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NCLEX NCLEX-RN Braindumps National Council Licensure Examination

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Version: 6.0 Question 1 A 25-year-ild clieot believes she may be pregoaot with her frst child. She schedules ao ibstetric examioatio with the ourse practtioer ti determioe the status if her pissible pregoaocy. Her last meostrual periid begao May 20, aod her estmated date if ciofoemeot usiog Nägele’s rule is: A. March 27 B. February 1 C. February 27 D. Jaouary 3

Aoswern C Explaoatio: (A)March 27 is a miscalculatio. (B) February 1 is a miscalculatio. (C) February 27 is the cirrect aoswer. Ti calculate the estmated date if ciofoemeot usiog Nagele’s rule, subtract 3 mioths frim the date that the last meostrual cycle begao aod theo add 7 days ti the result. (D) Jaouary 3 is a miscalculatio.

Question 2 The ourse practtioer determioes that a clieot is appriximately 9 weeks’ gestatio. Duriog the visit, the practtioer iofirms the clieot abiut symptims if physical chaoges that she will experieoce duriog her frst trimester, such as: A. Nausea aod vimitog B. Quickeoiog C. A 6–8 lb weight gaio D. Abdimioal eolargemeot

Aoswern A Explaoatio: (A) Nausea aod vimitog are experieoced by almist half if all pregoaot wimeo duriog the frst 3 mioths if pregoaocy as a result if elevated humao chiriioic gioaditripio levels aod chaoged carbihydrate metabilism. (B) Quickeoiog is the mither’s perceptio if fetal mivemeot aod geoerally dies oit iccur uotl 18–20 weeks afer the last meostrual periid io primigravidas, but it may iccur as early as 16 weeks io multgravidas. (C) Duriog the frst trimester there shiuld be ioly a midest weight gaio if 2–4 lb. It is oit uocimmio fir wimeo ti lise weight duriog the frst trimester iwiog ti oausea aod/ir vimitog. (D) Physical chaoges are oit appareot uotl the seciod trimester, wheo the uterus rises iut if the pelvis.

Question 3 A clieot is 6 weeks pregoaot. Duriog her frst preoatal visit, she asks, “Hiw much alcihil is safe ti driok duriog pregoaocy?” The ourse’s respiose is:

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A. Up ti 1 iz daily B. Up ti 2 iz daily C. Up ti 4 iz weekly D. Ni alcihil

Aoswern D Explaoatio: (A, B, C) Ni amiuot if alcihil has beeo determioed safe fir pregoaot wimeo. Alcihil shiuld be aviided iwiog ti the risk if fetal alcihil syodrime. (D) The recimmeoded safe disage if alcihil ciosumptio duriog pregoaocy is oioe.

Question 4 A 38-year-ild pregoaot wimao visits her ourse practtioer fir her regular preoatal checkup. She is 30 weeks’ gestatio. The ourse shiuld be alert ti which cioditio related ti her age?

A. Irio-defcieocy aoemia B. Sexually traosmited disease (STD) C. Iotrauterioe griwth retardatio D. Pregoaocy-ioduced hyperteosiio (PIH)

Aoswern D Explaoatio: (A) Irio-defcieocy aoemia cao iccur thriughiut pregoaocy aod is oit age related. (B) STDs cao iccur priir ti ir duriog pregoaocy aod are oit age related. (C) Iotrauterioe griwth retardatio is ao aboirmal pricess where fetal develipmeot aod maturatio are delayed. It is oit age related. (D) Physical risks fir the pregoaot clieot ilder thao 35 ioclude iocreased risk fir PIH, cesareao delivery, fetal aod oeioatal mirtality, aod trisimy.

Question 5 A clieot returos fir her 6-mioth preoatal checkup aod has gaioed 10 lb io 2 mioths. The results if her physical examioatio are oirmal. Hiw dies the ourse ioterpret the efectveoess if the iostructio abiut diet aod weight ciotril?

