NCLEX-RN Practice Test 15 — Questions and Answers
Question 1: A nonimmunized child appears at the clinic with a visible rash. Which of the following observations indicates the child may have rubeola (measles)?
- Small blue-white spots are visible on the oral mucosa (Correct answer)
- The rash begins on the trunk and spreads outward
- There is low-grade fever
- The lesions have a "teardrop-on-a-rose-petal" appearance.
Correct answer: Small blue-white spots are visible on the oral mucosa
Koplik's spots, which are small, irregular red spots with a bluish-white center, are a pathognomonic sign of rubeola (measles). They typically appear on the buccal mucosa (inside the cheeks) 1-2 days before the characteristic rash erupts. This distinctive oral finding is a crucial diagnostic indicator for measles.
Question 2: The clinic nurse asks a 13-year-old female to bend forward at the waist with arms hanging freely. Which of the following assessments is the nurse most likely conducting?
- Spinal flexibility
- Leg length disparity
- Hypostatic blood pressure
- Scoliosis (Correct answer)
Correct answer: Scoliosis
The forward bend test, also known as Adam's forward bend test, is a common screening maneuver used to detect scoliosis. By having the child bend forward at the waist with arms hanging freely, the nurse can observe for any asymmetry in the trunk, such as a rib hump or uneven shoulders, which are indicative of spinal curvature.
Question 3: A clinic nurse interviews a parent who is suspected of abusing her child. Which of the following characteristics is the nurse LEAST likely to find in an abusing parent?
- Low self-esteem.
- Unemployment
- Self-blame for the injury to the child. (Correct answer)
- Single status.
Correct answer: Self-blame for the injury to the child.
Abusing parents often exhibit characteristics such as low self-esteem, social isolation, and a lack of empathy, frequently externalizing blame for their actions. While they may express regret or remorse, genuine self-blame for the injury to the child is less common, as they often rationalize or deny their behavior. Instead, they might blame the child, other family members, or external stressors.
Question 4: A patient with Addison’s disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is NOT recommended?
- A diet high in grains.
- A diet with adequate caloric intake.
- A high protein diet.
- A restricted sodium diet. (Correct answer)
Correct answer: A restricted sodium diet.
Patients with Addison's disease have adrenal insufficiency, leading to decreased production of aldosterone, a hormone that regulates sodium and potassium balance. This can result in hyponatremia (low sodium) and hyperkalemia (high potassium). Therefore, a restricted sodium diet is contraindicated; instead, a diet with adequate or even increased sodium intake is often recommended to help maintain fluid and electrolyte balance.
Question 5: A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the following is the most likely route of transmission?
- Sexual contact with an infected partner
- Contaminated food (Correct answer)
- Blood transfusion
- Illegal drug use
Correct answer: Contaminated food
Hepatitis A is primarily transmitted through the fecal-oral route, most commonly by ingesting contaminated food or water. This can occur when an infected person handles food without proper hand hygiene or when food is grown in contaminated water. While other routes exist, contaminated food is the most frequent mode of transmission.
Question 6: A nurse is caring for a patient with peripheral vascular disease (PVD). The patient complains of burning and tingling of the hands and feet and cannot tolerate touch of any kind. Which of the following is the most likely explanation for these symptoms?
- Inadequate tissue perfusion leading to nerve damage. (Correct answer)
- Fluid overload leading to compression of nerve tissue.
- Sensation distortion due to psychiatric disturbance.
- Inflammation of the skin on the hands and feet.
Correct answer: Inadequate tissue perfusion leading to nerve damage.
Peripheral vascular disease (PVD) causes narrowing of blood vessels, leading to reduced blood flow (ischemia) to the extremities. Chronic ischemia can damage peripheral nerves, resulting in neuropathic symptoms such as burning, tingling (paresthesias), numbness, and extreme sensitivity to touch (allodynia or hyperesthesia). These symptoms are a direct consequence of nerve dysfunction due to insufficient oxygen and nutrient supply.
Question 7: A patient with leukemia is receiving chemotherapy that is known to depress bone marrow. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. Which of the following actions related specifically to the platelet count should be included in the nursing care plan?
- Monitor for fever every 4 hours
- Require visitors to wear respiratory masks and protective clothing
- Consider transfusion of packed red blood cells
- Check for signs of bleeding, including examination of urine and stool for blood (Correct answer)
Correct answer: Check for signs of bleeding, including examination of urine and stool for blood
A platelet count of 25,000/microliter is critically low (normal range is 150,000-450,000/microliter) and indicates severe thrombocytopenia. This significantly increases the risk of spontaneous bleeding. Therefore, the priority nursing action is to meticulously monitor for any signs of hemorrhage, such as petechiae, ecchymoses, epistaxis, gingival bleeding, and occult or frank blood in urine and stool.
Question 8: A nurse is providing discharge information to a patient with peripheral vascular disease. Which of the following information should be included in instructions?
- Walk barefoot whenever possible
- Use a heating pad to keep feet warm
- Avoid crossing the legs (Correct answer)
- Use antibacterial ointment to treat skin lesions at risk of infection
Correct answer: Avoid crossing the legs
Patients with peripheral vascular disease (PVD) have impaired blood circulation to their extremities. Crossing the legs can further compress blood vessels, restricting blood flow and exacerbating ischemia. Therefore, avoiding leg crossing is an important instruction to promote optimal circulation and prevent complications in PVD.
