NCLEX-RN Online Practice Questions and Answers
The nurse should know that according to current thinking, the most important prognostic factor for a client with breast cancer is:
A. Tumor size
B. Axillary node status
C. Client's previous history of disease
D. Client's level of estrogen-progesterone receptor assays
The nurse would be concerned if a client exhibited which of the following symptoms during her postpartum stay?
A. Pulse rate of 50?0 bpm by her third postpartum day
B. Diuresis by her second or third postpartum day
C. Vaginal discharge or rubra, serosa, then rubra
D. Diaphoresis by her third postpartum day
A 35-year-old client is admitted to the hospital with diabetic ketoacidosis. Results of arterial blood gases are pH 7.2, PaO2 90, PaCO2 45, and HCO3 16. The nursing assessment of arterial blood gases indicate the presence of:
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
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:
A. Monitoring the chest tubes
B. Positioning the client on the right side
C. Positioning the client in semi-Fowler position with a pillow under the shoulder and back
D. Monitoring the right lung for an increase in rales
A male client had a right below-the-knee amputation 4 days ago. His incision is healing well. He has gotten out of bed several times and sat at the side of the bed. Each time after returning to bed, he has experienced pain as if it were located in his right foot. Which nursing measure indicates the nurse has a thorough understanding of phantom pain and its management?
A. Phantom pain is entirely in the client's mind. The client should be instructed that the pain is psychological and should not be treated.
B. The basis for phantom pain may occur because the nerves still carry pain sensation to the brain even though the limb has been amputated. The pain is real, intense, and should be treated.
C. The cause of phantom pain is unknown. The nurse should provide the client with support, promote sleep, and handle the injured limb smoothly and gently.
D. Phantom pain is caused by trauma, spasms, and edema at the incisional site. It will decrease when postoperative edema decreases. It should be treated with nonnarcotic medication whenever possible.
A 27-year-old primigravida stated that she got up from the chair to fix dinner and bright red blood was running down her legs. She denies any pain previously or currently. The client is very concerned about whether her baby will be all right. Her vital signs include P 120 bpm, respirations 26 breaths/min, BP 104/58 mm Hg, temperature 98.2_F, and fetal heart rate 146 bpm. Laboratory findings revealed hemoglobin 9.0 g/dL, hematocrit 26%, and coagulation studies within normal range. On admission, the peripad she wore was noted to be half saturated with bright red blood. A medical diagnosis of placenta previa is made. The priority nursing diagnosis for this client would be:
A. Decreased cardiac output related to excessive bleeding
B. Potential for fluid volume excess related to fluid resuscitation
C. Anxiety related to threat to self
D. Alteration in parenting related to potential fetal injury
A client had a right below-the-knee amputation 4 days ago. He is complaining of pain in his right lower leg. The nurse should:
A. Remind the client that he no longer has that part of his leg and assure him he will be OK
B. Call the physician to request a psychological consultation for the client
C. Turn on the television to distract the client's attention from his amputated leg
D. Give the client his order of Demerol 50 mg IM prn
A successful executive left her job and became a housewife after her marriage to a plastic surgeon. She started doing volunteer work for a charity organization. She developed pain in her legs that advanced to the point of paralysis. Her physicians can find no organic basis for the paralysis. The client's behavior can be described as:
A. Housework phobia
B. Malingering
C. Conversion reaction
D. Agoraphobia
A depressed client is seen at the mental health center for follow-up after an attempted suicide 1 week ago. She has taken phenelzine sulfate (Nardil), a monoamine oxidase (MAO) inhibitor, for 7 straight days. She states that she is not feeling any better. The nurse explains that the drug must accumulate to an effective level before symptoms are totally relieved. Symptom relief is expected to occur within:
A. 10 days
B. 2-4 weeks
C. 2 months
D. 3 months
Forty-eight hours after a thyroidectomy, a female client complains of numbness and tingling of the toes and fingers. The nurse notes upper arm and facial twitching. The nurse needs to:
A. Report the findings to the physician
B. Assist the client to do range of motion exercises
C. Check the client's potassium level
D. Administer the as-needed dose of phenytoin (Dilantin)