NCLEX-RN Free Practice Test

- (Topic 2)
A client delivered her first-born son 4 hours ago. She asks the nurse what the white cheeselike substance is under the baby??s arms. The nurse should respond:

1. A. ??This is a normal skin variation in newborn
2. B. It will go away in a few days.??
3. C. ??Let me have a closer look at i
4. D. The baby may have an infection.??
5. E. ??This material, called vernix, covered the baby before it was bor
6. F. It will disappear in a few days.??
7. G. ??Babies sometimes have sebaceous glands that get plugged at birt
8. H. This substance is an example of that condition.??

Correct Answer: C
(A) This response identifies the fact that vernix is a normal neonatal variation, but it does not teach the client medical terms that may be useful in understanding other healthcare personnel. (B) This response may raise maternal anxiety and incorrectly identifies a normal neonatal variation. (C) This response correctly identifies this neonatal variation and helps the client to understand medical terms as well as the characteristics of her newborn. (D) Blocked sebaceous glands produce milia, particularly present on the nose.

- (Topic 2)
A client in active labor asks the nurse for coaching with her breathing during contractions. The client has attended Lamaze birth preparation classes. Which of the following is the best response by the nurse?

1. A. ??Keep breathing with your abdominal muscles as long as you can.??
2. B. ??Make sure you take a deep cleansing breath as the contractions start, focus on an object, and breathe about 16–20 times a minute with shallow chest breaths.??
3. C. ??Find a comfortable position before you start a contractio
4. D. Once the contraction has started, take slow breaths using your abdominal muscles.??
5. E. ??If a woman in labor listens to her body and takes rapid, deep breaths, she will be able to deal with her contractions quite well.??

Correct Answer: B
(A) Lamaze childbirth preparation teaches the use of chest, not abdominal, breathing. (B) In Lamaze preparation, every patterned breath is preceded by a cleansing breath; as labor progresses, shallow, paced breathing is found to be effective. (C) It is important to assume a comfortable position in labor, but the Lamazeprepared laboring woman is taught to breathe with her chest, not abdominal, muscles. (D) When deep chest breathing patterns are used in Lamaze preparation, they are slowly paced at a rate of 6–9 breaths/min.

- (Topic 5)
A mother brings a 6-month-old infant and a 4-year-old child to the nursing clinic for routine examination and screening. Which of these plans by the nurse would be most successful?

1. A. Examine the 4 year old first.
2. B. Provide time for play and becoming acquainted.
3. C. Have the mother leave the room with one child, and examine the other child privately.
4. D. Examine painful areas first to get them ??over with.??

Correct Answer: B
(A) The 6 month old should be examined first. If several children will be examined, begin with the most cooperative and less anxious child to provide modeling. (B) Providing time for play and getting acquainted minimizes stress and anxiety associated with assessment of body parts. (C) Children generally cooperate best when their mother remains with them.
(D) Painful areas are best examined last and will permit maximum accuracy of assessment.

- (Topic 1)
The child with iron poisoning is given IV deforoxamine mesylate (Desferal). Following administration, the child suffers hypotension, facial flushing, and urticaria. The initial nursing intervention would be to:

1. A. Discontinue the IV
2. B. Stop the medication, and begin a normal saline infusion
3. C. Take all vital signs, and report to the physician
4. D. Assess urinary output, and if it is 30 mL an hour, maintain current treatment

Correct Answer: B
(A) The IV line should not be discontinued because other IV medications will be needed.
(B) Stop the medication and begin a normal saline infusion. The child is exhibiting signs of an allergic reaction and could go into shock if the medication is not stopped. The line should be kept opened for other medication. (C) Taking vital signs and reporting to the physician is not an adequate intervention because the IV medication continues to flow. (D) Assessing urinary output and, if it is 30 mL an hour, maintaining current treatment is an inappropriate intervention owing to the child??s obvious allergic reaction.

- (Topic 4)
A 10-month-old infant??s mother says that he takes fresh whole milk eagerly, but that when she offered him baby foods at 6 months of age, he pushed them out of his mouth. Because he has gained weight appropriately, she has quit trying to get him to eat other foods. The nurse??s response is based on the knowledge that:

1. A. Milk intake should be limited to no more than four 8-oz bottles per day and should be followed by iron-enriched cereal or other solid foods or juices
2. B. Milk is an excellent food and will meet his nutritional needs adequately until he is ready to eat solid foods
3. C. It is acceptable to continue to give him whole milk and to delay giving solid foods as long as he takes a vitamin supplement daily
4. D. He should be started on iron-enriched cereal, meat, vegetables, fruits, and juices prior to bottle feed
5. E. Milk intake should be limited to 1 qt/day

Correct Answer: D
(A) If the infant is given the bottle first, he will be less likely to be hungry enough to eat the solid foods. (B) Milk is deficient in iron, vitamin C, zinc, and fluoride. It does not provide an adequate diet. (C) The vitamin supplement will help, but the infant needs an iron supplement. (D) Giving the solid food when the infant is hungriest will increase the likelihood that he will eat. The more solid food he takes, the less milk he will desire.