Questions written mainly at higher levels of the cognitive domain (analysis, synthesis, evaluation and creation). Addresses, telephone numbers, and websites for the National Council of State Boards of Nursing, Inc., and each state board of nursing.
Using This Review Package for Preparing for Nursing Exams
Introduction to the NCLEX-RN ® Licensing Examination and Preparation
Practice Tests 29
Postreview Tests 837
Overview
The Test Plan
The nurse also determines the concordance between the client's needs and the health care team members' ability to meet those needs. Four main categories of client needs organize the content of the NCLEX-RN test syllabus.
Exam Administration
The computer used at the test site has a countdown clock that shows the elapsed time for taking the exam. When the exam is finished, a message will appear on the screen that says "Exam Completed".
Additional Information
The test questions used for the NCLEX-RN exam are written to test the knowledge, skills, and abilities essential to providing safe client care. This chapter provides information about the test items used on the NCLEX-RN exam and offers strategies for answering questions for different types of test items and levels of the cognitive domain.
Types of Test Items
Make sure the pulse oximeter is correlating to the heart rate
Assess the neonate for color
Assess the neonate for respiratory effort
Double-check your answer by reviewing the question, answering the question based on nursing best practice, and matching the answer to the graphic option. Double-check your answer by reviewing the question and answering the question based on nursing best practice.
Cognitive Levels of Test Items
The nurse checks the capsule in the client's medicine box, which is located inside the client's room. The nurse should expect the infant to be able to do which of the following.
Consider all the elements necessary to have a complete care plan, discharge plan, etc. Double check your answer by reviewing the appropriateness of each of the elements in the plan you developed.
Assessing Study Needs
Define your testing strategies while evaluating your progress every step of the way, so that when you're ready to take the licensing exam, you'll be an experienced and successful test taker. As you use the questions and practice tests in this book and on the CD-ROM, give yourself time and, if necessary, determine ways you can increase your speed without sacrificing accuracy.
Developing a Study Plan
Read the question frame carefully and be clear about the priority (first, last) or order (first, last) in which you should answer the question. Remember that the NCLEX-RN is used to test for safe practice and that you have learned the information necessary to answer the question.
Refi ning Your Test-Taking Strategies
If you see a word you don't know, try to figure out its meaning from the known base of the word or the context of the question. Try to answer the question before you see the answers, then look for answers (hot spots and graphics) that are similar to the ones you created.
Evaluating Your Progress
Some students get bored during the exam and then become indifferent while answering questions towards the end of the exam. Practice taking tests of at least 265 questions and discover how long you can focus your attention on the test questions.
Tips from Students Who Have Passed the NCLEX-RN ®
Remember that everyone has their own test-taking speed and that each test is individualized.
Strategies for Managing Test Anxiety
It can be useful to visit the exam site and see the room where the exam will be held. Organize the information you need to bring to the test center the night before the exam.
The Preconception Client
Which of the following instructions should the nurse include regarding the use of condoms as a method of family planning? Which of the following statements would the nurse expect to include in the client's teaching plan.
The Pregnant Client Receiving Prenatal Care
- Explain that the fetal heart beat could not be found at this time
- Obtain different equipment and recheck
- Ask client if baby is or has been moving
- Call the health care provider
The nurse interprets these findings as indicating that the client's husband is experiencing which of the following. The nurse interprets these findings as a response related to which of the following.
The Pregnant Client in Childbirth Preparation Classes
Flexion 3. Descent
Internal rotation1. Engagement
The nurse's best course of action is to advise the client to do which of the following. Which of the following would be important for the nurse to include in the teaching plan.
The Pregnant Client with Risk Factors
The nurse should further assess the client for the expression of which of the following feelings. The nurse refers the client to a physician because the nurse suspects which of the following sexually transmitted diseases.
Managing Care Quality and Safety
- A multiparous client at 32 weeks’ gesta- tion asking for assistance with fi nding a new
- A single mother at 4 months postpartum fear- ful of shaking her baby when he cries
- An antenatal client at 16 weeks’ gestation who has occasional sharp pain on her left side radi-
- A primigravid client at 10 weeks’ gestation complaining of not feeling well with nausea
- Descent 2. Flexion
A multigravid client who has been standing for long periods of time while working in a factory visits the prenatal clinic at 35 weeks' gestation and states, "The varicose veins in my legs have been really bothering me lately." Which of the following instructions would be helpful. In the first maneuver, which is performed with the nurse facing the client's head, she palpates with both hands and determines which part of the fetus's body (e.g. head or buttocks) is in the bottom.
