrant notification of the physician. (B) Because early decelerations is a reassuring pattern, it would not be necessary to change the client's position. (C) Early decelerations warrant the continuation of close FHR monitoring to distinguish them from more ominous signs. (D) O2 is not warranted in this situation, but it is warranted in situations involving variable and/or late decelerations.
NEW QUESTION 457
The nurse writes the following nursing diagnosis for a client in acute renal failure-Impaired gas exchange related to:
- A. Decreased red blood cell production
- B. Decreased production of renin
- C. Increased red blood cell production
- D. Increased levels of vitamin D
Answer: A
Explanation:
Explanation
(A) Red blood cell production is impaired in renal failure owing to impaired erythropoietin production. This causes a decrease in the delivery of oxygen to the tissue and impairs gas exchange. (B) The conversion of vitamin D to its physiologically active form is impaired in renal failure. (C) In renal failure, a decrease in red blood cell production occurs owing to an impaired production of erythropoietin, leading to impaired gas exchange at the cellular level. (D) The decreased production of renin in renal failure causes an increased production of aldosterone causing sodium and water retention.
NEW QUESTION 458
......
NCLEX NCLEX-RN Dumps - Secret To Pass in First Attempt: https://www.free4torrent.com/NCLEX-RN-braindumps-torrent.html
NCLEX-RN Dumps - Grab Out For [NEW-2021] NCLEX Exam: https://drive.google.com/open?id=1w2EzSw97ssTxvHsLyvhfL86WSUT99vfd