[Aug-2026] NCLEX-RN Braindumps – NCLEX-RN Questions to Get Better Grades
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NEW QUESTION # 408
A 6-month-old infant who was diagnosed at 4 weeks of age with a ventricular septal defect, was admitted today with a diagnosis of failure to thrive. His mother stated that he had not been eating well for the past month. A cardiac catheterization reveals congestive heart failure. All of the following nursing diagnoses are appropriate. Which nursing diagnosis should have priority?
- A. Decreased cardiac output related to ineffective pumping action of the heart
- B. Altered growth and development related to decreased intake of food
- C. Activity intolerance related to imbalance between oxygen supply and demand
- D. Altered nutrition: less than body requirements related to inability to take in adequate calories
Answer: A
Explanation:
Explanation
(A) Altered nutrition occurs owing to the fatigue from decreased cardiac output associated with congestive heart failure. (B) The decreased intake occurs due to fatigue from the altered cardiac output. (C) Fatigue occurs due to the decreased cardiac output. (D) The ineffective action of the myocardium leads to inadequate O2 to the tissues, which produces activity intolerance, altered nutrition, and altered growth and development.
NEW QUESTION # 409
An 11-month-old infant is admitted with a possible diagnosis of pyloric stenosis. Which of the following best describes the characteristic clinical manifestations of pyloric stenosis?
- A. Increased frequency and quantity of stools
- B. Pain, especially when eating
- C. Poor appetite and sucking reflex
- D. Palpable olive-shaped mass in the epigastrium just right of the umbilical cord
Answer: D
Explanation:
(A) There is no evidence of pain in infants with pyloric stenosis whether eating or not. (B) There are both good appetite and feeding habits in these children. (C) Because of regurgitation, there is usually decreased frequency and quantity of stools and also signs of dehydration and weight loss. (D) Along with upper abdominal distention, there is a characteristic palpable olive-shaped mass located to the right of the umbilicus.
NEW QUESTION # 410
A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the gravida and para system to record the client's obstetrical history, the nurse should record:
- A. Gravida 2 para 2
- B. Gravida 2 para 1
- C. Gravida 3 para 2
- D. Gravida 3 para 1
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) This answer is an incorrect application of gravida and para. The client has had two prior deliveries of more than 20 weeks' gestation; therefore, para equals 2, not 1. (B) This answer is the correct application of gravida and para. The client is currently pregnant for the third time (G = 3), regardless of the length of the pregnancy, and has had two prior pregnancies with birth after the 20th week (P = 2), whether infant was alive or dead. (C) This answer is an incorrect application of gravida and para. The client is currently pregnant for the third time (G = 3, not 2); prior pregnancies lasted longer than 20 weeks (therefore, P = 2, not 1). (D) This is an incorrect application of gravida and para. Client is currently pregnant for third time (G
= 3, not 2).
NEW QUESTION # 411
A 26-year-old male client is brought by his wife to the emergency department (ED) unconscious. Blood is drawn for a stat blood count (CBC), fasting blood sugar level, and electrolytes. An indwelling urinary catheter is inserted. He has a history of type 1 diabetes (insulindependent diabetes mellitus [IDDM]). A diagnosis of ketoacidosis is made. Stat lab values reveal a blood sugar level of 520 mg/dL. Which of the following should the nurse expect to administer in the ER?
- A. NPH insulin SC
- B. Regular insulin by IV infusion
- C. Sweetened grape juice by mouth
- D. D50W by IV push
Answer: B
Explanation:
Section: Questions Set F
Explanation:
(A) This action would further increase the client's blood sugar. (B) NPH insulin is an intermediate-acting insulin, with an average of 4-6 hours before onset of action. The client needs insulin that will act immediately. During a ketoacidotic state, the client is dehydrated, so any insulin administered SC will be poorly absorbed. (C) Regular insulin is the fastest acting-insulin; when given IV, it will immediately act to decrease blood sugar. Regular insulin is given to decrease blood glucose levels by promoting metabolism of glucose, inhibiting lipolysis and formation of ketone bodies. (D) This action would further increase the client's blood sugar.
NEW QUESTION # 412
The physician of a client diagnosed with alcoholism orders neomycin 0.5 g q6h to prevent hepatic coma. Neomycin decreases serum ammonia levels by:
- A. Decreasing nitrogen-forming bacteria in the intestines
- B. Decreasing the uptake of vitamin D, thereby drawing more water into the colon
- C. Irritating the bowel and promoting evacuation of stool
- D. Acidifying colon contents by causing ammonia retention in the colon
Answer: A
Explanation:
(A) Neomycin interferes with protein synthesis in the bacterial cell, causing bacterial death. Neomycin reduces the growth of the ammonia-producing bacteria in the intestines and is used for the treatment of hepatic coma. (B) This choice describes the action of lactulose, another drug commonly used to decrease systemic ammonia levels. (C) Neomycin's action doesnotdecrease uptake of vitamin D to reduce serum ammonia levels. (D) Bowel irritation with diarrhea is more likely to occur with administration of lactulose rather than of neomycin. Besides, diarrhea is a side effect of a drug, not the action of the drug.
