NCLEX-RN Free Practice Test

- (Topic 3)
A newborn has been delivered with a meningomyelocele. The nursery nurse should position the newborn:

1. A. Prone
2. B. Supine
3. C. Side lying
4. D. Semi-Fowler

Correct Answer: A
(A) The prone position reduces pressure and tension on the sac. Primary nursing goals are to prevent trauma and infection of the sac. (B) The supine position exerts pressure on the sac. (C) Newborns usually cannot maintain side-lying position. (D) The semi- Fowler position exerts pressure on the sac.

- (Topic 7)
A client had a cardiac catheterization with angiography and thrombolytic therapy with streptokinase. The nurse should initiate which of the following interventions immediately after he returns to his room?

1. A. Place him on NPO restriction for 4 hours.
2. B. Monitor the catheterization site every 15 minutes.
3. C. Place him in a high Fowler position.
4. D. Ambulate him to the bathroom to void.

Correct Answer: B
(A) A contrast dye, iodine, is used in this procedure. This dye is nephrotoxic. The client must be encouraged to drink plenty of liquids to assist the kidneys in eliminating the dye.
(B) Streptokinase activates plasminogen, dissolving fibrin deposits. To prevent bleeding, pressure is applied at the insertion site. The client is assessed for both internal and external bleeding. (C) The extremity used for the insertion site must be kept straight and be immobilized because of the potential for bleeding. (D) The client is kept on bed rest for 8–12 hours following the procedure because of the potential for bleeding.

- (Topic 1)
The physician has ordered that a daily exercise program be instituted by a client with type I diabetes following his discharge from the hospital. Discharge instructions about exercise should include which of the following?

1. A. Exercise should be performed 30 minutes before meals.
2. B. A snack may be needed before and/or during exercise.
3. C. Hyperglycemia may occur 2–4 hours after exercise.
4. D. The blood glucose level should be 100 mg or below before exercise is begun.

Correct Answer: B
(A) Exercise should not be performed before meals because the blood sugar is usually lower just prior to eating; therefore, there is an increased risk for hypoglycemia. (B) Exercise lowers blood sugar levels; therefore, a snack may be needed to maintain the appropriate glucose level. (C) Exercise lowers blood sugar levels. (D) Exercise lowers blood sugar levels. If the blood glucose level is 100 mg or below at the start of exercise, the potential for hypoglycemia is greater.

- (Topic 7)
The nurse knows that children are more susceptible to respiratory tract infections owing to physiological differences. These childhood differences, when compared to an adult, include:

1. A. Fewer alveoli, slower respiratory rate
2. B. Diaphragmatic breathing, larger volume of air
3. C. Larger number of alveoli, diaphragmatic breathing
4. D. Rounded shape of chest, smaller volume of air

Correct Answer: D
(A) Although a child has fewer alveoli than an adult, the child??s respiratory rate is faster. (B) Although a child may use diaphragmatic breathing, the adult exchanges a larger volume of air. (C) The adult has a larger number of alveoli than a child. (D) The child??s chest is rounded whereas the adult chest is more of an oval shape, and the child does exchange a smaller volume of air than an adult.

- (Topic 4)
When assessing residual volume in tube feeding, the feeding should be delayed if the amount of gastric contents (residual) exceeds:

1. A. 20 mL
2. B. 25 mL
3. C. 30 mL
4. D. 50 mL

Correct Answer: D
(A) A residual volume of 20 mL is not excessive. (B) A residual volume of 25 mL is not excessive. (C) A residual volume of 30 mL is not excessive. (D) Tube feedings should be withheld and physician notified for residual volumes of 50–100 mL.