NCLEX NCLEX-PN
2024 PN NCLEX Questions
1. A nurse is caring for an older client who has a bronchopulmonary infection. The nurse monitors the client’s ability to maintain a patent airway because of which factor involved in the normal aging process?
- A. Increased respiratory system compliance
- B. Decreased number of alveoli and increased function of those remaining
- C. Decreased older client’s ability to clear secretions
- D. Increased production of surfactant
Correct answer: Decreased older client’s ability to clear secretions
Rationale: The correct answer is 'Decreased older client’s ability to clear secretions.' Respiratory changes related to the normal aging process decrease an older adult’s ability to clear secretions and protect the airway. In healthy older adults, the number of alveoli does not change significantly; their structure, however, is altered. Respiratory system compliance decreases with advancing age because of a progressive loss of elastic recoil of the lung parenchyma and conducting airways, and reduced elastic recoil of the lung and opposing forces of the chest wall. Production of surfactant in the lung does not usually decrease with aging, nor does it increase. However, the production of alveolar cells responsible for surfactant production is diminished. Choices A, B, and D are incorrect. Choice A is incorrect because respiratory system compliance decreases with aging. Choice B is incorrect as the number of alveoli does not significantly decrease in healthy older adults. Choice D is incorrect as the production of surfactant does not usually decrease with aging.
2. An assessment of the skull of a normal 10-month-old baby should identify which of the following?
- A. closure of the posterior fontanel.
- B. closure of the anterior fontanel.
- C. overlap of cranial bones.
- D. ossification of the sutures
Correct answer: closure of the posterior fontanel.
Rationale: The correct answer is the closure of the posterior fontanel. By 10 months of age, the posterior fontanel should be closed. The anterior fontanel typically closes around 12-18 months of age. Overlapping of cranial bones is not a normal finding and may indicate craniosynostosis, a condition where the sutures close too early. Ossification of the sutures is also not a normal finding in a 10-month-old baby as the sutures should remain open to allow for the growth of the skull.
3. A licensed practical nurse (LPN) in the long-term care unit who has another LPN and a nursing assistant on the nursing team is planning task assignments for the day. Which task should the nurse assign to the LPN?
- A. Monitoring a client receiving oxygen who requires frequent pulse oximetry monitoring and respiratory treatments
- B. Assisting a client who is wearing eye patches and requires assistance with hygiene measures
- C. Feeding a client on bedrest who needs assistance with feeding
- D. Turning a client who must be turned and repositioned every 2 hours
Correct answer: Monitoring a client receiving oxygen who requires frequent pulse oximetry monitoring and respiratory treatments
Rationale: When a nurse assigns tasks for a client’s care to another staff member, the nurse is responsible for appropriately assigning tasks based on the educational level and competency of the staff member. In this scenario, the LPN should be assigned the task of monitoring a client receiving oxygen who requires frequent pulse oximetry monitoring and respiratory treatments. This is because the LPN is competent to perform these tasks and can accurately note changes in the client’s condition. Tasks such as feeding a client, turning and repositioning a client, and assisting with hygiene measures, which are noninvasive interventions, can be assigned to a nursing assistant. These tasks do not require the same level of assessment and monitoring as the respiratory treatments and pulse oximetry monitoring.
4. A woman asks, “How much alcohol can I safely drink while pregnant?” The nurse’s best response is:
- A. “The amount of alcohol that is safe during pregnancy is unknown.”
- B. “Consuming one or two beers or glasses of wine a day is considered safe for a healthy pregnant woman.”
- C. “Drinking three or more drinks on any given occasion is the only harmful type of drinking during pregnancy.”
- D. “You can have a drink to help you relax and get to sleep at night.”
Correct answer: “The amount of alcohol that is safe during pregnancy is unknown.”
Rationale: The correct answer is, “The amount of alcohol that is safe during pregnancy is unknown.” It is crucial for pregnant women to avoid alcohol as there is no known safe amount during pregnancy. Consuming any amount of alcohol can harm the developing fetus and increase the risk of fetal alcohol syndrome, a condition characterized by mental and physical abnormalities in infants. Choices B, C, and D are incorrect because they provide misleading information that can potentially harm the fetus. Pregnant women should abstain from alcohol to ensure the health and well-being of their baby.
5. A nurse suspects that a client has a distended bladder. On percussing the client’s bladder, which finding does the nurse expect to note if the bladder is full?
- A. Dull sounds
- B. Hyperresonance sounds
- C. Hypoactive bowel sounds
- D. An absence of bowel sounds
Correct answer: Dull sounds
Rationale: When percussing a full bladder, the nurse expects to note dull sounds over the symphysis pubis. This is because a full bladder produces a flat or dull sound. Hyperresonance sounds are present with gaseous distention of the abdomen, not a full bladder. Bowel sounds are auscultated, not percussed, so hypoactive bowel sounds or an absence of bowel sounds are unrelated findings when assessing bladder distention.
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