NEW QUESTION # 413
A dose of theophylline may need to be altered if a client with COPD:
- A. Operates machinery
- B. Is allergic to morphine
- C. Is concurrently on cimetidine for ulcers
- D. Has a history of arthritis
Answer: C
Explanation:
Explanation
(A) The effects of morphine or an allergic response to the drug will not affect theophylline clearance. (B) Xanthines are used cautiously in clients with severe cardiac disease, liver disease, cor pulmonale, hypertension, or hyperthyroidism. Arthritis does not influence the dosage of theophylline. (C) Theophylline does not cause sedation or drowsiness. Conversely, its side effects may be exhibited by central nervous system stimulation. (D) Cimetidine decreases theophylline clearance from the system and increases theophylline levels in the blood, thus increasing the risk of toxicity.
NEW QUESTION # 414
The nurse is collecting a nutritional history on a 28- year-old female client with iron-deficiency anemia and learns that the client likes to eat white chalk. When implementing a teaching plan, the nurse should explain that this practice:
- A. Will cause more premenstrual cramping
- B. Interferes with iron absorption because the iron precipitates as an insoluble substance
- C. Causes competition at iron-receptor sites between iron and vitamin B1
- D. Will bind calcium and therefore interfere with its metabolism
Answer: B
Explanation:
(A) Eating chalk is not related to calcium and its absorption. (B) Poor nutritional habits may result in increased discomfort during premenstrual days, but this is not a primary reason for the client to stop eating chalk. Premenstrual discomfort has not been mentioned. (C) Iron is rendered insoluble and is excreted through the gastrointestinal tract. (D) There is no competition between the two nutrients.
NEW QUESTION # 415
After the fetal activity test (nonstress test) is completed, the RN is looking at the test results on the monitor strip. The RN observes that the fetal heart accelerated 5 beats/min with each fetal movement. The accelerations lasted 15 seconds and occurred 3 times during the 20- minute test. The RN knows that these test results will be interpreted as:
- A. An unsatisfactory test
- B. A reactive test
- C. A nonreactive test
- D. A negative test
Answer: B
Explanation:
(A) A nonstress test that shows at least two accelerations of the fetal heart rate of 15 bpm with fetal activity, lasting 15 seconds over a 20-minute period. (B) Reactive criteria are not met. The accelerations of the fetal heart rate are not at least 15 bpm and do not last 15 seconds. This could mean fetal well-being is compromised. Usually a contraction stress test is ordered if the nonstress test results are negative. (C) An unsatisfactory test means the data cannot be interpreted, or there was inadequate fetal activity. If this happens, usually the test is ordered to be done at a later date. (D) A negative test is a term used to describe the results of a contraction stress test.
NEW QUESTION # 416
Discharge teaching for the client who has a total gastrectomy should include which of the following?
- A. Need to eat three full meals with plenty of fiber per day
- B. Follow-up visits every 3 weeks for the first 6 months
- C. Need for the client to increase fluid intake to 3000 mL/day
- D. B12 injections needed for the rest of the client's life
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) There will be no need to increase fluid intake excessively, because dumping syndrome could present a problem. (B) Followup visits every 3 weeks are not a standard recommendation. Follow-up visits will be highly individualized. (C) With removal of the stomach, intrinsic factor will no longer be produced. Intrinsic factor is necessary for vitamin B12 absorption. Parenteral injections of B12 will be needed on a monthly basis for the rest of the person's life. (D) Smaller, more frequent meals, rather than large, bulky meals, are recommended to prevent problems with dumping syndrome.
NEW QUESTION # 417
A 3-year-old child has had symptoms of influenza including fever, productive cough, nausea, vomiting, and sore throat for the past several days. In caring for a young child with symptoms of influenza, the mother must be cautioned about:
- A. Giving aspirin and bismuth subsalicylate (Pepto-Bismol) to treat the symptoms
- B. The possibility of pneumonia as a complication
- C. Giving clear liquids too soon
- D. Allowing the child to come in contact with other children for 3 days
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Aspirin should never be given to children with influenza because of the possibility of causing Reye's syndrome. Pepto- Bismol is also classified as a salicylate and should be avoided. (B) Depending on the severity of symptoms, the child may be receiving IV therapy or clear liquids. (C) The disease has a 1-3 day incubation period and affected children are most infectious 24 hours before and after the onset of symptoms. (D) Although viral pneumonia can be a complication of influenza, this would not be an initial priority.
