NCLEX-RN
Exam Cram NCLEX RN Practice Questions
1. The nurse is assessing an 80-year-old male patient. Which assessment finding would be considered normal?
- A. Decrease in body weight from his younger years
- B. Decrease in deposits of fat in the cheeks and forearms
- C. Presence of kyphosis and flexion in bilateral knees and hips
- D. Change in overall body proportion, including a longer trunk and shorter extremities
Correct answer: C
Rationale: In an 80-year-old male patient, the presence of kyphosis (rounded upper back) and flexion in bilateral knees and hips are considered normal age-related changes. These postural changes are commonly seen in older adults due to structural changes in the spine and joints. Option A is incorrect as aging individuals typically experience a decrease in body weight, not an increase. Option B is also incorrect as there is usually a decrease in subcutaneous fat from the face and periphery, rather than an increase in fat deposits in specific areas. Option D is incorrect because the change in overall body proportion with aging usually involves a shorter trunk and relatively longer extremities, not the other way around. This is because long bones do not shorten with age, leading to this characteristic change in body proportions.
2. Which brain structure serves as the heat-regulating center?
- A. Hypothalamus
- B. Pituitary Gland
- C. Pons
- D. Medulla Oblongata
Correct answer: A
Rationale: The correct answer is the Hypothalamus. The hypothalamus is responsible for regulating body temperature, ensuring it stays within a narrow range. Moreover, the hypothalamus controls various essential bodily functions, such as hunger, thirst, and circadian rhythms. Choices B, C, and D are incorrect because the Pituitary Gland primarily produces and releases hormones, the Pons is involved in functions like sleep, respiration, and bladder control, and the Medulla Oblongata controls vital functions like breathing and heart rate, but not body temperature regulation.
3. A client is receiving high-dose brachytherapy as a form of cancer treatment. What type of teaching must the nurse include when educating this client about safety?
- A. The client must remain in isolation under airborne precautions
- B. The client should stay in a private room at the hospital
- C. The client may need to limit visits from friends and family
- D. Both B and C
Correct answer: D
Rationale: A client undergoing high-dose brachytherapy has a radiation implant placed for cancer treatment. To ensure safety, the client should be in a private hospital room to prevent radiation exposure to others. Limiting visits from friends and family is necessary to prevent overexposure. Option A is incorrect as isolation under airborne precautions is not required for brachytherapy. Option B and C are the correct choices as they focus on minimizing radiation exposure to others, ensuring safety during treatment.
4. Which of the following is NOT an acceptable abbreviation?
- A. D/C
- B. tid
- C. bid
- D. qid
Correct answer: A
Rationale: The correct answer is A: D/C. D/C is not an acceptable abbreviation as it can be easily confused with both 'discharge' and 'discontinue.' The abbreviations 'tid' (three times a day), 'bid' (twice a day), and 'qid' (four times a day) are commonly used in medical contexts to indicate dosing frequencies and are widely accepted in healthcare settings.
5. The nurse is assessing the vital signs of a 3-year-old patient who appears to have an irregular respiratory pattern. How would the nurse assess this child's respirations?
- A. Respirations should be counted for 1 full minute.
- B. Child's pulse and respirations should be simultaneously checked for 30 seconds and then multiplied by 2.
- C. Child's respirations should be checked for a minimum of 5 minutes to identify any variations in his or her respiratory pattern.
- D. Patient's respirations should be counted for 15 seconds and then multiplied by 4.
Correct answer: A
Rationale: To accurately assess a child's respiratory pattern, the nurse should count respirations for a full minute. This duration provides a comprehensive view of the child's breathing pattern, ensuring abnormalities are not missed. Counting for only 30 seconds may not capture irregularities effectively. Checking respirations for 5 minutes is excessive and unnecessary for a routine assessment. Counting for 15 seconds and multiplying by 4 is not as precise as a full-minute count. Pulse and respirations should not be checked simultaneously; instead, the nurse should count respirations unobtrusively while appearing to take the child's pulse. Therefore, the correct approach is to count the child's respirations for 1 full minute to obtain an accurate assessment.
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