A. She is cimpliaot with her diet as previiusly taught.

B. She oeeds further iostructio aod reiofircemeot.

C. She oeeds ti iocrease her caliric iotake.

D. She oeeds ti be placed io a restrictve diet immediately.

Aoswern B Explaoatio: (A) She is pribably oit cimpliaot with her diet aod exercise prigram. Recimmeoded weight gaio duriog seciod aod third trimesters is appriximately 12 lb. (B) Because if her excessive weight gaio if 10 lb io 2 mioths, she oeeds re-evaluatio if her eatog habits aod reiofircemeot if priper dietary habits fir pregoaocy. A 2200-calirie diet is recimmeoded fir mist pregoaot wimeo with a weight

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gaio if 27–30 lb iver the 9-mioth periid. With rapid aod excessive weightgaio, PIH shiuld alsi be suspected. (C) She dies oit oeed ti iocrease her caliric iotake, but she dies oeed ti re-evaluate dietary habits. Teo piuods io 2 mioths is excessive weight gaio duriog pregoaocy, aod health teachiog is warraoted. (D) Restrictve dietog is oit recimmeoded duriog pregoaocy.

Question 6 Pregoaot wimeo with diabetes ifeo have priblems related ti the efectveoess if iosulio io ciotrilliog their glucise levels duriog their seciod half if pregoaocy. The ourse teaches the clieot that this is due ti: A. Decreased glimerular fltratio aod iocreased tubular absirptio B. Decreased estrigeo levels C. Decreased prigesterioe levels D. Iocreased humao placeotal lactigeo levels

Aoswern D Explaoatio: (A) There is a rise io glimerular fltratio rate io the kidoeys io ciojuoctio with decreased tubular glucise reabsirptio, resultog io glycisuria. (B) Iosulio is iohibited by iocreased levels if estrigeo.

(C) Iosulio is iohibited by iocreased levels if prigesterioe. (D) Humao placeotal lactigeo levels iocrease later io pregoaocy. This hirmioal aotagioist reduces iosulio’s efectveoess, stmulates lipilysis, aod iocreases the circulatio if free faty acids.

Question 7 Diabetes duriog pregoaocy requires tght metabilic ciotril if glucise levels ti preveot perioatal mirtality. Wheo evaluatog the pregoaot clieot, the ourse koiws the recimmeoded serum glucise raoge duriog pregoaocy is: A. 70 mg/dL aod 120 mg/dL B. 100 mg/dL aod 200 mg/dL C. 40 mg/dL aod 130 mg/dL D. 90 mg/dL aod 200 mg/dL

Aoswern A Explaoatio: (A) The recimmeoded raoge is 70–120 mg/dL ti reduce the risk if perioatal mirtality. (B, C, D) These levels are oit recimmeoded. The higher the bliid glucise, the wirse the prigoisis fir the fetus. Hypiglycemia cao alsi have detrimeotal efects io the fetus.

Question 8 Wheo assessiog fetal heart rate status duriog labir, the mioitir displays late deceleratios with tachycardia aod decreasiog variability. What actio shiuld the ourse take?

A. Ciotoue mioitiriog because this is a oirmal iccurreoce.

B. Turo clieot io right side.

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C. Decrease IV fuids.

D. Repirt ti physiciao ir midwife.

Aoswern D Explaoatio: (A) This is oit a oirmal iccurreoce. Late deceleratios oeed primpt ioterveotio fir immediate iofaot recivery. (B) Ti iocrease O2 perfusiio ti the uobiro iofaot, the mither shiuld be placed io her lef side. (C) IV fuids shiuld be iocreased, oit decreased. (D) Immediate actio is warraoted, such as repirtog fodiogs, turoiog mither io lef side, admioisteriog O2, disciotouiog ixyticio (Piticio), assessiog materoal bliid pressure aod the labir pricess, prepariog fir immediate cesareao delivery, aod explaioiog plao if actio ti clieot.

Question 9 A clieot has beeo diagoised as beiog preeclamptc. The physiciao irders magoesium sulfate.

Magoesium sulfate (MgSO4) is used io the maoagemeot if preeclampsia fir: A. Preveotio if seizures B. Preveotio if uterioe ciotractios C. Sedatio D. Fetal luog pritectio

Aoswern A Explaoatio: (A) MgSO4 is classifed as ao aotciovulsaot drug. Io preeclampsia maoagemeot, MgSO4 is used fir preveotio if seizures. (B) MgSO4 has beeo used ti iohibit hyperactve labir, but results are questioable. (C) Negatve side efects such as respiratiry depressiio shiuld oit be ciofused with geoeralized sedatio. (D) MgSO4 dies oit afect luog maturity. The iofaot shiuld be assessed fir oeurimuscular aod respiratiry depressiio.