NEW QUESTION # 418
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. Give the client his order of Demerol 50 mg IM prn
- 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. Remind the client that he no longer has that part of his leg and assure him he will be OK
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) The nurse is ignoring the client's pain. Telling the client that he will be OK will not relieve his phantom pain. (B) The client does not need a psychological consultation. Phantom pain is a normal sensation experienced by clients with amputations. (C) Using the television as a distractor will not relieve the client's phantom pain. (D) Phantom pain is a normal, very real experience for an amputee and should be treated with pain medication.
NEW QUESTION # 419
On a mother's 2nd postpartum day after having a vaginal delivery, the RN is preparing to assess her perineum and anus as part of her daily assessment. The best position for the client to be placed in for this assessment is:
- A. Any position that the RN chooses
- B. Sims'
- C. Prone
- D. Fowler's
Answer: B
Explanation:
Section: Questions Set C
Explanation:
(A) The Sims' position is the best position for assessment of the perineum and anus. The top leg is placed over the bottom leg, and the RN raises the upper buttocks to fully expose the perineum and anus. (B) Fowler's position is a sitting position, and the perineum and anus would not be exposed. (C) The prone position would have the mother on her back, and her perineum and anus would not be exposed. (D) The position of choice should always be the Sims'.
NEW QUESTION # 420
A 30-year-old female client is receiving antineoplastic chemotherapy. Which of the following symptoms should especially concern the nurse when caring for her?
- A. A sore throat
- B. Respiratory rate of 16 breaths/min
- C. Complaints of muscle aches
- D. Pulse rate of 80 bpm
Answer: A
Explanation:
(A) A respiratory rate of 16 breaths/min is normal and is not a cause for alarm. (B) A pulse rate of 80 bpm is normal and is not a cause for alarm. (C) Complaints of muscle aches are unrelated to her receiving chemotherapy. There may be other causes related to her hospital stay or the disease process. (D) A sore throat is an indication of a possible infection. A client receiving chemotherapy is at risk of neutropenia. An infection in the presence of neutropenia can result in a life-threatening situation.
NEW QUESTION # 421
A client is experiencing visual problems at school. She has complained of difficulty seeing the blackboard and squinting. She no longer likes to participate in physical activities such as softball. The client has displayed possible classic symptoms of which refractive error?
- A. Myopia
- B. Amblyopia
- C. Astigmatism
- D. Hyperopia
Answer: A
Explanation:
Explanation
(A) Visual images are blurred and distorted. (B) Symptoms are headaches, burning eyes, fatigue, squinting, and difficulty reading. (C) These symptoms are classic for myopia. (D) Amblyopia is not a refractive error. It is a loss of vision in one or both eyes.
NEW QUESTION # 422
When planning care for a 9-year-old client, the nurse uses which of the most effective means of helping siblings cope with their feelings about a brother who is terminally ill?
- A. Open discussion and understanding
- B. Storytelling
- C. Play-acting out feelings in different roles
- D. Drawing pictures
Answer: C
Explanation:
Section: Questions Set G
Explanation:
(A) When dealing with grief, siblings are usually most comfortable initially with open discussion. (B) Assuming different roles allows children to act out their feelings without fear of reprisals and to gain insight and control.
(C) This method may be helpful, but having the child take an active part through role playing is more effective.
(D) This technique may be helpful, but being an active participant through role playing is more effective.
NEW QUESTION # 423
A 55-year-old client is unconscious, and his physician has decided to begin tube feeding him using a smallbore silicone feeding tube (Keofeed, Duo-Tube). After the tube is inserted, the nurse identifies the most reliable way to confirm appropriate placement is to:
- A. Aspirate gastric contents
- B. Place the tip of the tube under water and observe for air bubbles
- C. Obtain a chest x-ray
- D. Auscultate air insufflated through the tube
Answer: C
Explanation:
Explanation
(A) Aspiration of gastric contents is usually a reliable way to verify tube placement. However, if the client has dark respiratory secretions from bleeding, tube feedings could be mistaken for respiratory secretions; in other words, aspirating an empty stomach is less reliable in this instance. In addition, it is common for small-bore feeding tubes to collapse when suction pressure is applied. (B) Insufflation of air into large-bore nasogastric tubes can usually be clearly heard. In small-bore tubes, it is more difficult to hear air, and it is difficult to distinguish between air in the stomach and air in the esophagus. (C) A chest x-ray is the most reliable means to determine placement of small-bore nasogastric tubes. (D) Observing for air bubbles when the tip is held under water is an unreliable means to determine correct tube placement for all types of nasogastric tubes. Air may come from both the respiratory tract and the stomach, and the client who is breathing shallowly may not force air out of the tube into the water.
