Free NCLEX Questions Test Bank 2020 / 2021 116th Edition

Free NCLEX Questions Test Bank 2020 / 2021 116th Edition

Free NCLEX Questions Test Bank 2020 / 2021 116th Edition

1. A nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The nurse notes that the pH is 5 and determines that the:
A. NG tube needs to be pulled back approximately 1 inch
B. NG tube needs to be reinserted
C. pH of the aspirate needs to be rechecked
D. Placement of the NG tube is accurate

Answer: D. Placement of the NG tube is accurate

Rationale: After the nurse inserts an NG tube into a client, the correct location of the tube must be verified. Testing the pH of the gastric fluid (determining its acidity) further verifies that the tube is in the stomach. The stomach contents are acidic, and a pH of 5 would indicate accurate placement. Options 1, 2, and 3 are incorrect.

Test-Taking Strategy: Recalling that the stomach contents are acidic will assist you in determining that an aspirate with a pH of 5 indicates appropriate placement. If you had difficulty with this question, review NG tube insertion and placement techniques.

Level of Cognitive Ability: Analysis

Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Adult Health/Gastrointestinal
Reference: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, p. 479.

2. A 52-year-old male client is seen in the physician’s office for a physical examination after experiencing unusual fatigue over the last several weeks. Height is 5 feet, 8 inches, with a weight of 220 lb. Vital signs are: temperature 98° F oral, pulse 86 beats/min, respirations 18 breaths per minute, and blood pressure 184/96 mm Hg. Random blood glucose is 110 mg/dl. Which of the following questions should the nurse ask the client first?

A. “Do you exercise regularly?”
B. “Are you considering trying to lose weight?”
C. “Is there a history of diabetes mellitus in your family?”
D. When was the last time you had your blood pressure checked?”

Answer: D. When was the last time you had your blood pressure checked?”

Rationale: The client is hypertensive, which is a known major modifiable risk factor for coronary artery disease (CAD). The other major modifiable risk factors for CAD not exhibited by this client include smoking and hypercholesterolemia. The client is overweight, which is also a contributing risk factor. The client’s nonmodifiable risk factors are age and gender. Since the client has several risk factors, the nurse places priority on the client’s major modifiable risk factors.

Test-Taking Strategy: Use the process of elimination and note the key word first. Options 1 and 2 are similar and can be eliminated first. Option 4 is the priority over option 3 because of the obvious degree of abnormality of the blood pressure. Review the risk factors associated with CAD and hypertension if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Cardiovascular
Reference: Linton, A., & Maebius, N. (2003). Introduction to medical-surgical nursing (3rd ed.). Philadelphia: W.B. Saunders, p. 579.

3. Levothyroxine sodium (Synthroid) is prescribed for a client with hypothyroidism. The nurse instructs the client to take the medication:

A. In the morning
B. At bedtime
C. At lunchtime
D. At dinnertime

Answer: A. In the morning

Rationale: Synthetic levothyroxine sodium (Synthroid) increases basal metabolic rate and is used to treat hypothyroidism. It is administered in the morning (on an empty stomach) to prevent insomnia. Options 2, 3, and 4 are incorrect.

Test-Taking Strategy: Use the process of elimination. Eliminate options 3 and 4 first because they are similar and indicate administering the medication with food. From the remaining options, recalling the action and purpose of this medication will direct you to option A. Review the guidelines for administering this medication if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Mosby’s 2005 Drug consult for nurses. (2005). St. Louis: Mosby, p. 1167.

4. A nurse in an outpatient diabetes clinic is assisting in caring for a client on insulin pump therapy. Which statement by the client indicates that a knowledge deficit exists regarding insulin pump therapy?

A. “If my blood sugars are elevated, I can bolus myself with additional insulin as ordered.”
B. “I’ll need to check my blood sugars before meals in case I need a premeal insulin bolus.”
C. “Now that I have this pump, I don’t have to worry about insulin reactions or ketoacidosis ever happening again.”
D. “I still need to follow a diet and exercise plan even though I don’t inject myself daily anymore.”

Answer: C. “Now that I have this pump, I don’t have to worry about insulin reactions or ketoacidosis ever happening again.”

Rationale: All of the statements are correct in regard to insulin pump therapy except  option C. Hypoglycemic reactions can occur if there is an error in calculating the insulin  dose or if the pump malfunctions. Ketoacidosis can occur if too little insulin is used or if there is an increase in metabolic need. The pump does not have a built-in blood glucose monitoring feedback system, so the client is subject to the usual complications associated with insulin administration without the use of a pump.

Test-Taking Strategy: Knowledge of the basics of insulin therapy is helpful to answer this question even if you know little about insulin pump therapy. Options 1, 2, and 4 are logical statements regarding the use of endogenous insulin. Option 3, however, presumes a guarantee from the usual complications of insulin therapy. No biomedical equipment is capable of being 100% safe. Additionally the option also contains the word “ever,” which is an absolute word. Review the principles of insulin pump therapy if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Adult Health/Endocrine
Reference: Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed.). St. Louis: Mosby, p. 484.

Read also:

• Free NCLEX Questions Test Bank 2020 / 2021 115th Edition
• NCLEX Questions Test Bank 2020 / 2021 114th Edition
• NCLEX Questions Test Bank and Review 113th Edition

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