The Pregnant Client with Risk Factors
A multiparous client at 32 weeks’ gestation ask- ing for assistance with fi nding a new physician
A single mother at 4 months postpartum fearful of shaking her baby when he cries
The Pregnant Client with Preeclampsia or Eclampsia
Which of the following medications should the nurse have readily available at the client's bedside? Which of the following would alert the nurse that the client may be about to experience a seizure.
The Pregnant Client with a Chronic Hypertensive Disorder
Fifteen minutes after a client experiences an eclamptic seizure, the nurse should assess the client for which of the following. The nurse should notify the health care provider about which of the following test results.
The Pregnant Client with Third- Trimester Bleeding
When caring for a multigravid client admitted to the hospital with vaginal bleeding at 38 weeks' gestation, which of the following would the nurse expect to administer intravenously if the client develops disseminated intravascular coagulation (DIC). None of my other deliveries were like that." The nurse's response to the client is based on understanding which of the following.
The Pregnant Client with Preterm Labor
After the nurse provides instructions about the cause of the vaginal bleeding to a multigravid client at 36 weeks' gestation who has been diagnosed with placenta previa, the nurse determines that the teaching was effective when the client states that the bleeding is the result of which of the following. When preparing a multigravid client at 34 weeks' gestation who is experiencing preterm labor for the shaking test performed on amniotic fluid, the nurse would instruct the client that this test be performed to assess the maturity of which of the following fetal systems evaluate.
The Pregnant Client with Premature Rupture of the Membranes
At which of the following maternal sites would the nurse place the ultrasound transducer on the external electronic fetal heart rate monitor if a fetus at 34 weeks' gestation is in the left occipitoanterior (LOA) position. After instruction on home care, which of the following client statements indicates effective teaching.
The Pregnant Client with Diabetes Mellitus
When teaching a primigravid client with diabetes about common causes of hyperglycemia in pregnancy, which of the following would the nurse include. The nurse explains to the client that delivery helps prevent which of the following.
The Pregnant Client with Heart Disease
The client asks, "What causes the baby to be so big?" The nurse's response is based on the understanding that fetal macrosomia is usually associated with which of the following. Which of the following statements about postpartum insulin requirements for breastfeeding mothers should the nurse include in the explanation.
The Client with an Ectopic Pregnancy
The Pregnant Client with Hyperemesis Gravidarum
A primigravida hospitalized with a diagnosis of hyperemesis gravidarum is placed on nothing by mouth (NPO) status and receives intravenous (IV) fluid replacement therapy.
The Client with a Hydatidiform Mole
The Pregnant Client with Miscellaneous Complications
- Ask staff to activate emergency response system
- Establish unresponsiveness
- Give 2 breaths
- Check the pulse
- Open airway using head tilt-chin lift
- Assess the client’s current status
- Initiate an incident report
- Notify the physician of the incident
- Turn the client to her side
- Note the time when the seizure began
- Maintain airway
- Call for immediate assistance
When reviewing the client's history, which of the following factors places the client at risk for cord prolapse. Mild back pain is a common problem during pregnancy that is not related to the progression of the patient's preeclampsia.
The Pregnant Client with Third-Trimester Bleeding
The nurse must support the client, listen with empathy and allow them time to grieve. The nurse should also plan to monitor the client's vital signs and fetal heart rate.
The Pregnant Client with Preterm Labor
The likelihood that the client will experience postpartum blues is not known, and no evidence is presented. A priority assessment for the nurse to make is to document the client's temperature every 2 to 4 hours.
The Pregnant Client with Diabetes Mellitus
If the cord prolapses, the client should be placed in the knee-to-chest or Trendelenburg position. The patient should avoid contact with infected persons due to the increased risk of developing endocarditis.
The Client with an Ectopic Pregnancy
Assess the client’s current status 1. Notify the physician of the incident
The nurse should then notify the physician to explain the error and report on the actions taken.
Maintain airway
Note the length of time of seizure
The Primigravid Client in Labor
Which of the following indicates that the client had a therapeutic response to the medication. The nurse should assess the client for which of the following contraindications to the procedure.
The Multigravid Client in Labor
After the drug is administered, the nurse should assess the client for reduction in which of the following. Before administering anesthesia, the nurse instructs the client to assume which of the following positions.
