NCLEX Practice Test With Answers 88th Edition
NCLEX Practice Test With Answers 88th Edition
1. A nurse is collecting data on a client suspected of having Alzheimer's disease. The priority data would focus on which of the following characteristic of this disease?
A. Recent memory loss
B. Difficulty in performing new tasks
C. Problems with concrete thinking
D. Problems with hearing and discriminating the spoken word from other sounds
Answer: A. Recent memory loss
Rationale: Dementia is the hallmark of Alzheimer's disease. Recent memory loss is one characteristic. Others include problems with abstract thinking, problems with speech (not hearing), and difficulty in performing familiar tasks.
Test-Taking Strategy: Focus on the client’s diagnosis. Recalling that recent memory loss is associated with this disease will direct you to option A. Review Alzheimer's disease if you have difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Neurological
Reference: Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed.). St. Louis: Mosby, p. 633.
2. A nurse is providing instructions to a client with a diagnosis of rheumatoid arthritis (RA) who is receiving acetylsalicylic acid (ASA [aspirin])), 5 g orally daily. Which of the following if stated by the client would indicate an understanding of the instructions?
A. “I should notify the physician if I get any ringing in my ears.”
B. “A slow pulse might indicate a reaction to the medication.”
C. “If I have joint pain, I need to notify the physician.”
D. “If I have discomfort with exercise, I need to stop the medication.”
Answer: A. “I should notify the physician if I get any ringing in my ears.”
Rationale: ASA is a nonsteroidal anti-inflammatory medication. Adverse reactions include gastrointestinal bleeding and/or gastric mucosal lesions, ringing in the ears (tinnitus), and generalized pruritus. Headache, dizziness, flushing, tachycardia, hyperventilation, sweating, and thirst also are adverse reactions. Options 2, 3, and 4 are incorrect client statements.
Test-Taking Strategy: Use the process of elimination. Eliminate option 3 first recalling that one of the primary complaints of clients with RA is joint pain, which is one of the reasons that ASA would be prescribed. Next eliminate option 4 because discomfort with exercise is expected with RA and ASA is administered to alleviate this discomfort. Remembering that this medication can cause ototoxicity will assist in directing you to the correct option from those remaining. Review the adverse effects of this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 88.
3. A nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which of the following data is least likely associated with the development of this disease?
A. History of tarry black stools
B. History of alcohol abuse
C. History of gastric pain 2 to 4 hours after meals
D. History of the use of acetaminophen (Tylenol) for pain and discomfort
Answer: D. History of the use of acetaminophen (Tylenol) for pain and discomfort
Rationale: Unlike acetylsalicylic acid (ASA [aspirin]), acetaminophen has little effect on platelet function, does not affect bleeding time, and generally produces no gastric bleeding. The data in options 1, 2, and 3, if reported by the client, indicate risk factors associated with peptic ulcer disease.
Test-Taking Strategy: Use the process of elimination and note the key words least likely. Options 1 and 3 are signs and symptoms of peptic ulcers. Because alcohol may irritate the stomach mucosa, a history of alcohol abuse is often seen in clients with peptic ulcer disease. This leaves option 4 as the correct answer to this question. Review the risk factors associated with peptic ulcer disease if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Gastrointestinal
Reference: Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed.). St. Louis: Mosby, p. 186.
4. A child is to be admitted to the orthopedic unit following a Harrington rod insertion for the treatment of scoliosis. The nurse is assisting in preparing a plan of care for the child. The nurse plans to monitor which priority item in the immediate postoperative period?
A. Pain level
B. Capillary refill, sensation, and motion in all extremities
C. Ability to turn using the log-roll technique
D. Ability to flex and extend the lower extremities
Answer: B. Capillary refill, sensation, and motion in all extremities
Rationale: When the spinal column is manipulated during surgery, altered neurovascular status is a possible complication; therefore neurovascular assessments, including circulation, sensation, and motion, should be done every 2 hours. Level of pain and ability to flex and extend the lower extremities are important postoperative assessments, but not the priorities of the options provided. Log rolling would be performed by nurses.
Test-Taking Strategy: Use the ABCs, airway, breathing, and circulation to answer this question. Option 2 addresses circulatory status. Review postoperative care following Harrington rod insertion 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
References: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 582.
Wong, D., & Hockenberry, M. (2003). Nursing care of infants and children (7th ed.).
St. Louis: Mosby, pp. 1812-1813.
Source : NCLEX Questions and answer
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