Real NCLEX-RN Exam Answers, Latest NCLEX-RN Material

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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q39-Q44):

NEW QUESTION # 39
A 48-year-old client is in the surgical intensive care unit after having had three-vessel coronary artery bypass surgery yesterday. She is extubated, awake, alert and talking. She is receiving digitalis for atrial arrhythmias.
This morning serum electrolytes were drawn. Which abnormality would require immediate intervention by the nurse after contacting the physician?

A. Blood urea nitrogen is subnormal. The nurse should increase the protein in the client's diet as soon as possible.
B. Serum sodium is low. The nurse should change IV fluids to normal saline.
C. Serum osmolality is elevated indicating hemoconcentration.The nurse should increase IV fluid rate.
D. Serum potassium is low. The nurse should administer KCl as ordered.

Answer: D

Explanation:
Explanation
(A) An elevated serum osmolality poses no immediate danger and is not corrected rapidly. (B) A low serum sodium alone does not warrant changing IV fluids to normal saline. Other assessment parameters, such as hydration status, must be considered. (C) A low serum blood urea nitrogen is not necessarily indicative of protein deprivation. It may also be the result of overhydration. (D)A low serum potassium potentiates the effects of digitalis, predisposing the client to dangerous arrhythmias. It must be corrected immediately.

NEW QUESTION # 40
Pin care is a part of the care plan for a client who is in skeletal traction. When assessing the site of pin insertion, which one of the following findings would the nurse know as an indicator of normal wound healing?

A. Crust
B. Erythema
C. Exudate
D. Edema

Answer: A

Explanation:
Explanation
(A) Exudate (moist, active drainage) is a clinical sign of wound infection. (B) Crust (dry, scaly) is part of the normal stages of wound healing and should not be removed from around the pin site. It usually sloughs off after the underlying tissue has healed. (C) Edema (swelling) is a clinical sign of wound infection. (D) Erythema (redness) is a clinical sign of wound infection.

NEW QUESTION # 41
A client develops an intestinal obstruction postoperatively. A nasogastric tube is attached to low, intermittent suction with orders to "Irrigate NG tube with sterile saline q1h and prn." The rationale for using sterile saline, as opposed to using sterile water to irrigate the NG tube is:

A. Saline will reduce the risk of severe, colicky abdominal pain during NG irrigation.
B. Water will deplete electrolytes resulting in metabolic acidosis.
C. Water is not isotonic and will increase restlessness and insomnia in the immediate postoperative period.
D. Saline will increase peristalsis in the bowel.

Answer: B

Explanation:
(A) Water is a hypotonic solution and will deplete electrolytes and cause metabolic acidosis when used for nasogastric irrigation. (B) Irrigating with saline does not cause abdominal discomfort. Severe, colicky abdominal pain is a symptom of intestinal obstruction. (C) Irrigating with water will not cause restlessness or insomnia in the postoperative client. Restlessness and insomnia can be emotional complications of surgery. (D) A nasogastric tube placed in the stomach is used to decompress the bowel. Irrigating with saline ensures a patent, well-functioning tube. Irrigating with saline will not increase peristalsis.

NEW QUESTION # 42
A client is being discharged from the hospital today. The discharge teaching for care of her colostomy included which of the following basic principles for protecting the skin around her stoma:

A. Using a skin sealant under pouch adhesives
B. Cutting the skin barrier 112 inches larger than the stoma
C. Changing the pouch only when leakage occurs
D. Taping a pouch that is leaking

Answer: A

Explanation:
(A) When a pouch seal leaks, the pouch should be immediately changed, not taped. Stool held against the skin can quickly result in severe irritation. (B) The skin barrier should be cut only slightly larger than the stoma (one-half inch). (C) The client should be taught to change pouches whenever possible before leakage occurs. (D) When skin sealant is used under the tape, the outermost layer of the epidermis remains intact. When no skin sealant
is used, this layer is removed when the tape is removed.

NEW QUESTION # 43
A 55-year-old woman entered the emergency room by ambulance. Her primary complaint is chest pain. She is receiving O2 via nasal cannula at 2 L/min for dyspnea. Which of the following findings in the client's nursing assessment demand immediate nursing action?

A. Inability to tolerate assessment session with the admitting nurse
B. Restlessness and apprehensiveness
C. History of hypertension treated with pharmacological therapy
D. Associated symptoms of indigestion and nausea

Answer: B

Explanation:
Explanation
(A) Indigestion or nausea may accompany angina or myocardial infarction, but they do not indicate imminent danger for the client. (B) Restlessness and apprehensiveness require immediate nursing action because they are indicative of very low oxygenation of body tissues and are frequently the first indication of impending cardiac or respiratory arrest. (C) It is common for the cardiac client to experience fatigue and inability to physically tolerate long assessment sessions. (D) A history of hypertension requires no immediate nursing intervention.
In the situation described, the blood pressure is not given and therefore cannot be assumed to be elevated.

NEW QUESTION # 44
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