The Labor Experience
Which of the following assessments and interventions should be done immediately, which the nurse assigns to the LPN. While working with this customer, which of the following responses indicates that the customer may be approaching delivery.
The Intrapartal Client with Risk Factors
Which of the following should the nurse be alert to when assessing the client's newborn? The nurse determines that the client is most likely to experience which of the following.
The Postpartal Client with a Vaginal Birth
Which of the following would the nurse include when explaining to the client about increased lochia on ambulation. The nurse tells the client to expect which of the following results from taking the medication.
The Postpartal Client Who Breast-Feeds
The nurse answers that breast milk is high in which of the following. Which of the following should the nurse include in the teaching plan of a primiparous mother who is asking about weaning her newborn.
The Postpartal Client Who Bottle-Feeds
The baby was nursing every 4 hours, but now she is crying to be fed every 2 hours.” The nurse explains that the newborn's behavior is most likely due to which of the following. A first-time client who is bottle-feeding her newborn asks, "When should I start giving my baby solids?" The nurse instructs the client to introduce solid foods only at what age.
The Postpartal Client with a Cesarean Birth
After instructing a primiparous client who is bottle-fed about burping, which of the following statements by the client indicates that the client needs further teaching. When preparing for discharge from the hospital a 15-year-old primipara who is bottle-feeding her newborn, the nurse instructs the client not to "prop up" the bottle while feeding the newborn because this may lead to which of the following .
The Postpartal Client with Complications
- Clean Betadine from client’s vaginal area
- Notify physician ordering catheterization
- File an incident report
- Ask client what her reaction is when exposed to Betadine
- Document incident
To promote maximum maternal comfort, which of the following would be most appropriate for the nurse to suggest. When assessing the client, which of the following would the nurse expect to find.
The Postpartal Client with a Vaginal Birth
The nurse should first allow the client to "hang" on the side of the bed for several minutes before attempting to ambulate. After the first 1 to 3 days after birth, the client is in the receiving phase and can focus more on the newborn's needs.
The Postpartal Client Who Breast-Feeds
Good times for a newborn to burp are when the mother switches from one breast to the other and at the end of breastfeeding. Lack of adequate intake to meet the mother's nutritional needs is not associated with the newborn's desire to breastfeed more often.
The Postpartal Client Who Bottle-Feeds
This position can be uncomfortable due to the pressure on the client's incision line. The client must be placed in the supine position to enable evaluation of the fundus.
Neonatal Care
The nurse is teaching the mother of a newborn to develop her infant's sensory system. Which of the following statements about baby powder should the nurse associate with the mother?
Physical Assessment of the Neonatal Client
When performing a complete assessment of a full-term newborn, which of the following findings would prompt the nurse to notify the pediatrician. Which of the following findings in a full-term neonate would prompt the nurse to notify the pediatrician.
The Preterm Neonate
While the oxygen is being administered, the nurse will place the neonate in which of the following positions. The nurse should plan to assist the neonatologist by preparing the neonate for which of the following.
The Neonate with Risk Factors
A newborn is admitted to the neonatal intensive care unit for observation with a diagnosis of probable meconium aspiration syndrome (MAS). Risk of disturbed parent-child-child attachment related to transfer to intensive care.
The Post-Term Neonate
Make sure the pulse oximeter is correlating to the heart rate
Which of the following should the nurse include in the preoperative teaching plan on feeding the newborn? The nurse determines that the mother needs further instructions if she states which of the following is present.
The Neonatal Client
- Check the room to which the new client will be admitted to be sure all supplies and equip-
- Log on to the clinical information system and determine if there are new orders
- Review notes from shift report and prioritize all clients; make rounds on the most critical
- Move quickly from room to room and assess all clients
Assessment of the newborn is the most important priority and should be completed first. The size of the nasogastric (NG) feeding tube is based on the newborn's weight.
Health Promotion of the Infant and Family
Which of the following would be appropriate for the nurse to administer during this visit. The nurse should expect the infant to be able to do which of the following.
Health Promotion of the Toddler and Family
The nurse and mother decide that the best course of action would be to do which of the following. When planning a 15-month-old's daily diet with the parents, which of the following amounts of milk should the nurse include.
Health Promotion of the Preschooler and Family
When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse compares the child's height and weight to standard growth charts and finds that the child is in the 50th percentile for height and the 45th percentile for weight.
Health Promotion of the Adolescent and Family
The mother asks the nurse about her 9-year-old child's apparent need for snacks, especially after school.
Health Promotion of the School-Age Child and Family