NEW QUESTION # 424
A 45-year-old male client was admitted to a chemical dependency treatment center following legal problems related to alcohol abuse. He states, "I know that alcohol is a problem for some people, but I can stop whenever I want to. I'm never sick or miss work, and no one can complain about me." During the initial assessment, the best response by the nurse would be:
- A. "It's good that you can stop drinking when you want to."
- B. "The fact is you are an alcoholic or you wouldn't be here."
- C. "I understand it took strength to admit yourself to the unit, and I will do my part to help you to stay alcohol- free."
- D. "If you can stop drinking when you want to, why don't you stop?"
Answer: C
Explanation:
(A) Direct confrontation initially is nontherapeutic and may result in the client becoming frustrated and wanting to leave. (B) A positive, supportive attitude builds trust, and identifying positive strength raises self-esteem. Offering help allows the client to feel that he is not alone in dealing with problems. (C) Asking the client why or to give an explanation for his behavior puts him in a position of having to justify his behavior to the nurse. (D) Giving approval or placing a value on feelings or a behavior may limit the client's freedom to behave in a way that may displease another. This response may lead to seeking praise instead of progress.
NEW QUESTION # 425
A physician's order reads: Administer furosemide oral solution 0.5 mL stat. The furosemide bottle dosage is
10 mg/mL. What dosage of furosemide should the nurse give to this infant?
- A. 0.5 mg
- B. 5 mg
- C. 20 mg
- D. 0.05 mg
Answer: B
Explanation:
Explanation
(A) 1 mg = 0.1 mL, then 0.5 mL X= 55 mg. (B) Thisanswer is a miscalculation. (C) This answer is a miscalculation. (D) This answer is a miscalculation.
NEW QUESTION # 426
A 29-year-old client delivered her fifth child by the Lamaze method and developed a postpartal hemorrhage in the recovery room. What are the initial symptoms of shock that she may experience?
- A. Decreased systolic pressure, cold skin, and anuria
- B. Rapid pulse; narrowed pulse pressure; cool, moist skin
- C. No urinary output, tachycardia, and restlessness
- D. Marked elevation in blood pressure, respirations, and pulse
Answer: B
Explanation:
(A) Early shock does not exhibit the symptom of marked elevation in blood pressure. A narrowing of the pulse pressure is indicative of early shock. (B) Anuria is a clinical finding in late shock. (C) All of these clinical findings are congruent with early shock. (D) Absence of urinary output is a clinical finding in the late phase of shock.
NEW QUESTION # 427
A 16-month-old infant is being prepared for tetralogy of Fallot repair. In the nursing assessment, which lab value should elicit further assessment and requires notification of physician?
- A. White blood cell (WBC) count 10,000 WBCs/mm3
- B. Hematocrit 60%
- C. pH 7.39
- D. Bleeding time of 4 minutes
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Normal pH of arterial blood gases for an infant is 7.35-7.45. (B) Normal white blood cell count in an infant is 6,000-17,500 WBCs/mm3. (C) Normal hematocrit in infant is 28%-42%. A 60% hematocrit may indicate polycythemia, a common complication of cyanotic heart disease. (D) Normal bleeding time is 2-7 minutes.
NEW QUESTION # 428
Which of the following would the nurse expect to find following respiratory assessment of a client with advanced emphysema?
- A. Decreased anteroposterior chest diameter
- B. Increased heart sounds
- C. Distant breath sounds
- D. Collapsed neck veins
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(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.
NEW QUESTION # 429
A client tells the nurse that he has been hearing voices that tell him to kill his girlfriend because she is a spy. He further states that he is having difficulty not obeying the voices because, if he does not, his house will be burned down. The highest priority nursing diagnosis for him at this time is:
- A. Potential for violence directed at others
- B. Alteration in thought processes: paranoid delusions
- C. Sensory-perceptual alteration: auditory command hallucinations
- D. Impaired verbal communication: loose associations
Answer: A
Explanation:
(A) Although the client is having command hallucinations, this is second in priority to real or potential violence, which can be a threat to life itself. (B) Although the client is experiencing delusions, this is also a lower priority than his potential or actual loss of control. (C) Whether real or potential, violence directed at self or others is always high priority. (D) There is no evidence of loosening of associations.
NEW QUESTION # 430
Children often experience visual impairments. Refractive errors affect the child's visual activity. The main refractive error seen in children is myopia. The nurse explains to the child's parents that myopia may also be described as:
- A. Farsightedness
- B. Cataracts
- C. Lazy eye
- D. Nearsightedness
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Cataracts are not considered refractive errors. Cataracts canbe described as opacity of the lens. (B) Hyperopiais the term forfarsightedness. One can see objects at a distance more clearlythan close objects.
(C)Myopiais the term for nearsightedness.Objects that are close in distance are more clearly seen. (D) Lazyeye refers to strabismus or misalignment of the eyes.
NEW QUESTION # 431
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