NCLEX-RN NCLEX Exam Questions and Free Practice Test

Question 79

- (Topic 7)
The nurse is interviewing a client with a diagnosis of possible abdominal aortic aneurysm. Which of the following statements will be reflected in the client??s chief complaint?

A. ??I??ve been having a dull pain at the upper left shoulder.??

B. ??My legs have been numb for three months.??

C. ??I??ve only been urinating three times a day lately.??

D. ??I don??t remember anything in particular, I just haven??t felt well.??

Correct Answer:D
(A, B, C) These complaints are not specific signs and symptoms associated with abdominal aortic aneurysm. If symptoms are present, the aneurysm is expanding or rupture is imminent. (D) Many clients may experience no symptoms. The only symptom may be a pulsation noted in the abdomen in the reclining position.

Question 80

- (Topic 7)
Which of the following physician??s orders would the nurse question on a client with chronic arterial insufficiency?

A. Neurovascular checks every 2 hours

B. Elevate legs on pillows

C. Arteriogram in the morning

D. No smoking

Correct Answer:B
(A) Neurovascular checks are a routine part of assessment with clients having this diagnosis. (B) Elevation of the legs is contraindicated because it reduces blood flow to areas already compromised. (C) Arteriogram is a routine diagnostic order. (D) Smoking is highly correlated with this disorder.

Question 81

- (Topic 1)
Which of the following nursing orders should be included in the plan of care for a client with hepatitis C?

A. The nurse should use universal precautions when obtaining blood samples.

B. Total bed rest should be maintained until the client is asymptomatic.

C. The client should be instructed to maintain a low semi-Fowler position when eating meals.

D. The nurse should administer an alcohol backrub at bedtime.

Correct Answer:A
(A) The source of infection with hepatitis C is contaminated blood products. (B) Modified bed rest should be maintained while the client is symptomatic. Routine activities can be slowly resumed once the client is asymptomatic. (C) Nausea and vomiting occur frequently with hepatitis C. A high Fowler position may decrease the tendency to vomit. (D) The buildup of bilirubin in the client??s skin may cause pruritus. Alcohol is a drying agent.

Question 82

- (Topic 3)
A client??s physician has prescribed theophylline (Theo- Dur) to help control the bronchospasm associated with the client??s COPD. Instructions that should be given to the client include:

A. ??Call your physician if you develop palpitations, dizziness, or restlessness.????

B. ??Cigarette smoking may significantly increase the risk for theophylline toxicity.????

C. ??Take this medication on an empty stomach.????

D. ??Do not take your medicine if your pulse is less than 60 beats per minute.????

Correct Answer:A
(A) Indications of theophylline toxicity include palpitations, dizziness, restlessness, nausea, vomiting, shakiness, and anorexia. (B) Cigarette smoking significantly lowers theophylline plasma levels. (C) Theophylline should be taken with food to decrease stomach upset. (D) These instructions are appropriate for someone taking digoxin.

Question 83

- (Topic 5)
A male client has burns over 90% of his body after an automobile accident resulting in a fire. He was trapped inside the auto and pulled out by a bystander. After several months in the hospital and over 20 surgeries, discharge planning has begun. Throughout his hospitalization the nursing staff has been aware of psychological changes the client faces after burns over a large portion of his body resulting in disfigurement. The nursing staff can best foster the client??s self-esteem by:

A. Adhering to a strict schedule of diet, exercise, and wound care

B. Allowing him to go to physical therapy for whirlpool treatment when other clients were not in physical therapy

C. Following a standardized plan of care for burn clients formulated by a world-renowned burn center

D. Allowing him to plan, assist in, and perform his own care whenever possible

Correct Answer:D
(A) A regimented schedule, allowing no flexibility, will not foster the client??s self-esteem. (B) Isolating the client may only enhance his feelings of social isolation due to his disfigurement. (C) Standardized care plans must be personalized and adapted to each client??s situation. (D) Allowing the client control over his care will foster his self-esteem and prepare him for life outside of the hospital.

Question 84

- (Topic 6)
Two weeks after a client??s admission for depression, the physician orders a consult for electroconvulsive therapy (ECT). Which of the following conditions, if present, would be a contraindication for ECT?

A. Brain tumor or other space-occupying lesion

B. History of mitral valve prolapse

C. Surgically repaired herniated lumbar disk

D. History of frequent urinary tract infections

Correct Answer:A
(A) A contraindication for ECT is a space-occupying lesion such as a brain tumor. During ECT, intracranial pressure increases. Therefore, ECT would not be prescribed for a client whose intracranial pressure is already elevated. (B) Any cardiac dysrhythmias or complications that arise during ECT are usually attributed to the IV anesthetics used, not to preexisting cardiac structural conditions. (C) Musculoskeletal injuries during ECT are extremely rare because of the IV use of centrally acting muscle relaxers. (D) A history of any kind of infection would not contraindicate the use of ECT. In fact, concurrent treatment of infections with ECT is not uncommon.

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