NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. The healthcare provider calculates the IV flow rate for a patient receiving lactated Ringer's solution. The patient needs to receive 2000mL of Lactated Ringer's over 36 hours. The IV infusion set has a drop factor of 15 drops per milliliter. How many drops per minute should the healthcare provider set the IV to deliver?
- A. 8
- B. 10
- C. 14
- D. 18
Correct answer: C
Rationale: To determine the drops per minute, we use the formula Drops Per Minute = (Milliliters x Drop Factor) / Time in Minutes. In this case, Drops Per Minute = (2000mL x 15 drops/mL) / (36 hours x 60 minutes/hour) = 30000 / 2160 = 13.89 (approximately 14). Therefore, the correct answer is 14 drops per minute. Choice A (8), Choice B (10), and Choice D (18) are incorrect as they do not correctly calculate the drops per minute based on the given information.
2. Clinical manifestations of asthma include:
- A. Decreased expiratory time
- B. Increased peak expiratory flow
- C. Increased use of accessory muscles
- D. Increased oxygen saturation
Correct answer: C
Rationale: Clinical manifestations of asthma include increased use of accessory muscles, increased expiratory time, increased peak expiratory flow, and decreased oxygen saturation. Choice A, 'Decreased expiratory time,' is incorrect because asthma typically presents with increased expiratory time due to airway obstruction. Choice B, 'Increased peak expiratory flow,' is incorrect as asthma commonly leads to decreased peak expiratory flow due to airway constriction. Choice D, 'Increased oxygen saturation,' is incorrect because asthma exacerbations often result in decreased oxygen saturation levels.
3. Which of the following statements made by a client during an individual therapy session would the nurse most identify as reflecting schizoaffective disorder?
- A. ''I just want to stab myself with this pen.''
- B. ''What's the point in life anyways?''
- C. ''My thoughts are racing because of the conspiracies against me.''
- D. ''I hear voices every day and sometimes see old friends that don't exist.''
Correct answer: C
Rationale: The correct answer is, ''My thoughts are racing because of the conspiracies against me.'' Schizoaffective disorder combines the symptoms of bipolar disorder (mania and depression) with those of schizophrenia (delusions and disturbed thought processes). Racing thoughts are a characteristic symptom of a manic episode, while beliefs in conspiracies indicate paranoia, which are common in schizoaffective disorder. Choices A, B, and D do not specifically align with the symptoms of schizoaffective disorder. Choice A suggests self-harm, which may be seen in various mental health conditions; choice B reflects existential questioning or depression; and choice D describes hallucinations, which are more characteristic of schizophrenia rather than schizoaffective disorder.
4. The nurse has provided dietary instructions to the mother of a child with celiac disease. The nurse determines that further instruction is needed if the mother states that she will include which food item in the child's nutritional plan?
- A. Corn
- B. Chicken
- C. Oatmeal
- D. Vitamin supplements
Correct answer: C
Rationale: In celiac disease, individuals need to avoid gluten-containing foods like wheat, rye, barley, and oats. Oatmeal contains gluten unless it is specifically labeled as gluten-free. Corn and rice are safe alternatives for individuals with celiac disease as they do not contain gluten. Chicken is a naturally gluten-free protein source. While vitamin supplements may be necessary to address deficiencies due to malabsorption, oatmeal poses a risk of gluten exposure, making it an incorrect choice for a child with celiac disease.
5. The physician has decided to perform a thoracentesis based on Mr. R's assessment. Which of the following actions from the nurse is most appropriate?
- A. Instruct the client not to talk during the procedure
- B. Assist the client to sit upright or slightly lean forward
- C. Insert a 20-gauge needle just above the 4th intercostal space
- D. Connect the needle to suction to remove fluid that has collected in the pleural space
Correct answer: A
Rationale: The correct answer is to instruct the client not to talk during the procedure. This is important to prevent air from being drawn into the pleural space during the thoracentesis. Choice B is incorrect because the client should be sitting upright or slightly leaning forward during the procedure to facilitate access to the pleural space. Choice C is incorrect as the nurse should not perform the thoracentesis procedure, which involves inserting a needle into the pleural space - this is the physician's responsibility. Choice D is incorrect as connecting the needle to suction to remove fluid is not the appropriate procedure for a thoracentesis. Thoracentesis is typically done to remove fluid or air for diagnostic or therapeutic purposes, not to connect to suction to remove fluid that has collected in the pleural space.
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