This page was exported from Free Exam Dumps Collection [ http://free.examcollectionpass.com ] Export date:Wed Nov 27 21:43:50 2024 / +0000 GMT ___________________________________________________ Title: Pass Authentic NCLEX NCLEX-RN with Free Practice Tests and Exam Dumps [Q403-Q424] --------------------------------------------------- Pass Authentic NCLEX NCLEX-RN with Free Practice Tests and Exam Dumps New NCLEX-RN  Exam Questions Real NCLEX Dumps The NCLEX-RN exam is computer-adaptive, meaning that the difficulty of the questions adapts to the test-taker's performance. The exam consists of a minimum of 75 questions and a maximum of 265 questions, with the number of questions varying depending on the test-taker's performance. The exam covers a wide range of topics, including pharmacology, patient care, nursing ethics, and health promotion. The NCLEX-RN exam is a critical component of the nursing profession and is essential for anyone who wishes to become a licensed registered nurse. 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High marks VCE exam simulator are the best source for NCLEX-RN test preparation, rn real exam questions bank and nclex-rn practice test. Refund policy is the most important thing when we talk about reliability. Register to download the product and take the exam.   Q403. 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:  Bright red with streaks  Rust colored  Green colored  Pink-tinged and frothy 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.Q404. A client has a history of alcoholism. He is currently diagnosed with cirrhosis of the liver. The nurse would expect him to be on which type of diet?  High protein and high calorie  High calorie and high carbohydrate  Low-fat 2-g sodium diet  High protein and high fat Explanation(A) A high-protein diet is contraindicated in hepatic disease. (B) High carbohydrates provide high-caloric content to prevent tissue catabolism. (C) A low-fat 2-g sodium diet is a cardiac diet; however, a low-fat diet would be beneficial. (D) A high-protein and high-fat diet is contraindicated in hepatic disease.Q405. A female client has been recently diagnosed as bipolar. She has taken lithium for the past several weeks to control mania. What must be included in client education regarding lithium toxicity?  Maintain a normal diet; however, limit salt intake to no more than 3 g/day.  Take lithium between meals to increase absorption.  Withhold lithium if experiencing diarrhea, vomiting, or diaphoresis.  For pain or fever, avoid aspirin or acetaminophen (Tylenol). Nonsteroidal antiinflammatory drugs are preferred. (A) The client should maintain a normal diet including normal salt intake. A low-sodium diet can cause lithium retention, leading to toxicity. (B) Lithium must be taken with meals because it is irritating to the gastric mucosa. (C) Diarrhea, vomiting, or diaphoresis can cause dehydration, which will increase lithium blood levels. If these symptoms occur, the nurse should instruct the client to withhold lithium. (D) Lithium is not to be taken with over-the-counter drugs without specific instruction. Some drugs raise lithium levels, whereas others lower lithium levels.Q406. 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:  It may be a bid for attention and an indication that more diversionary activity should be planned for him  No threat of suicide should be ignored or challenged in any way  He needs to be observed carefully for signs that his depression has been relieved  He needs to be confronted with his feelings and forced to work through them (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.Q407. Which of the following nursing care goals has the highest priority for a child with epiglottitis?  Sleep or lie quietly 10 hr/day.  Consume foods from all four food groups.  Be afebrile throughout her hospital stay.  Participate in play activities 4 hr/day. Explanation/Reference:Explanation:(A) Of these four goals, maintenance of a calm, quiet atmosphere to reduce anxiety and to allow for rest is the most important. (B) Although nutrition is important, the child needs fluids to maintain fluid and electrolyte balance more than solid foods. In addition, the child may not be able to swallow solid foods owing to epiglottic swelling. (C) This goal is unrealistic because fever is a common symptom of the infection associated with epiglottitis. (D) If overexerted, the child will need more O2 and energy than available, and these requirements may exacerbate the condition.Q408. Following a bicycle accident, a 12-year-old client sustained a complete fracture of the left femur. He was placed in 90◦-90◦ skeletal traction with a pin in the distal end of the femur to achieve realignment and immobilization of the left femur. When providing nursing care, it is important for the nurse to remember that:  The nurse may lift only the weights that are applying traction in order to reposition him in bed  The client will need special skin care at the pin site according to hospital policy or the physician’s preference  The traction pull should result in an immediate increase in comfort and