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Friday, March 13, 2009

Test Yourself: NCLEX practice questions

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. Answers are found below.

1.A nurse is preparing to bathe a client who has been hospitalized for emphysema. Which nursing intervention is correct?
1.Remove the oxygen and proceed with the bath.
2.Increase the flow of oxygen to 6 L/minute by nasal cannula.
3.Keep the head of the bed slightly elevated during the procedure.
4.Lower the head of the bed and roll the client to his left side to increase oxygenation.
2.A 56-year-old client with heart failure is allergic to sulfa-based medications. Which type of diuretic should be used cautiously?
1.Osmotic diuretics
2.Thiazide and thiazide-like diuretics
Potassium-sparing diuretics
4.Carbonic anhydrase inhibitors
3.Which condition most commonly results in coronary artery disease (CAD)?
2.Diabetes mellitus
3.Myocardial infarction (MI)
4.Renal failure
4.Which blood test is used first to identify a response to human immunodeficiency virus (HIV) infection?
1.Western blot
2.CD4+ T-cell count
3.Erythrocyte sedimentation rate
4.Enzyme-linked immunosorbent assay (ELISA)
5.An elderly client with pneumonia may appear with which symptoms first?
1.Altered mental status and dehydration
2.Fever and chills
3.Hemoptysis and dyspnea

Pleuritic chest pain and cough

Answers to NCLEX practice questions 1. 3 The elasticity of the lungs is lost for clients with emphysema, who can't tolerate lying flat because the abdominal organs compress the lungs. The best position is one with the head slightly elevated. The rate of oxygen delivery shouldn't be increased or decreased without an order from the physician. Increasing oxygen flow in a client with emphysema may also suppress the hypoxic drive to breathe. Positioning the client on his left side with the head of the bed flat would decrease oxygenation.

2. 2 Thiazide and thiazide-like diuretics are sulfonamide derivatives, so their use should be used cautiously in clients allergic to sulfa-based medications. Osmotic, potassium-sparing, and carbonic anhydrase inhibitor diuretics can be safely administered to these clients.

3. 1 Atherosclerosis, or plaque formation, is the leading cause of CAD. Diabetes mellitus is a risk factor for CAD but it isn't the most common cause. Renal failure doesn't cause CAD, but the two conditions are related. MI is commonly a result of CAD.

4. 4 The ELISA is the first screening test for HIV. A Western blot confirms a positive ELISA test. Other blood tests that support the diagnosis of HIV include CD4+ and CD8+ counts, complete blood counts, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays.

5. 1 Fever, chills, hemoptysis, dyspnea, cough, and pleuritic chest pain are the common symptoms of pneumonia, but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response. Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2007.

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