NCLEX-RN Free Practice Test

- (Topic 4)
A male client had a right below-the-knee amputation 4 days ago. His incision is healing well. He has gotten out of bed several times and sat at the side of the bed. Each time after returning to bed, he has experienced pain as if it were located in his right foot. Which nursing measure indicates the nurse has a thorough understanding of phantom pain and its management?

1. A. Phantom pain is entirely in the client??s min
2. B. The client should be instructed that the pain is psychological and should not be treated.
3. C. The basis for phantom pain may occur because the nerves still carry pain sensation to the brain even though the limb has been amputate
4. D. The pain is real, intense, and should be treated.
5. E. The cause of phantom pain is unknow
6. F. The nurse should provide the client with support, promote sleep, and handle the injured limb smoothly and gently.
7. G. Phantom pain is caused by trauma, spasms, and edema at the incisional sit
8. H. It will decrease when postoperative edema decrease
9. I. It should be treated with nonnarcotic medication whenever possible.

Correct Answer: B
(A) This statement is entirely false. (B) Phantom pain may be caused by nerves continuing to carry sensation to the brain even though the limb is removed. It is real, intense, and should be treated as ordinary pain would. (C) Although the cause of phantom pain is still unknown, thesemeasures may promote the relief of any type of pain, not just phantom pain. (D) Phantom pain is not caused by trauma, spasms, and edema and will not be relieved by decreasing edema.

- (Topic 2)
After a 10-year-old child with insulin-dependent diabetes mellitus receives her dinner tray, she tells the nurse that she hates broccoli and wants some corn on the cob. The nurse??s appropriate response is:

1. A. ??No vegetable exchanges are allowed.??
2. B. ??Corn and other starchy vegetables are considered to be bread exchanges.??
3. C. ??Yes, you may exchange any vegetable for any other vegetable.??
4. D. ??Yes, but only one-half ear is allowed.??

Correct Answer: B
(A) Sites for injection need to be rotated, including abdominal sites, to enhance insulin absorption. (B) The pinch technique is the most effective method for obtaining skin tightness to allow easy entrance of the needle to subcutaneous tissues. (C) Massaging the site of injectionfacilitates absorption of the insulin. (D) Changing the needle will break the sterility of the system. It has become acceptable practice to reuse disposable needles and syringes for 3–7 days.

- (Topic 7)
The pediatric nurse charts that the parents of a 4-yearold child are very anxious. Which observation would indicate to the nurse unhealthy coping by these parents:

1. A. Discussing their needs with the nursing staff
2. B. Discussing their needs with other family members
3. C. Seeking support from their minister
4. D. Refusing to participate in the child??s care

Correct Answer: D
(A, B, C) These methods are healthy ways of dealing with anxiety. (D) Participation minimizes feelings of helplessness and powerlessness. It is important that parents have accurate information and that they seek support from sources available to them.

- (Topic 7)
One of the most reliable assessment tools for adequacy of fluid resuscitation in burned children is:

1. A. Blood pressure
2. B. Level of consciousness
3. C. Skin turgor
4. D. Fluid intake

Correct Answer: B
(A) Blood pressure can remain normotensive in a state of hypovolemia. (B) Capillary refill, alterations in sensorium, and urine output are the most reliable indicators for assessing hydration. (C) Skin turgor is not a reliable indicator for assessing hydration in a burn client.
(D) Fluid intake does not indicate adequacy of fluid resuscitation in a burn client.

- (Topic 1)
Pregnant women with diabetes often have problems related to the effectiveness of insulin in controlling their glucose levels during their second half of pregnancy. The nurse teaches the client that this is due to:

1. A. Decreased glomerular filtration and increased tubular absorption
2. B. Decreased estrogen levels
3. C. Decreased progesterone levels
4. D. Increased human placental lactogen levels

Correct Answer: D
(A) There is a rise in glomerular filtration rate in the kidneys in conjunction with decreased tubular glucose reabsorption, resulting in glycosuria. (B) Insulin is inhibited by increased levels of estrogen. (C) Insulin is inhibited by increased levels of progesterone. (D) Human placental lactogen levels increase later in pregnancy. This hormonal antagonist reduces insulin??s effectiveness, stimulates lipolysis, and increases the circulation of free fatty acids.