reduce the need for pain medication  The client should be discouraged from participating in self-care activities to avoid the risk of disrupting the traction Explanation/Reference:Explanation:(A) Skeletal traction, including the weights that are applying the traction, is never released by the nurse. (B) It is necessary to keep the pin site clean and free from infection. (C) When first placed in traction, the client may experience increased discomfort as a result of the traction pull fatiguing the muscle. (D) When the child in traction is allowed to participate in his care, it gives him a measure of control and helps him to cope with the situation.Q409. Azulfidine (Sulfasalazine) may be ordered for a client who has ulcerative colitis. Which of the following is a nursing implication for this drug?  Limit fluids to 500 mL/day.  Administer 2 hours before meals.  Observe for skin rash and diarrhea.  Monitor blood pressure, pulse. (A) Fluids up to 2500-3000 mL/day are needed to prevent kidney stones. (B) The client should be instructed to take oral preparations with meals or snacks to lessen gastric irritation. (C) Sulfasalazine causes skin rash and diarrhea. (D) Blood pressure and pulse are not altered by sulfasalazine.Q410. What specific hormone must be present in serum or urine laboratory tests used to diagnose pregnancy?  Human chorionic gonadotropin  Estrogen  α-fetoprotein  Sphingomyelin Section: Questions Set DExplanation:(A) Human chorionic gonadotropin is the biochemical basis for pregnancy tests. It is produced by the placenta to help maintain the corpus luteum. Its levels climb rapidly following conception, peaking at about 8 weeks and then gradually decreasing to low levels after 16 weeks. (B) Estrogen does steadily rise throughout pregnancy, increasing to 30 times that of prepregnancy levels. Although estrogen levels do change during pregnancy, it is not used as the main hormone of evaluation in pregnancy tests. (C) α-Fetoprotein is the major protein in the serum of the embryo. It is initially produced by the yolk sac. (D) Lecithin and sphingomyelin are two phospholipids of which fetal lung surfactant is composed. Levels are evaluated to determine fetal lung maturity.Q411. A 14-year-old client has a history of lying, stealing, and destruction of property. Personal items of peers have been found missing. After group therapy, a peer approaches the nurse to report that he has seen the 14- year-old with some of the missing items. The best response of the nurse is to:  Request that he explain to the group why he took personal items from peers  Approach him when he is alone to inquire about his involvement in the incident  Imply to him that you doubt his involvement in the incident and request his denial  Confront him openly in group and request an apology (A) This answer is incorrect. There is no proof that he removed the missing items. (B) This answer is correct. Anxiety and defensiveness are lessened if the individual is approached in this manner. (C) This answer is incorrect. It is difficult for one to admit to wrongdoing with this approach. (D) This answer is incorrect. He has not yet been proved guilty. Confrontation will only increase defensiveness and anxiety.Q412. The most frequent cause of early postpartum hemorrhage is:  Hematoma  Coagulation disorders  Uterine atony  Retained placental fragments (A) Hematomas, which are the result of damage to a vessel wall without laceration of thetissue, are a cause, though not the most frequent cause. (B) Coagulation disorders are among the causes of postpartal hemorrhage, but they are less common. (C) The most frequent causes of hemorrhage in the postpartal period are related to an interference with involution of the uterus. Uterine atony is the most frequent cause, occurring in the first 24 hours after delivery. (D) Retained placental fragments are also a cause, although these bleeds usually occur 7-14 days after delivery.Q413. A female baby was born with talipes equinovarus. Her mother has requested that the nurse assigned to the baby come to her room to discuss the baby’s condition. The nurse knows that the pediatrician has discussed the baby’s condition with her mother and that an orthopedist has been consulted but has not yet seen the baby.What should the nurse do first?  Call the orthopedist and request that he come to see the baby now.  Question the mother and find out what the pediatrician has told her about the baby’s condition.  Tell the mother that this is not a serious condition.  