NCLEX NCLEX-RN
NCLEX RN Exam Questions
1. When admitting a 64-year-old patient with acute pancreatitis, the healthcare provider should specifically inquire about a history of
- A. diabetes mellitus.
- B. high-protein diet.
- C. cigarette smoking.
- D. alcohol consumption.
Correct answer: alcohol consumption.
Rationale: In patients with acute pancreatitis, alcohol consumption is a significant risk factor and one of the most common causes in the United States. It is crucial to assess alcohol intake as it plays a key role in the development of pancreatitis. While cigarette smoking, diabetes mellitus, and high-protein diets can contribute to various health issues, they are not directly associated with the development of acute pancreatitis.
2. When reading a lab report, you notice that a patient's sample is described as having anisocytosis. Which of the following most accurately describes the patient's condition?
- A. The patient has an abnormal condition of skin cells.
- B. The patient's red blood cells vary in size.
- C. The patient has a high level of fat cells and is obese.
- D. The patient's cells are indicative of necrosis.
Correct answer: The patient's red blood cells vary in size.
Rationale: Anisocytosis is a term that indicates variation in the size of red blood cells. When a patient is described as having anisocytosis, it means their red blood cells exhibit differences in size. This condition can be detected in blood samples and may indicate underlying blood disorders. The other choices are incorrect: Choice A refers to a skin cell condition, Choice C relates to obesity and fat cells, and Choice D suggests necrosis, none of which are associated with anisocytosis or red blood cell abnormalities. It is important to recognize specific terms like anisocytosis in laboratory reports to understand the potential implications for the patient's health.
3. During a physical exam, a healthcare professional assisting a client suspected of having meningitis bends the client's leg at the hip to a 90-degree angle. When attempting to extend the leg at the knee, the client experiences severe pain. What type of test is being performed?
- A. Brudzinski's sign
- B. Romberg's sign
- C. Kernig's sign
- D. Babinski's sign
Correct answer: Kernig's sign
Rationale: The healthcare professional is performing Kernig's sign, a test for meningeal irritation often seen in meningitis cases. Kernig's sign involves bending the client's leg at a 90-degree angle at the hip and then attempting to extend the leg at the knee. Severe pain during this maneuver indicates a positive Kernig's sign, suggesting irritation of the meningeal membranes. Brudzinski's sign involves flexing the neck causing involuntary flexion of the hips and knees; Romberg's sign assesses balance and proprioception; Babinski's sign checks for abnormal reflexes in the foot.
4. A client arrives at an occupational health clinic after being struck by lightning while working in a truck bed. The client is alert but reports feeling faint. Which assessment will the nurse perform first?
- A. Pulse characteristics
- B. Open airway
- C. Entrance and exit wounds
- D. Cervical spine injury
Correct answer: Pulse characteristics
Rationale: Assessing pulse characteristics is the priority in this situation due to the potential impact of lightning as a form of electrical current, which can cause irregular heart rhythms. It is crucial to evaluate the pulse rate and regularity to assess for adequate circulation and potential cardiac issues. Since the client is alert and talking, the airway is likely patent, making assessing the airway less urgent. Entrance and exit wounds and cervical spine injury assessments should follow the evaluation of pulse characteristics to ensure proper circulation and prioritize life-threatening issues first. Checking the pulse first will guide further interventions and help in determining the client's hemodynamic status.
5. The nurse prepares a patient with a left-sided pleural effusion for a thoracentesis. How should the nurse position the patient?
- A. Supine with the head of the bed elevated 30 degrees
- B. In a high-Fowler's position with the left arm extended
- C. On the right side with the left arm extended above the head
- D. Sitting upright with the arms supported on an overbed table
Correct answer: D: Sitting upright with the arms supported on an overbed table
Rationale: The correct position for a patient with a left-sided pleural effusion undergoing thoracentesis is sitting upright with the arms supported on an overbed table. This position helps increase lung expansion, allows fluid to collect at the lung bases, and expands the intercostal space making access to the pleural space easier. Placing the patient supine, in a high-Fowler's position, or on the right side with the left arm extended above the head could increase the work of breathing for the patient and complicate the thoracentesis procedure for the healthcare provider.
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