Blog about quiz / question and answer NCLEX (National Council Licensure Examination) For Nursing Student, Example Question NCLEX RN and NCLEX PN. Exam for Nurse
1. A nursing student is caring for a hospitalized client with a diagnosis of lung cancer. The physician has ordered a partial rebreathing facemask for the client, and the nursing instructor asks the student about the purpose of the partial rebreather facemask. The student correctly responds by stating that:
A. “The mask requires a low liter flow to prevent rebreathing of carbon dioxide.”
B. “The device conserves oxygen by having the client rebreathe his or her own exhaled air.”
C. “The mask requires that the reservoir bag be deflated to work effectively.”
D. “The device delivers accurate fraction of inspired oxygen (FiO2) to the client.”
Answer: B. “The device conserves oxygen by having the client rebreathe his or her own exhaled air.”
Rationale: Rebreathing masks have a reservoir bag that conserves oxygen and requires a high liter flow to achieve concentrations of 40% to 60%. It does not deliver accurate FiO2 to the client. The bag should not deflate during inspiration. The rebreathing bags conserve oxygen by having the client rebreathe his or her own exhaled air.
Test-Taking Strategy: Use the process of elimination. Note the relationship between the words “partial rebreather” in the question and “rebreathe his or her own exhaled air” in the correct option. Review oxygen delivery systems if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Adult Health/Respiratory
Reference: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, pp. 507-508.
2. A nurse is caring for a client following total hip replacement who has a Hemovac wound suction in place. At the end of the 8-hour shift, the nurse empties 45 mL of drainage from the wound suction device. Based on this amount of drainage, which action is appropriate?
A. Document the findings
B. Check the client’s blood pressure
C. Notify the registered nurse immediately
D. Place the leg in a flat position
Answer: A. Document the findings
Rationale: Following total hip replacement, the hip incision may have a wound suction drain in place, which is expected to drain usually less than 50 mL every 8 hours. The nurse would document the findings. The nurse may check the client’s blood pressure, but this action is unrelated to the amount of drainage from the Hemovac. There is no need to notify the registered nurse immediately. Placing the leg flat in bed would be done only if prescribed by the physician. Additionally, this action is unrelated to the issue of the question.
Test-Taking Strategy: Focus on the issue of the question and the amount of drainage noted. Recalling the normal postoperative findings following total hip replacement will direct you to option A. Review these postoperative expectations if you had difficulty with this question.
Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Adult Health/Musculoskeletal
References: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th ed.). St. Louis: Mosby, p. 408.
Phipps, W., Monahan, F., Sands, J., Marek, J., & Neighbors, M. (2003). Medical-surgical nursing: Health and illness perspectives (7th ed.). St. Louis: Mosby, p. 1535.
3. A nurse is reinforcing instructions to the family of a client with Alzheimer’s disease regarding tacrine (Cognex). Which statement by the family would indicate an understanding of the adverse effects related to this medication?
A. “I need to call the physician if constipation occurs.”
B. “Fever is a sign of an adverse effect of the medication.”
C. “Increased urination may be an indication of an adverse effect.”
D. “If difficulty voiding occurs, I need to call the physician immediately because the medication will need to be discontinued.”
Answer: C. “Increased urination may be an indication of an adverse effect.”
Rationale: Tacrine is a cholinergic agent. Frequent side effects of this medication include nausea, vomiting, diarrhea, dizziness, and headache. Overdose (adverse effects) cause cholinergic crisis, including increased salivation, lacrimation, urination, defecation, bradycardia, hypotension, and increased muscle weakness.
Test-Taking Strategy: Use the process of elimination. If you can remember that this medication is a cholinergic agent, it will assist you in determining that an overdose will cause cholinergic symptoms. This knowledge will direct you to option C. Review cholinergic symptoms and 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. 1001.
4. A nurse is caring for a client with a diagnosis of metastatic breast carcinoma. Tamoxifen citrate (Nolvadex) 10 mg orally twice daily is prescribed for the client, and the nurse provides instructions to the client regarding the medication. Which statement by the client would indicate an understanding of the medication?
A. “Pelvic pain and pressure from this medication are expected.”
B. “If I have difficulty seeing, I need to call the physician.”
C. “If hot flashes occur, I need to call the physician.”
D. “Vaginal bleeding should not occur with this medication.”
Answer: B. “If I have difficulty seeing, I need to call the physician.”
Rationale: Tamoxifen citrate is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing a high concentration of receptors, such as the breasts, the uterus, and the vagina. Frequent side effects include hot flashes, nausea, vomiting, vaginal bleeding or discharge, pruritis vulvae, and skin rash. Adverse or toxic reactions include retinopathy, corneal opacity, and decreased visual acuity. The client needs to report menstrual irregularities, pelvic pain or pressure, and visual disturbances.
Test-Taking Strategy: Knowledge of tamoxifen citrate is necessary to answer this question. Reading the options carefully and discriminating side effects from adverse effects will direct you to option B. Review the teaching points regarding 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: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 815
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