NCLEX Practice Exam 2 — Questions and Answers

Question 1: An 84-year-old male has been losing mobility and gaining weight over the last two (2) months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?

FBC (full blood count)
ECG (electrocardiogram)
CT scan
Thyroid function tests (Correct answer)

Correct answer: Thyroid function tests

The symptoms described—losing mobility, gaining weight, and feeling cold even on warm days (requiring the heater constantly)—are classic indicators of hypothyroidism. This condition results from an underactive thyroid gland, leading to a slowed metabolism. Thyroid function tests directly measure thyroid hormone levels, making them the most appropriate diagnostic tool to confirm or rule out this suspected endocrine disorder.

Question 2: A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is.

The life span of RBC is 45 days
The life span of RBC is 45 days
The life span of RBC is 90 days
The life span of RBC is 120 days (Correct answer)

Correct answer: The life span of RBC is 120 days

Red blood cells (RBCs), also known as erythrocytes, have a distinct and relatively long lifespan in the human body. They circulate for approximately 120 days before being removed from the bloodstream, primarily by the spleen. This physiological fact is fundamental to understanding hematopoiesis and various blood disorders.

Question 3: Rhogam is most often used to treat mothers that have a infant.

RH positive, RH positive
RH positive, RH negative
RH negative, RH positive (Correct answer)
RH negative, RH negative

Correct answer: RH negative, RH positive

Rhogam (Rh immune globulin) is administered to Rh-negative mothers who are pregnant with or have delivered an Rh-positive infant. Its purpose is to prevent the mother's immune system from developing antibodies against the Rh-positive fetal red blood cells, which could lead to hemolytic disease in subsequent Rh-positive pregnancies. This intervention is critical for preventing Rh sensitization and protecting future babies.

Question 4: When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?

Amitriptyline (Elavil) (Correct answer)
Calcitonin
Pergolide mesylate (Permax)
Verapamil (Calan)

Correct answer: Amitriptyline (Elavil)

Amitriptyline (Elavil) is a tricyclic antidepressant (TCA) commonly prescribed for the treatment of depression and various anxiety disorders. It works by increasing the levels of certain neurotransmitters in the brain, such as serotonin and norepinephrine. The other listed medications are used for different conditions, making Amitriptyline the most likely choice for a patient with depression and an anxiety disorder.

Question 5: A 65-year-old man has been admitted to the hospital for spinal stenosis surgery. When should the discharge training and planning begin for this patient?

Following surgery
Upon admit (Correct answer)
Within 48 hours of discharge
Preoperative discussion

Correct answer: Upon admit

Discharge planning is a continuous process that should ideally commence upon a patient's admission to the hospital. Starting early allows the healthcare team to thoroughly assess the patient's needs, identify potential barriers to discharge, and coordinate necessary resources, education, and follow-up care. This proactive approach ensures a safe, timely, and effective transition back home, optimizing patient outcomes.

Question 6: A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?

The age of the child
The child's ability to understand instruction
The overall mental and physical abilities of the child (Correct answer)
Frequent attempts with positive reinforcement

Correct answer: The overall mental and physical abilities of the child

Successful toilet training is primarily dependent on a child's readiness, which encompasses their overall mental and physical abilities. This includes having sufficient bladder and bowel control, the ability to recognize and communicate the urge to go, and the physical dexterity to manage clothing and get to the toilet. While age provides a general guideline, individual developmental readiness is the most crucial factor.

Question 7: A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?

Atherosclerosis
Diabetic nephropathy
Autonomic neuropathy (Correct answer)
Somatic neuropathy

Correct answer: Autonomic neuropathy

Long-standing diabetes can lead to autonomic neuropathy, a condition where nerve damage affects involuntary bodily functions. Inability to urinate (urinary retention) in a diabetic patient is a classic manifestation of autonomic neuropathy affecting the bladder, impairing its ability to sense fullness and contract effectively. This complication highlights the systemic impact of uncontrolled diabetes on various organ systems.

Question 8: A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that nursing student should take?

Immediately see a social worker.
Start prophylactic AZT treatment. (Correct answer)
Start prophylactic Pentamidine treatment.
Seek counseling.

Correct answer: Start prophylactic AZT treatment.

Following a needlestick injury from a patient positive for HIV (AIDS), the most critical immediate action is to initiate post-exposure prophylaxis (PEP) with antiretroviral medications, such as AZT. This treatment, started as soon as possible (ideally within hours), significantly reduces the risk of HIV transmission. While counseling and support are important, immediate medical intervention to prevent infection takes precedence.

Question 9: Which of the following conditions would a nurse not administer erythromycin?