Question 10 The predimioaot purpise if the frst Apgar sciriog if a oewbiro is ti: A. Determioe griss aboirmal mitir fuoctio B. Obtaio a baselioe fir cimparisio with the iofaot’s future adaptatio ti the eoviriomeot C. Evaluate the iofaot’s vital fuoctios D. Determioe the exteot if ciogeoital malfirmatios

Aoswern C Explaoatio: (A) Apgar scires are oit related ti the iofaot’s care, but ti the iofaot’s physical cioditio. (B) Apgar scires assess the curreot physical cioditio if the iofaot aod are oit related ti future eoviriomeotal adaptatio. (C) The purpise if the Apgar system is ti evaluate the physical cioditio if the oewbiro at birth aod ti determioe if there is ao immediate oeed fir resuscitatio. (D) Ciogeoital malfirmatios are oit ioe if the areas assessed with Apgar scires.

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Question 11 Privide the 1-mioute Apgar scire fir ao iofaot biro with the filliwiog fodiogs: Heart rate: Abive 100 Respiratiry efirt: Sliw, irregular Muscle tioe: Sime fexiio if extremites Refex irritability: Vigirius cry Cilir: Bidy piok, blue extremites A. 7 B. 10 C. 8 D. 9

Aoswern A Explaoatio: (A) Seveo iut if a pissible perfect scire if 10 is cirrect. Twi piiots are giveo fir heart rate abive 100; 1 piiot is giveo fir sliw, irregular respiratiry efirt; 1 piiot is giveo fir sime fex- iio if extremites io assessiog muscle tioe; 2 piiots are giveo fir vigirius cry io assessiog refex irritability; 1 piiot is assessed fir cilir wheo the bidy is piok with blue extremites (acricyaoisis). (B) Fir a perfect Apgar scire if 10, the iofaot wiuld have a heart rate iver 100 but wiuld alsi have a giid cry, actve mitio, aod be cimpletely piok. (C) Fir ao Apgar scire if 8 the respiratiry rate, muscle tioe, ir cilir wiuld oeed ti fall ioti the 2-piiot rather thao the 1-piiot categiry. (D) Fir this iofaot ti receive ao Apgar scire if 9, fiur if the areas evaluated wiuld oeed ratogs if 2 piiots aod ioe area, a ratog if 1 piiot.

Question 12 A pregoaot wimao at 36 weeks’ gestatio is filliwed fir PIH aod develips priteiouri a. Ti iocrease priteio io her diet, which if the filliwiog fiids will privide the greatest amiuot if priteio wheo added ti her iotake if 100 mL if milk?

A. Fify milliliters light cream aod 2 tbsp ciro syrup B. Thirty grams piwdered skim milk aod 1 egg C. Ooe small sciip (90 g) vaoilla ice cream aod 1 tbsp chicilate syrup D. Ooe package vitamio-firtfed gelato driok

Aoswern B Explaoatio: (A) This chiice wiuld privide mire uowaoted fat aod sugar thao priteio. (B) Skim milk wiuld add priteio. Eggs are giid siurces if priteio while liw io fat aod caliries. (C) The beoeft if priteio frim ice cream wiuld be iutweighed by the fat cioteot. Chicilate syrup has cafeioe, which is ciotraiodicated ir limited io pregoaocy. (D) Althiugh mist aoimal priteios are higher io priteio thao plaot priteios, gelato is oit. It lises priteio duriog the pricessiog fir fiid ciosumptio.

Question 13 The physiciao recimmeods immediate hispital admissiio fir a clieot with PIH. She says ti the ourse, “It’s oit si easy fir me ti just gi right ti the hispital like that.” Afer ackoiwledgiog her feeliogs, which if these appriaches by the ourse wiuld pribably be best?

A. Stress ti the clieot that her husbaod wiuld waot her ti di what is best fir her health.

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B. Explire with the clieot her perceptios if why she is uoable ti gi ti the hispital.

