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Exam Code : NCLEX-RN
Exam Name : National Council Licensure Examination (NCLEX-RN) - 2024
Vendor Name :
"NCLEX"

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NCLEX

NCLEX-RN

National Council Licensure Examination (NCLEX-RN)

- 2023

https://killexams.com/pass4sure/exam-detail/NCLEX-RN

Question: 1661

When teaching a sex education class, the nurse identifies the most common STDs in the United States as:

1. Chlamydia

2. Herpes genitalis

3. Syphilis

4. Gonorrhea

Answer: A

Explanation:

(A) Chlamydia trachomatis infection is the most common STD in the United States. The Centers for Disease Control and Prevention recommend screening of all high-risk women, such as adolescents and women with multiple sex partners. (B) Herpes simplex genitalia is estimated to be found in 5-20 million people in the United States and is rising in occurrence yearly. (C) Syphilis is a chronic infection caused by Treponema pallidum. Over the last several years the number of people infected has begun to increase. (D) Gonorrhea is a bacterial infection caused by the organism Neisseria gonorrhoeae. Although gonorrhea is common, chlamydia is still the most common STD.

Question: 1662

A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. For the last 2 months, his family describes him as being "on the move," sleeping 34 hours nightly, spending lots of money, and losing approximately 10 lb. During the initial assessment with the client, the nurse would expect him to exhibit which of the following?

1. Short, polite responses to interview questions

2. Introspection related to his present situation

3. Exaggerated self-importance

4. Feelings of helplessness and hopelessness

Answer: C

Explanation:

(A) During the manic phase of bipolar disorder, clients have short attention spans and may be abusive toward authority figures. (B) Introspection requires focusing and concentration; clients with mania experience flight of ideas, which prevents concentration. (C) Grandiosity and an inflated sense of self-worth are characteristic of this disorder. (D) Feelings of helplessness and hopelessness are symptoms of the depressive stage of bipolar disorder.
Question: 1663

A client has been diagnosed as being preeclamptic. The physician orders magnesium sulfate. Magnesium sulfate (MgSO4) is used in the management of preeclampsia for:

1. Prevention of seizures

2. Prevention of uterine contractions

3. Sedation

4. Fetal lung protection

Answer: A

Explanation:

(A) MgSO4 is classified as an anticonvulsant drug. In preeclampsia management, MgSO4 is used for prevention of seizures. (B) MgSO4 has been used to inhibit hyperactive labor, but results are questionable. (C) Negative side effects such as respiratory depression should not be confused with generalized sedation. (D) MgSO4 does not affect lung maturity. The infant should be assessed for neuromuscular and respiratory depression.

Question: 1664

The predominant purpose of the first Apgar scoring of a newborn is to:

1. Determine gross abnormal motor function

2. Obtain a baseline for comparison with the infant’s future adaptation to the environment

3. Evaluate the infant’s vital functions

4. Determine the extent of congenital malformations

Answer: C

Explanation:

(A) Apgar scores are not related to the infant’s care, but to the infant’s physical condition. (B) Apgar scores assess the current physical condition of the infant and are not related to future environmental adaptation. (C) The purpose of the Apgar system is to evaluate the physical condition of the newborn at birth and to determine if there is an immediate need for resuscitation. (D) Congenital malformations are not one of the areas assessed with Apgar scores.

Question: 1665

A pregnant woman at 36 weeks’ gestation is followed for PIH and develops proteinuria. To increase protein in her diet, which of the following foods will provide the greatest amount of protein when added to her intake of 100 mL of milk?

1. Fifty milliliters light cream and 2 tbsp corn syrup

2. Thirty grams powdered skim milk and 1 egg

3. One small scoop (90 g) vanilla ice cream and 1 tbsp chocolate syrup

4. One package vitamin-fortified gelatin drink

Answer: B

Explanation:

(A) This choice would provide more unwanted fat and sugar than protein. (B) Skim milk would add protein. Eggs are good sources of protein while low in fat and calories. (C) The benefit of protein from ice cream would be outweighed by the fat content. Chocolate syrup has caffeine, which is contraindicated or limited in pregnancy. (D) Although most animal proteins are higher in protein than plant proteins, gelatin is not. It loses protein during the processing for food consumption.

Question: 1666

The physician recommends immediate hospital admission for a client with PIH. She says to the nurse, "It’s not so easy for me to just go right to the hospital like that." After acknowledging her feelings, which of these approaches by the nurse would probably be best?

1. Stress to the client that her husband would want her to do what is best for her health.

2. Explore with the client her perceptions of why she is unable to go to the hospital.

3. Repeat the physician’s reasons for advising immediate hospitalization.

4. Explain to the client that she is ultimately responsible for her own welfare and that of her baby.

Answer: B

Explanation:

(A) This answer does not hold the client accountable for her own health. (B) The nurse should explore potential reasons for the client’s anxiety: are there small children at home, is the husband out of town? The nurse should aid the client in seeking support or interventions to decrease the anxiety of hospitalization. (C) Repeating the physician’s reason for recommending hospitalization may not aid the client in dealing with her reasons for anxiety.

(D) The concern for self and welfare of baby may be secondary to a woman who is in a crisis situation. The nurse should explore the client’s potential reasons for anxiety. For example, is there another child in the home who is ill, or is there a husband who is overseas and not able to return on short notice?

Question: 1667

What is the most effective method to identify early breast cancer lumps?