Campylobacteriosis infection
Legionnaire’s disease
Pneumonia
Multiple Sclerosis (Correct answer)

Correct answer: Multiple Sclerosis

Erythromycin is a macrolide antibiotic used to treat a wide range of bacterial infections, including those caused by Campylobacteriosis, Legionnaire's disease, and certain types of pneumonia. Multiple Sclerosis (MS), however, is a chronic autoimmune disease affecting the central nervous system, and erythromycin has no therapeutic role in its treatment. Therefore, administering erythromycin for MS would be inappropriate.

Question 10: A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client’s:

Level of consciousness
Gag reflex (Correct answer)
Urinary output
Movement of extremities

Correct answer: Gag reflex

An esophagoscopy often involves the use of local anesthetic to numb the throat, which temporarily suppresses the gag reflex. Before offering any fluids or food, it is paramount for the nurse to assess the client's gag reflex to ensure it has fully returned. A diminished or absent gag reflex puts the client at significant risk for aspiration, making this assessment a top priority for patient safety.

Question 11: Which instruction should be included in the discharge teaching for the client with cataract surgery?

Over-the-counter eyedrops can be used to treat redness and irritation.
The eye shield should be worn at night. (Correct answer)
It will be necessary to wear special cataract glasses.
A prescription for medication to control post-operative pain will be needed.

Correct answer: The eye shield should be worn at night.

After cataract surgery, wearing an eye shield at night is a crucial instruction to protect the operative eye from accidental rubbing, bumping, or pressure during sleep. This prevents potential injury to the delicate surgical site and helps ensure proper healing. Other instructions typically include avoiding strenuous activities and not rubbing the eye.

Question 12: An 8-year-old is admitted with drooling, muffled phonation, and a temperature of 102°F. The nurse should immediately notify the doctor because the child’s symptoms are suggestive of:

Strep throat
Epiglottitis (Correct answer)
Laryngotracheobronchitis
Bronchiolitis

Correct answer: Epiglottitis

The symptoms of drooling, muffled phonation (difficulty speaking clearly), and a high fever in an 8-year-old child are classic and alarming signs of epiglottitis. This condition involves rapid inflammation and swelling of the epiglottis, which can quickly lead to severe airway obstruction and respiratory distress. Immediate notification of the doctor is essential for prompt medical intervention to secure the child's airway.

Question 13: Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:

Offer the baby sterile water between feedings of formula (Correct answer)
Apply an emollient to the baby’s skin to prevent drying
Wear a gown, gloves, and a mask while caring for the infant
Place the baby on enteric isolation

Correct answer: Offer the baby sterile water between feedings of formula

Phototherapy for neonatal jaundice increases insensible fluid loss and can lead to dehydration. Offering sterile water or additional breast milk/formula between feedings helps maintain adequate hydration and promotes the excretion of bilirubin through urine and stool. This intervention is crucial for preventing dehydration and aiding in the effective elimination of bilirubin from the baby's system.

Question 14: A teen hospitalized with anorexia nervosa is now permitted to leave her room and eat in the dining room. Which of the following nursing interventions should be included in the client’s plan of care?

Weighing the client after she eats
Having a staff member remain with her for 1 hour after she eats (Correct answer)
Placing high-protein foods in the center of the client’s plate
Providing the client with child-size utensils

Correct answer: Having a staff member remain with her for 1 hour after she eats

Patients with anorexia nervosa often engage in compensatory behaviors, such as purging, excessive exercise, or hiding food, after meals. Having a staff member remain with the client for a period after eating helps to prevent these behaviors and ensures that the nutritional intake is maintained. This close supervision is a critical component of their treatment plan to promote healthy eating habits and weight restoration.

Question 15: According to Erikson’s stage of growth and development, the developmental task associated with middle childhood is:

Trust
Initiative
Independence
Industry (Correct answer)

Correct answer: Industry

According to Erik Erikson's stages of psychosocial development, middle childhood (approximately ages 6-12 years) is characterized by the 'Industry vs. Inferiority' stage. During this period, children focus on developing a sense of competence and mastery in school, sports, and social activities. They strive to achieve and gain recognition for their efforts, fostering a sense of industry and accomplishment.

Question 16: A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:

Uses an electric blanket at night
Dresses in extra layers of clothing (Correct answer)
Applies a heating pad to her feet
Takes a hot bath morning and evening

Correct answer: Dresses in extra layers of clothing

Hypothyroidism causes a slowed metabolism, which often leads to cold intolerance and a persistent feeling of being cold. Dressing in extra layers of clothing is a practical, safe, and effective non-pharmacological intervention to help the client maintain body warmth and feel more comfortable. This directly addresses the symptom and improves the client's comfort.

NCLEX Practice Exam 2

An 84-year-old male has been losing mobility and gaining weight over the last two (2) months.
The patient also has the heater running in his house 24 hours a day, even on warm days.
Which of the following tests is most likely to be performed?