Example Nursing Question NCLEX RN PN with Answer 41th Edition
Example Nursing Question NCLEX RN PN with Answer 41th Edition
1. A nurse is providing dietary instructions to the mother of a child with celiac disease. Which statement by the mother indicates a need for further instructions?
A. “I can give my child rice.”
B. “I am so pleased that I won’t have to eliminate oatmeal from my child’s diet.”
C. “My child loves corn. I will be sure to include corn in the diet.”
D. “I will be sure to give my child vitamin supplements every day.”
Answer: B. “I am so pleased that I won’t have to eliminate oatmeal from my child’s diet.”
Rationale: Dietary management is the mainstay of treatment for the child with celiac disease. All wheat, rye, barley, and oats should be eliminated from the diet and replaced with corn and rice. Vitamin supplements, especially fat-soluble vitamins and folate, may be needed in the early period of treatment to correct deficiencies.
Test-Taking Strategy: Note the key words need for further instructions. These words indicate a false response question and that you need to select the incorrect client statement. Knowledge that wheat, rye, oats, and barley need to be eliminated from the diet will direct you to option B. Review the diet for the child with celiac disease if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Content Area: Child Health
Reference: Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 238.
2. A nurse is caring for a newborn in the nursery and notes that the physician has documented that the child has gastroschisis. The parents ask the nurse about the treatment for the disorder. Which statement would the nurse make to the parents?
A. “No treatment is prescribed. It will resolve on its own.”
B. “Surgical repair will be performed if it causes symptoms in the newborn.”
C. “The defect will be closed surgically after all of the contents have been returned to the abdominal cavity.”
D. “Surgical repair will be performed if it persists past age 5.”
Answer: C. “The defect will be closed surgically after all of the contents have been returned to the abdominal cavity.”
Rationale: Gastroschisis is an abdominal wall defect. It involves embryonal weakness in the abdominal wall, causing herniation of the gut on one side of the umbilical cord during development. The defect will be closed surgically after all of the contents have been returned to the abdominal cavity. Even if the defect is small, immediate surgical repair may be done in several stages. Options 1, 2, and 4 describe therapeutic management for an umbilical hernia.
Test-Taking Strategy: Use the process of elimination. Recalling that a gastroschisis is an abdominal wall defect in which viscera are outside the abdominal cavity and not covered with a sac will direct you to option C. This is the only option that addresses surgical repair. Review therapeutic management for this disorder if you are unfamiliar with it.
Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Maternity/Postpartum
Reference: Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 98.
3. A 2-year-old child is diagnosed with constipation. Which of the following describes a characteristic of this disorder?
A. Incomplete development of the anus
B. Invagination of a section of the intestine into the distal bowel
C. The infrequent and difficult passage of dry stools
D. The presence of fecal incontinence
Answer: C. The infrequent and difficult passage of dry stools
Rationale: Constipation can affect any child at any time, although its incidence peaks at age 2 to 3 years. Option 4 describes encopresis, which can develop as a result of constipation and is one of the major concerns regarding constipation. Encopresis generally affects preschool and school-age children. Option 1 describes imperforate anus, which is diagnosed in the neonatal period. Option 2 describes intussusception, which is the most common cause of bowel obstruction in children age 3 months to 6 years.
Test-Taking Strategy: Use the process of elimination. Noting the child’s age should help you eliminate option 1, because imperforate anus is diagnosed in the neonatal period. Next, focus on the disorder to assist in directing you to option C. Review this disorder if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 666.
4. A newborn who is suspected of having an imperforate anus is admitted to the nursery. While reviewing the health care record of the newborn, the nurse understands that which documented finding is unassociated with this disorder?
A. Stenosis of the anorectal canal
B. Failure to pass meconium stool
C. The presence of stool in the vagina
D. The passage of bloody mucous stool
Answer: D. The passage of bloody mucous stool
Rationale: Clinical manifestations of an imperforate anus include failure to pass meconium stool within 24 hours following birth, absence or stenosis of the anorectal canal, an anal membrane, and an external fistula to the perineum. During neonatal assessment, the defect should be easily identified on sight. However, a rectal thermometer may be necessary to determine patency if meconium stool is not passed. The presence of stool in the urine, the vagina, or a skin dimple should be reported immediately as an indication of abnormal anorectal development. Option 4 is a clinical manifestation of intussusception.
Test-Taking Strategy: Note the key word unassociated. Next, note the name of the disorder identified in the question. Options 1, 2, and 3 relate to the name of this disorder. Review the clinical manifestations associated with imperforate anus if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Postpartum
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 658.
5. A nurse is preparing to feed a 1-year-old hospitalized child. The nurse prepares the amount of formula to be given to this child knowing that generally a 1-year-old child consumes approximately:
A. 90 mL per feeding
B. 125 mL per feeding
C. 175 mL per feeding
D. 300 mL per feeding
Answer: C. 175 mL per feeding
Rationale: A 1-year-old child consumes approximately 175 mL (6 oz) of formula per feeding. Options 1, 2, and 4 are incorrect.
Test-Taking Strategy: Knowledge regarding the pediatric differences in the upper gastrointestinal system is required to answer this question. Note the key words 1-year-old. This should assist you in eliminating options 1 and B. Attempt to visualize the amount in options 3 and 4 to help you select the correct option. Review these pediatric differences if you had difficulty with this question.
Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Child Health
Reference: Wong, D., & Hockenberry, M. (2003). Nursing care of infants and children (7th ed.). St. Louis: Mosby, p. 521.
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