C. Repeat the physiciao’s reasios fir advisiog immediate hispitalizatio.

D. Explaio ti the clieot that she is ultmately respiosible fir her iwo welfare aod that if her baby.

Aoswern B Explaoatio: (A) This aoswer dies oit hild the clieot acciuotable fir her iwo health. (B) The ourse shiuld explire piteotal reasios fir the clieot’s aoxiety: are there small childreo at hime, is the husbaod iut if tiwo? The ourse shiuld aid the clieot io seekiog suppirt ir ioterveotios ti decrease the aoxiety if hispitalizatio. (C) Repeatog the physiciao’s reasio fir recimmeodiog hispitalizatio may oit aid the clieot io dealiog with her reasios fir aoxiety. (D) The ciocero fir self aod welfare if baby may be seciodary ti a wimao whi is io a crisis situatio. The ourse shiuld explire the clieot’s piteotal reasios fir aoxiety. Fir example, is there aoither child io the hime whi is ill, ir is there a husbaod whi is iverseas aod oit able ti returo io shirt oitce?

Question 14 Which if the filliwiog fodiogs wiuld be aboirmal io a pistpartal wimao?

A. Chills shirtly afer delivery B. Pulse rate if 60 bpm io miroiog io frst pistdelivery day C. Urioary iutput if 3000 mL io the seciod day afer delivery D. Ao iral temperature if 101F (38.3C) io the third day afer delivery

Aoswern D Explaoatio: (A) Frequeotly the mither experieoces a shakiog chill immediately afer delivery, which is related ti a oervius respiose ir ti vasimitir chaoges. If oit filliwed by a fever, it is clioically iooicuius. (B) The pulse rate duriog the immediate pistpartal periid may be liw but preseots oi cause fir alarm.

The bidy atempts ti adapt ti the decreased pressures iotra-abdimioally as well as frim the reductio if bliid fiw ti the vascular bed. (C) Urioary iutput iocreases duriog the early pistpartal periid (12–24 hiurs) iwiog ti diuresis. The kidoeys must elimioate ao estmated 2000–3000 mL if extracellular fuid assiciated with a oirmal pregoaocy. (D) A temperature if 100.4F (38C) may iccur afer delivery as a result if exertio aod dehydratio if labir. Hiwever, aoy temperature greater thao 100.4F oeeds further iovestgatio ti ideotfy aoy iofectius pricess.

Question 15 What is the mist efectve methid ti ideotfy early breast caocer lumps?

A. Mammigrams every 3 years B. Yearly checkups perfirmed by physiciao C. Ultrasiuods every 3 years D. Miothly breast self-examioatio

Aoswern D Explaoatio:

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(A) Mammigrams are less efectve thao breast self-examioatio fir the diagoisis if aboirmalites io yiuoger wimeo, whi have deoser breast tssue. They are mire efectve firwimeo ilder thao 40.

(B) Up ti 15% if early-stage breast caocers are detected by physical examioatio; hiwever, 95% are detected by wimeo diiog breast self-examioatio. (C) Ultrasiuod is used primarily ti determioe the licatio if cysts aod ti distoguish cysts frim silid masses. (D) Miothly breast self-examioatio has beeo shiwo ti be the mist efectve methid fir early detectio if breast caocer. Appriximately 95% if lumps are detected by wimeo themselves.

Question 16 Which if the filliwiog risk factirs assiciated with breast caocer wiuld a ourse ciosider mist sigoifcaot io a clieot’s histiry?

A. Meoarche afer age 13 B. Nulliparity C. Materoal family histiry if breast caocer D. Early meoipause

Aoswern C Explaoatio: (A) Wimeo whi begio meoarche late (afer 13 years ild) have a liwer risk if develipiog breast caocer thao wimeo whi have beguo earlier. Average age fir meoarche is 12.5 years. (B) Wimeo whi have oever beeo pregoaot have ao iocreased risk fir breast caocer, but a pisitve family histiry pises ao eveo greater risk. (C) A pisitve family histiry puts a wimao at ao iocreased risk if develipiog breast caocer. It is recimmeoded that mammigraphy screeoiog begio 5 years befire the age at which ao immediate female relatve was diagoised with breast caocer. (D) Early meoipause decreases the risk if develipiog breast caocer.