1. Mammograms every 3 years

2. Yearly checkups performed by physician

3. Ultrasounds every 3 years

4. Monthly breast self-examination

Answer: D

Explanation:

(A) Mammograms are less effective than breast self-examination for the diagnosis of abnormalities in younger women, who have denser breast tissue. They are more effective forwomen older than 40. (B) Up to 15% of early- stage breast cancers are detected by physical examination; however, 95% are detected by women doing breast self-examination. (C) Ultrasound is used primarily to determine the location of cysts and to distinguish cysts from solid masses. (D) Monthly breast self-examination has been shown to be the most effective method for early detection of breast cancer. Approximately 95% of lumps are detected by women themselves.

Question: 1668

Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client’s history?

1. Menarche after age 13

2. Nulliparity

3. Maternal family history of breast cancer

4. Early menopause

Answer: C

Explanation:

(A) Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. (B) Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. (C) A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. (D) Early menopause decreases the risk of developing breast cancer.

Question: 1669

The nurse practitioner determines that a client is approximately 9 weeks’ gestation. During the visit, the practitioner informs the client about symptoms of physical changes that she will experience during her first trimester, such as:

1. Nausea and vomiting

2. Quickening

3. A 68 lb weight gain

4. Abdominal enlargement

Answer: A

Explanation:

(A) Nausea and vomiting are experienced by almost half of all pregnant women during the first 3 months of pregnancy as a result of elevated human chorionic gonadotropin levels and changed carbohydrate metabolism. (B) Quickening is the mother’s perception of fetal movement and generally does not occur until 1820 weeks after the last menstrual period in primigravidas, but it may occur as early as 16 weeks in multigravidas. (C) During the first trimester there should be only a modest weight gain of 24 lb. It is not uncommon for women to lose weight during the first trimester owing to nausea and/or vomiting. (D) Physical changes are not apparent until the second trimester, when the uterus rises out of the pelvis.

Question: 1670

A client is 6 weeks pregnant. During her first prenatal visit, she asks, "How much alcohol is safe to drink during pregnancy?" The nurse’s response is:

1. Up to 1 oz daily

2. Up to 2 oz daily

3. Up to 4 oz weekly

4. No alcohol

Answer: D

Explanation:

(A, B, C) No amount of alcohol has been determined safe for pregnant women. Alcohol should be avoided owing to the risk of fetal alcohol syndrome. (D) The recommended safe dosage of alcohol consumption during pregnancy is none.

Question: 1671

A 38-year-old pregnant woman visits her nurse practitioner for her regular prenatal checkup. She is 30 weeks’ gestation. The nurse should be alert to which condition related to her age?

1. Iron-deficiency anemia

2. Sexually transmitted disease (STD)

3. Intrauterine growth retardation

4. Pregnancy-induced hypertension (PIH)

Answer: D

Explanation:

(A) Iron-deficiency anemia can occur throughout pregnancy and is not age related. (B) STDs can occur prior to or during pregnancy and are not age related. (C) Intrauterine growth retardation is an abnormal process where fetal development and maturation are delayed. It is not age related. (D) Physical risks for the pregnant client older than 35 include increased risk for PIH, cesarean delivery, fetal and neonatal mortality, and trisomy.

Question: 1672

A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the effectiveness of the instruction about diet and weight control?

1. She is compliant with her diet as previously taught.

2. She needs further instruction and reinforcement.

3. She needs to increase her caloric intake.

4. She needs to be placed on a restrictive diet immediately.

Answer: B

Explanation:

(A) She is probably not compliant with her diet and exercise program. Recommended weight gain during second and third trimesters is approximately 12 lb. (B) Because of her excessive weight gain of 10 lb in 2 months, she needs re-evaluation of her eating habits and reinforcement of proper dietary habits for pregnancy. A 2200-calorie diet is recommended for most pregnant women with a weight gain of 2730 lb over the 9-month period. With rapid and excessive weightgain, PIH should also be suspected. (C) She does not need to increase her caloric intake, but she does need to re-evaluate dietary habits. Ten pounds in 2 months is excessive weight gain during pregnancy, and health teaching is warranted. (D) Restrictive dieting is not recommended during pregnancy.

Question: 1673

Diabetes during pregnancy requires tight metabolic control of glucose levels to prevent perinatal mortality. When evaluating the pregnant client, the nurse knows the recommended serum glucose range during pregnancy is:

1. 70 mg/dL and 120 mg/dL

2. 100 mg/dL and 200 mg/dL

3. 40 mg/dL and 130 mg/dL

4. 90 mg/dL and 200 mg/dL

Answer: A

Explanation:

(A) The recommended range is 70120 mg/dL to reduce the risk of perinatal mortality. (B, C, D) These levels are not recommended. The higher the blood glucose, the worse the prognosis for the fetus. Hypoglycemia can also have detrimental effects on the fetus.

Question: 1674

A 25-year-old client believes she may be pregnant with her first child. She schedules an obstetric examination with the nurse practitioner to determine the status of her possible pregnancy. Her last menstrual period began May 20, and her estimated date of confinement using Nägele’s rule is:

1. March 27

2. February 1

3. February 27

4. January 3

Answer: C

Explanation:

(A)March 27 is a miscalculation. (B) February 1 is a miscalculation. (C) February 27 is the correct answer. To calculate the estimated date of confinement using Nagele’s rule, subtract 3 months from the date that the last menstrual cycle began and then add 7 days to the result. (D) January 3 is a miscalculation.

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