Tell the mother that this condition has been successfully treated with exercises, casts, and/or braces. Explanation(A) The nurse should call the orthopedist after assessing the mother’s knowledge. (B) The nurse must first assess the knowledge of the parent before attempting any explanation. (C) The nurse should assess the mother’s knowledge of the baby’s condition as the first priority. (D) This answer is correct, but the priority is B.Q414. A client is having a pneumonectomy done today, and the nurse is planning her postoperative care. Nursing interventions for a postoperative left pneumonectomy would include:  Monitoring the chest tubes  Positioning the client on the right side  Positioning the client in semi-Fowler position with a pillow under the shoulder and back  Monitoring the right lung for an increase in rales Explanation/Reference:Explanation:(A) Chest tubes are usually not necessary in a pneumonectomy because there is no lung to re-expand on the operative side. (B) The pneumonectomy client should be positioned on the back or operated side because the sutured bronchial stump may open, allowing fluid to drain into the unoperated side and drown the client. (C) The client should not have a pillow under the shoulder and back because of the subscapular incision. (D) Rales are commonly heard over the base of the remaining lung, but an increase could indicate circulatory overload and therefore should be closely monitored.Q415. The physician has ordered that a daily exercise program be instituted by a client with type I diabetes following his discharge from the hospital. Discharge instructions about exercise should include which of the following?  Exercise should be performed 30 minutes before meals.  A snack may be needed before and/or during exercise.  Hyperglycemia may occur 2-4 hours after exercise.  The blood glucose level should be 100 mg or below before exercise is begun. Section: Questions Set AExplanation:(A) Exercise should not be performed before meals because the blood sugar is usually lower just prior to eating; therefore, there is an increased risk for hypoglycemia. (B) Exercise lowers blood sugar levels; therefore, a snack may be needed to maintain the appropriate glucose level. (C) Exercise lowers blood sugar levels. (D) Exercise lowers blood sugar levels. If the blood glucose level is 100 mg or below at the start of exercise, the potential for hypoglycemia is greater.Q416. When assessing a child with diabetes insipidus, the nurse should be aware of the cardinal signs of:  Anemia and vomiting  Polyuria and polydipsia  Irritability relieved by feeding formula  Hypothermia and azotemia Explanation(A) Anemia and vomiting are not cardinal signs of diabetes insipidus. (B) Polyuria and polydipsia are the cardinal signs of diabetes insipidus. (C) Irritability relieved by feeding water, not formula, is a common sign, but not the cardinal sign, of diabetes insipidus. (D) Hypothermia and azotemia are signs, but not cardinal signs, of diabetes insipidus.Q417. An 8-year-old child is admitted to the hospital for surgery. She has had no previous hospitalizations, and both she and her family appear anxious and fearful. It will be most helpful for the nurse to:  Take the child to her room and calmly and matter-offactly begin to get her ready to go to the operating room  Take time to orient the child and her family to the hospital and the forthcoming events  Explain that as soon as the child goes to the operating room she will have time to answer any questions the family has  Tell the child and her family that there is nothing to worry about, that the operation will not take long, and she will soon be as “good as new” (A) This action does nothing to prepare the child and her family for what will happen or to relieve their anxiety and fear. (B) This action provides security by preparing the child and the family for what will happen and will help to relieve fear and anxiety. (C) This action does nothing to help prepare the child for what will happen and does not give the parents permission to ask questions until later. (D) This action provides possibly false reassurance and may prevent the child and/or the family from asking pressing questions.Q418. A physician’s order reads: Administer KCl 10% oral solution 1.5 mL. The KCl bottle reads 20 mEq/15 mL.What dosage should the nurse administer to the infant?  1 mEq  1.13 mEq  2 mEq  Not enough information to calculate Section: Questions Set CExplanation:(A) This answer is a miscalculation. (B) This answer is a miscalculation. (C) 1.33 mEq = 1 mL, then 1.5 mL x1.99, or 2 mEq. (D) Information is adequate for calculation.Q419. The nurse working with a client who is out of control should follow a model of intervention that includes which of the following?  Approach the client on a continuum of least restrictive care.  Challenge client’s behavior immediately with steps to prevent injury to self or others.  Leave the aggressive client to himself or herself, and take other clients away.  To ensure safety of other clients, place client in seclusion immediately when he or she begins shouting. (A) Approaching a client’s aggressive behavior on a continuum of least restrictive care is in agreement with his or her rights (i.e., verbal methods to help maintain control, medication, seclusion, and restraints, as necessary). (B) Approaching a client in a challenging manner is threatening and inappropriate. A nonchallenging and calm approach reflects staff in control and may increase client’s internal control. (C) It is inappropriate to leave an aggressive client who is acting out alone. The nurse should acquire qualified help to prevent client from harm or injury to self or others. (D) Moving a client to seclusion immediately for shouting is inappropriate. The nurse should offer the client an opportunity to control self with limit setting. The client should understand that the staff will assist with control if necessary (i.e., quietly accompany out of environment to decrease stimulation and allow for verbalization) employing the least restrictive care model of intervention.Q420. A 27-year-old primigravida at 32 weeks’ gestation has been diagnosed with complete placenta previa.Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:  Dinitrophenylhydrazine  Metachromatic stain  Blood serum phenylalanine test  Lecithin-sphingomyelin ratio Explanation(A) Dinitrophenylhydrazine is a laboratory test used to detect phenylketonuria, maple syrup urine disease, and Lowe’s syndrome. (B) Metachromatic stain is a laboratory test that may be used to diagnose Tay-Sachs and other lipid diseases of the central nervous system. (C) The blood serum phenylalanine test is diagnostic of phenylketonuria and can be used for wide-scale screening. (D) A lecithin-sphingomyelin ratio of at least 2:1 is indicative of fetal lung maturity, and survival of the fetus is likely.Q421. The nurse has been assigned a client who delivered a 6- lb, 12-oz baby boy vaginally 40 minutes ago. The initial assessment of greatest importance for this client would be:  Length of her labor  Type of episiotomy  Amount of IV fluid to be infused  Character of the fundus ExplanationThe length of labor has little bearing on the fourth stage of labor. The type of labor and delivery is significant.(B) The type of episiotomy will affect the client’s comfort level. However, the nurse’s assessment and implementations center on prevention of hemorrhage during the fourthstage of labor. The amount of bleeding from the episiotomy or hematoma formation is of higher priority than the type of episiotomy. (C) The amount of IV fluid to be infused is a nursing function to be attended to; however, it is lower in priority than determining if hemorrhaging is occurring. (D) Character of the fundus would be the priority nursing assessment because changes in uterine tone may identify possible postpartum hemorrhage.Q422. A client who has been diagnosed with anorexia nervosa reluctantly agrees to eat all prescribed meals. The most important intervention in monitoring her dietary compliance would be to:  Allow her privacy at mealtimes  Praise her for eating everything  Observe behavior for 1-2 hours after meals to prevent vomiting  Encourage her to eat in moderation, choose foods that she likes, and avoid foods that she dislikes (A) Eating alone is not recommended for anorexic clients because they tend to hoard food instead of eating it. (B) The client should be praised for whatever she eats, which is usually a small portion or percentage of what is served. Praise should not be withheld until she eats everything. (C) The client should be observed eyeto- eye for at least 1 hour following meals to prevent discarding food stashed in her clothing at mealtime or engaging in selfinduced vomiting. (D) If offered these choices, the client would choose low-caloric foods, not a nutritious diet.Q423. A baby is circumcised. Immediate postoperative care should include:  Applying a loose diaper  Keeping the baby NPO for 4 hours to avoid vomiting  Changing the dressing frequently using dry, sterile gauze  Taking the baby to his mother for cuddling Explanation(A) A pressure diaper should be applied to discourage hemorrhage. (B) The baby can be fed by his mother soon after the procedure, once it is assessed that he is not in any distress and is stable. (C) Dressing changes should not be dry. Dry dressing will stick. (D) Cuddling after the procedure will hopefully quiet the baby.Feeding is also important if his feeding was withheld prior to the procedure or it is time for a feeding.Q424. Which of the following would the nurse expect to find following respiratory assessment of a client with advanced emphysema?  Distant breath sounds  Increased heart sounds  Decreased anteroposterior chest diameter  Collapsed neck veins (A) Distant breath sounds are found in clients with emphysema owing to increased anteroposterior chest diameter, overdistention, and air trapping. (B) Deceased heart sounds arepresent because of the increased anteroposterior chest diameter. (C) A barrel-shaped chest is characteristic of emphysema. (D) Increased distention of neck veins is found owing to right-sided heart failure, which may be present in advanced emphysema. Loading … NCLEX-RN Exam Info and Free Practice Test Professional Quiz Study Materials: https://www.examcollectionpass.com/NCLEX/NCLEX-RN-practice-exam-dumps.html --------------------------------------------------- Images: https://free.examcollectionpass.com/wp-content/plugins/watu/loading.gif https://free.examcollectionpass.com/wp-content/plugins/watu/loading.gif --------------------------------------------------- --------------------------------------------------- Post date: 2023-07-13 11:25:03 Post date GMT: 2023-07-13 11:25:03 Post modified date: 2023-07-13 11:25:03 Post modified date GMT: 2023-07-13 11:25:03