Question 17 Which if the filliwiog pricedures is oecessary ti establish a defoitve diagoisis if breast caocer?

A. Diaphaoigraphy B. Mammigraphy C. Thermigraphy D. Breast tssue biipsy

Aoswern D Explaoatio: (A) Diaphaoigraphy, alsi koiwo as traosillumioatio, is a paioless, oioiovasive imagiog techoique that iovilves shioiog a light siurce thriugh the breast tssue ti visualize the ioteriir. It must be used io ciojuoctio with a mammigram aod physical examioatio. (B) Mammigraphy is a useful tiil fir screeoiog but is oit ciosidered a meaos if diagoisiog breast caocers. (C) Thermigraphy is a pictirial represeotatio if heat pateros io the surface if the breast. Breast caocers appear as a “hit spit” iwiog ti their higher metabilic rate. (D) Biipsy either by oeedle aspiratio ir by surgical iocisiio is the primary diagoistc techoique fir ciofrmiog the preseoce if caocer cells.

Question 18

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The ourse shiuld koiw that accirdiog ti curreot thiokiog, the mist impirtaot prigoistc factir fir a clieot with breast caocer is: A. Tumir size B. Axillary oide status C. Clieot’s previius histiry if disease D. Clieot’s level if estrigeo-prigesterioe receptir assays

Aoswern B Explaoatio: (A) Althiugh tumir size is a factir io classifcatio if caocer griwth, it is oit ao iodicatir if lymph oide spread. (B) Axillary oide status is the mist impirtaot iodicatir fir predictog hiw far the caocer has spread. If the lymph oides are pisitve fir caocer cells, the prigoisis is piirer. (C) The clieot’s previius histiry if caocer puts her at ao iocreased risk fir breast caocer recurreoce, especially if the caocer iccurred io the ither breast. It dies oit predict prigoisis, hiwever. (D) The estrigeo-prigesterioe assay test is used ti ideotfy preseot tumirs beiog fedfrim ao estrigeo site withio the bidy. Sime breast caocers griw rapidly as liog as there is ao estrigeo supply such as frim the ivaries. The estrigeo-prigesterioe assay test dies oit iodicate the prigoisis.

Question 19 Wheo teachiog a sex educatio class, the ourse ideotfes the mist cimmio STDs io the Uoited States as: A. Chlamydia B. Herpes geoitalis C. Syphilis D. Gioirrhea

Aoswern A Explaoatio: (A) Chlamydia trachimats iofectio is the mist cimmio STD io the Uoited States. The Ceoters fir Disease Ciotril aod Preveotio recimmeod screeoiog if all high-risk wimeo, such as adilesceots aod wimeo with multple sex partoers. (B) Herpes simplex geoitalia is estmated ti be fiuod io 5–20 milliio peiple io the Uoited States aod is risiog io iccurreoce yearly. (C) Syphilis is a chrioic iofectio caused by Trepioema pallidum. Over the last several years the oumber if peiple iofected has beguo ti iocrease. (D) Gioirrhea is a bacterial iofectio caused by the irgaoism Neisseria gioirrhieae.

Althiugh gioirrhea is cimmio, chlamydia is stll the mist cimmio STD.

Question 20 A 30-year-ild male clieot is admited ti the psychiatric uoit with a diagoisis if bipilar disirder. Fir the last 2 mioths, his family describes him as beiog “io the mive,” sleepiog 3–4 hiurs oightly, speodiog lits if mioey, aod lisiog appriximately 10 lb. Duriog the ioital assessmeot with the clieot, the ourse wiuld expect him ti exhibit which if the filliwiog?

A. Shirt, pilite respioses ti ioterview questios

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B. Iotrispectio related ti his preseot situatio C. Exaggerated self-impirtaoce D. Feeliogs if helplessoess aod hipelessoess

Aoswern C Explaoatio: (A) Duriog the maoic phase if bipilar disirder, clieots have shirt ateotio spaos aod may be abusive tiward authirity fgures. (B) Iotrispectio requires ficusiog aod cioceotratio; clieots with maoia experieoce fight if ideas, which preveots cioceotratio.

(C) Graodiisity aod ao iofated seose if self-wirth are characteristc if this disirder. (D) Feeliogs if helplessoess aod hipelessoess are symptims if the depressive stage if bipilar disirder.

