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NCLEX-RN Practice Questions

National Council Licensure Examination(NCLEX-RN)

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Question # 121

When planning care for the passive-aggressive client, the nurse includes the following goal:

Options:

A.  

Allow the client to use humor, because this may be the only way this client can express self.

B.  

Allow the client to express anger by using “I” messages, such as “I was angry when . . .,” etc.

C.  

Allow the client to have time away from therapeutic responsibilities.

D.  

Allow the client to give excuses if he forgets to give staff information.

Discussion 0
Question # 122

A pregnant client during labor is irritable and feels the urge to vomit. The nurse should recognize this as the:

Options:

A.  

Fourth stage of labor

B.  

Third stage of labor

C.  

Transition stage of labor

D.  

Second stage of labor

Discussion 0
Question # 123

A 67-year-old client will be undergoing a coronary arteriography in the morning. Client teaching about postprocedure nursing care should include that:

Options:

A.  

Bed rest with bathroom privileges will be ordered

B.  

He will be kept NPO for 8–12 hours

C.  

Some oozing of blood at the arterial puncture site is normal

D.  

The leg used for arterial puncture should be keptstraight for 8–12 hours

Discussion 0
Question # 124

A pregnant client experiences spontaneous rupture of membranes. The first nursing action is to:

Options:

A.  

Assess the client’s respirations

B.  

Notify the physician

C.  

Auscultate fetal heart rate

D.  

Transfer to delivery suite

Discussion 0
Question # 125

An 11-year-old boy has received a partial-thickness burn to both legs. He presents to the emergency room approximately 15 minutes after the accident in excruciating pain with charred clothing to both legs. What is the first nursing action?

Options:

A.  

Apply ice packs to both legs.

B.  

Begin débridement by removing all charred clothing from wound.

C.  

Apply Silvadene cream (silver sulfadiazine).

D.  

Immerse both legs in cool water.

Discussion 0
Question # 126

A female client who has chronic obstructive pulmonary disease (COPD) has presented in the emergency department with cough productive of yellow sputum and increasing shortness of breath. On room air, her blood gases are as follows: pH 7.30 mm Hg, PCO2 60 mm Hg, PO2 55 mm Hg, HCO3 32 mEq/L. These arterial blood gases reflect:

Options:

A.  

Compensated respiratory acidosis

B.  

Normal blood gases

C.  

Uncompensated metabolic acidosis

D.  

Uncompensated respiratory acidosis

Discussion 0
Question # 127

A 30-year-old client has a history of several recent traumatic experiences. She presents at the physician’s office with a complaint of blindness. Physical exam and diagnostic testing reveal no organic cause. The nurse recognizes this as:

Options:

A.  

Delusion

B.  

Illusion

C.  

Hallucination

D.  

Conversion

Discussion 0
Question # 128

The nurse is assessing and getting a history from a client treated for depression with a monoamine oxidase (MAO) antidepressant. The most serious side effect associated with this antidepressant and the ingestion of tyramine in aged foods may be:

Options:

A.  

Hypertensive crisis

B.  

Severe rash

C.  

Severe hypotension

D.  

Severe diarrhea

Discussion 0
Question # 129

A newborn infant is exhibiting signs of respiratory distress. Which of the following would the nurse recognize as the earliest clinical sign of respiratory distress?

Options:

A.  

Cyanosis

B.  

Increased respirations

C.  

Sternal and subcostal retractions

D.  

Decreased respirations

Discussion 0
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