Question 9: A nurse calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the nurse most likely observed?
- The patient is somnolent with decreased response to the family
- The patient suddenly complains of chest pain and shortness of breath. (Correct answer)
- The patient has developed a wet cough and the nurse hears crackles on auscultation of the lungs
- The patient has a fever, chills, and loss of appetite
Correct answer: The patient suddenly complains of chest pain and shortness of breath.
A pulmonary embolism (PE) is a sudden blockage in a lung artery, usually by a blood clot that has traveled from elsewhere in the body. The classic symptoms of PE include the sudden onset of dyspnea (shortness of breath), pleuritic chest pain (pain that worsens with breathing), and sometimes tachycardia or tachypnea. These acute symptoms are indicative of a medical emergency requiring immediate attention.
Question 10: Which one of the following statements about hypotheses is most accurate?
- Hypotheses represent the main idea to be studied and are the foundations of research studies.
- Hypotheses help frame a test of the validity of a theory. (Correct answer)
- Hypotheses provide the means to test nursing theory.
- A hypothesis can also be called a problem statement.
Correct answer: Hypotheses help frame a test of the validity of a theory.
Hypotheses are testable statements that propose a relationship between variables, often derived from existing theories. In quantitative research, hypotheses are formulated to be empirically tested, and the results of these tests can either support or refute the underlying theory, thereby contributing to its validation or refinement.
Question 11: A nurse wants to study the effectiveness of meditation on people with anxiety disorder. Which variable would be most relevant to explore in the literature on this topic?
- Use of meditation during childbirth
- Meditation techniques found to be effective (Correct answer)
- Pain management for people with anxiety disorders
- Outcomes of meditation when used by elderly populations
Correct answer: Meditation techniques found to be effective
When studying the effectiveness of meditation on anxiety disorder, the most relevant variable to explore in the literature would be specific meditation techniques that have demonstrated efficacy. This information is crucial for designing the intervention, understanding mechanisms of action, and comparing potential outcomes. Focusing on effective techniques directly addresses the core of the research question.
Question 12: What is a characteristic of an independent variable?
- It is the variable that is predicted to change.
- It varies with a change in the dependent variable.
- It is manipulated by the researcher. (Correct answer)
- It can be identified only by changes in the dependent variable.
Correct answer: It is manipulated by the researcher.
In experimental and quasi-experimental research, the independent variable is the factor that the researcher intentionally changes or manipulates to observe its effect on another variable. It is the presumed cause in a cause-and-effect relationship. The dependent variable, in contrast, is the outcome that is measured and is expected to change as a result of the independent variable's manipulation.
Question 13: Which statement is most accurate regarding hypotheses?
- Hypotheses operationally define the dependent variables.
- Hypotheses are statements about the relationships among variables. (Correct answer)
- Hypotheses describe the effect of the dependent variable on the independent variable.
- Hypotheses must include a definition of the treatment or intervention used.
Correct answer: Hypotheses are statements about the relationships among variables.
A hypothesis is a clear, concise, and testable statement that proposes a predicted relationship between two or more variables. It serves as an educated guess or a tentative explanation for an observed phenomenon, which can then be empirically investigated through research. This relationship can be one of cause and effect, association, or difference.
Question 14: What is a characteristic of a hypothesis?
- It flows from interpretation of the data collected.
- It operationally defines the variable to be studied.
- It eliminates the need to designate a dependent variable.
- It implies a causative or associative relationship. (Correct answer)
Correct answer: It implies a causative or associative relationship.
A hypothesis is a testable statement that proposes a relationship between two or more variables. It predicts an outcome, suggesting either that one variable causes another (causative) or that they occur together (associative). This predictive nature is fundamental to scientific inquiry, allowing researchers to investigate and potentially confirm or refute the proposed relationship.
Question 15: When should a hypothesis be developed by the researcher during the research process?
- Before development of the research question
- After development of the research question (Correct answer)
- After a research design is determined
- Before any statistical analysis
Correct answer: After development of the research question
The research process typically begins with identifying a broad area of interest, which is then narrowed down into a specific research question. Once the question is clearly defined, the researcher can formulate a testable hypothesis that proposes an answer or relationship to be investigated. The hypothesis directly stems from and attempts to answer the research question.
Question 16: Which research hypothesis is most testable?
- There is a relationship between meditation and anxiety disorders.
- Patients with anxiety disorders who learn meditation techniques have less anxiety than those who do not.
- Teaching one meditation technique to patients with anxiety disorders will be better than teaching multiple techniques.
- The ability to meditate causes lower anxiety in patients with anxiety disorder than in those who do not meditate. (Correct answer)
Correct answer: The ability to meditate causes lower anxiety in patients with anxiety disorder than in those who do not meditate.
A testable hypothesis must be specific, measurable, and clearly define the variables and their proposed relationship. Option D clearly identifies the independent variable (ability to meditate), the dependent variable (lower anxiety), and the population (patients with anxiety disorder), making it directly observable and quantifiable. The other options are too vague or less specific in their proposed relationships, making them harder to test empirically.
NCLEX-RN Practice Test 15
A nonimmunized child appears at the clinic with a visible rash.
Which of the following observations indicates the child may have rubeola (measles)?