NCLEX-RN Free Practice Test

- (Topic 1)
A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the
effectiveness of the instruction about diet and weight control?

1. A. She is compliant with her diet as previously taught.
2. B. She needs further instruction and reinforcement.
3. C. She needs to increase her caloric intake.
4. D. She needs to be placed on a restrictive diet immediately.

Correct Answer: B
(A) She is probably not compliant with her diet and exercise program. Recommended weight gain during second and third trimesters is approximately 12 lb. (B) Because of her excessive weight gain of 10 lb in 2 months, she needs re-evaluation of her eating habits and reinforcement of proper dietary habits for pregnancy. A 2200-calorie diet is recommended for most pregnant women with a weight gain of 27–30 lb over the 9-month period. With rapid and excessive weightgain, PIH should also be suspected. (C) She does not need to increase her caloric intake, but she does need to re-evaluate dietary habits. Ten pounds in 2 months is excessive weight gain during pregnancy, and health teaching is warranted. (D) Restrictive dieting is not recommended during pregnancy.

- (Topic 7)
A couple is experiencing difficulties conceiving a baby. The nurse explains basal body temperature (BBT) by instructing the female client to take her temperature:

1. A. Orally in the morning and at bedtime
2. B. Only one time during the day as long as it is always at the same time of day
3. C. Rectally at bedtime
4. D. As soon as she awakens, prior to any activity

Correct Answer: D
(A) Monitoring temperature twice a day predicts the biphasic pattern of ovulation. (B) Prediction of ovulation relies on consistency in taking temperature. (C) Nightly rectal temperatures are more accurate in predicting ovulation. (D) Activity changes the accuracy of basal body temperature and ability to detect the luteinizing hormone surge.

- (Topic 5)
A 30-year-old female client is receiving antineoplastic chemotherapy. Which of the following symptoms should especially concern the nurse when caring for her?

1. A. Respiratory rate of 16 breaths/min
2. B. Pulse rate of 80 bpm
3. C. Complaints of muscle aches
4. D. A sore throat

Correct Answer: D
(A) A respiratory rate of 16 breaths/min is normal and is not a cause for alarm. (B) A pulse rate of 80 bpm is normal and is not a cause for alarm. (C) Complaints of muscle aches are unrelated to her receiving chemotherapy. There may be other causes related to her hospital stay or the disease process. (D) A sore throat is an indication of a possible infection. A client receiving chemotherapy is at risk of neutropenia. An infection in the presence of neutropenia can result in a life-threatening situation.

- (Topic 1)
The nurse is aware that nutrition is an important aspect of care for a client with hepatitis. Which of the following diets would be most therapeutic?

1. A. High protein and low carbohydrate
2. B. Low calorie and low protein
3. C. High carbohydrate and high calorie
4. D. Low carbohydrate and high calorie

Correct Answer: C
(A) Protein increases the workload of the liver. Increased carbohydrates provide needed calories and promote palatability. (B) Dietary intake should be adequate to ensure wound healing. (C) Increased carbohydrates provide needed calories. (D) A highcalorie diet is best obtained from carbohydrates because of their palatability. Fats increase the workload of the liver.

- (Topic 4)
A 48-year-old client is in the surgical intensive care unit after having had three-vessel coronary artery bypass surgery yesterday. She is extubated, awake, alert and talking. She is receiving digitalis for atrial arrhythmias. This morning serum electrolytes were drawn. Which abnormality would require immediate intervention by the nurse after contacting the physician?

1. A. Serum osmolality is elevated indicating hemoconcentration.The nurse should increase IV fluid rate.
2. B. Serum sodium is lo
3. C. The nurse should change IV fluids to normal saline.
4. D. Blood urea nitrogen is subnorma
5. E. The nurse should increase the protein in the client??s diet as soon as possible.
6. F. Serum potassium is lo
7. G. The nurse should administer KCl as ordered.

Correct Answer: D
(A) An elevated serum osmolality poses no immediate danger and is not corrected rapidly.
(B) A low serum sodium alone does not warrant changing IV fluids to normal saline. Other assessment parameters, such as hydration status, must be considered. (C) A low serum blood urea nitrogen is not necessarily indicative of protein deprivation. It may also be the result of overhydration. (D)A low serum potassium potentiates the effects of digitalis, predisposing the client to dangerous arrhythmias. It must be corrected immediately.