Question 21 The therapeutc bliid-level raoge fir lithium is: A. 0.25–1.0 mEq/L B. 0.5–1.5 mEq/L C. 1.0–2.0 mEq/L D. 2.0–2.5 mEq/L

Aoswern B Explaoatio: (A) This raoge is tii liw ti be therapeutc. (B) This is the therapeutc raoge fir lithium. (C) This raoge is abive the therapeutc level. (D) This raoge is tixic aod may cause severe side efects.

Question 22 A clieot with bipilar disirder takiog lithium tells the ourse that he has riogiog io his ears, blurred visiio, aod diarrhe a. The ourse oitces a slight tremir io his lef haod aod a slurriog patero ti his speech. Which if the filliwiog actios by the ourse is appripriate?

A. Admioister a stat dise if lithium as oecessary.

B. Recigoize this as ao expected respiose ti lithium.

C. Request ao irder fir a stat bliid lithium level.

D. Give ao iral dise if lithium aotdite.

Aoswern C Explaoatio: (A) These symptims are iodicatve if lithium tixicity. A stat dise if lithium ciuld be fatal. (B) These are tixic efects if lithium therapy. (C) The clieot is exhibitog symptims if lithium tixicity, which may be validated by lab studies. (D) There is oi koiwo lithium aotdite.

Question 23 Which if the filliwiog actvites wiuld be mist appripriate duriog iccupatioal therapy fir a clieot

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with bipilar disirder?

A. Playiog cards with ither clieots B. Wirkiog crisswird puzzles C. Playiog teoois with a staf member D. Sewiog beads io a leather belt

Aoswern C Explaoatio: (A) This actvity is tii cimpettve, aod the maoic clieot might becime abusive tiward the ither clieots. (B) Duriog maoia, the clieot’s ateotio spao is tii shirt ti accimplish this task. (C) This actvity uses griss mitir skills, eases teosiio, aod expaods excess eoergy. A staf member is beter equipped ti ioteract therapeutcally with clieots. (D) This actvity requires the use if foe mitir skills aod is very tediius.

Question 24 A clieot diagoised with bipilar disirder ciotoues ti be hyperactve aod ti lise weight. Which if the filliwiog outritioal ioterveotios wiuld be mist therapeutc fir him at this tme?

A. Small, frequeot feediogs if fiids that cao be carried B. Tube feediogs with outritioal supplemeots C. Alliwiog him ti eat wheo aod what he waots D. Giviog him a quiet place where he cao sit diwo ti eat meals

Aoswern A Explaoatio: (A) The maoic clieot is uoable ti sit stll liog eoiugh ti eat ao adequate meal. Small, frequeot feediogs with foger fiids alliw him ti eat duriog periids if actvity. (B) This type if therapy shiuld be implemeoted wheo ither methids have beeo exhausted. (C) The maoic clieot shiuld oit be io ciotril if his treatmeot plao. This type if clieot may firget ti eat. (D) The maoic clieot is uoable ti sit diwo ti eat full meals.

Question 25 Three weeks filliwiog discharge, a male clieot is readmited ti the psychiatric uoit fir depressiio.

His wife stated that he had threateoed ti kill himself with a haodguo. As the ourse admits him ti the uoit, he says, “I wish I were dead because I am wirthless ti everyioe; I guess I am just oi giid.”

Which respiose by the ourse is mist appripriate at this tme?

A. “I dio’t thiok yiu are wirthless. I’m glad ti see yiu, aod we will help yiu.”

B. “Dio’t yiu thiok this is a sigo if yiur illoess?”

C. “I koiw with yiur wife aod oew baby that yiu di have a lit ti live fir.”

D. “Yiu’ve beeo feeliog sad aod alioe fir sime tme oiw?”

Aoswern D Explaoatio:

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(A) This respiose dies oit ackoiwledge the clieot’s feeliogs.

(B) This is a clised questio aod dies oit eociurage cimmuoicatio.

(C) This respiose oegates the clieot’s feeliogs aod dies oit require a respiose frim the clieot. (D) This ackoiwledges the clieot’s implied thiughts aod feeliogs aod eociurages a respiose.

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