NCLEX QUESTIONS
Summer 2010 Set 4
(Answers follow all questions)
Fundamentals of Nursing
1. The registered nurse is preparing the client assignment for the day in a long-term care
facility. What assignments would be appropriate for the registered nurse to delegate to
unlicensed personnel?
A. Application of a prescribed restraint
B. Administration of medications through a nasogastric tube
C. Assessment of a postoperative stoma
D. Irrigation of a Foley catheter
Maternity
2. The nurse reviewing a newborn’s chart informs the parents that ABO incompatibility is
not possible in their newborn because the mother’s blood type is
A. A
B. B
C. AB
D. O
Pediatrics
3. The nurse observes a child having a seizure that begins with tonic contractions of the
fingers in the left hand and progresses into tonic-clonic movements that proceed up the
muscles of the left side of the body. The nurse should report these seizures as
A. Jacksonian
B. Rolandic
C. General
D. Complex
Neurological Disorders (Adult)
4. The nurse should monitor a client receiving pyridostigmine (Mestinon) for which of
the following adverse reactions?
A. Constipation
B. Decreased heart rate
C. Hypertension
D. Increased intraocular pressure
Musculoskeletal/Integumentary Disorders (Adult)
5. Which of the following would be the best indicators to the nurse that a client receiving
Naprosyn for rheumatoid arthritis is experiencing adverse reactions from this drug?
Select all that apply:
A. Tinnitus
B. Blurred vision
C. Confusion
D. Headache
E. Vasoconstriction
F. Hypokalemia
Oncological/Immune Disorders (Adult)
6. A client asks the nurse if the chemotherapy will only affect the cancer cells in the
body. Which of the following is the appropriate response by the nurse?
A. “The chemotherapy affects only the cancer cells.”
B. “The chemotherapy affects both the normal as well as the cancer cells.”
C. “It depends on the type of chemotherapy.”
D. “The effect on cells is different in every client.”
Cardiovascular Disorders (Adult)
7. The client with a recent diagnosis of cardiomyopathy asks the nurse, “What
contributed to my getting this illness?” The most appropriate response is to say that the
majority of clients with cardiomyopathy also have
A. Hypertension
B. A viral infection
C. A genetic trait
D. An unknown cause
Respiratory Disorders (Adult)
8. Which of the following treatments is the priority for the nurse to administer to a client
who has a positive tuberculosis (TB) skin test but has no other evidence of active
disease?
A. No treatment and repeat skin test in 6 months
B. Isoniazid (INH) for 12 months
C. Multidrug therapy for at least 12 months
D. Streptomycin for 12 months
Endocrine Disorders (Adult)
9. Which of the following nursing interventions should be included in a plan of care for a
client with Addison’s disease?
A. Administer the prescribed diuretics
B. Give diet instructions for a low-carbohydrate, low-protein diet
C. Monitor for signs of Na+ and K+ imbalances
D. Encourage self-care activities
GI/GU Disorders (Adult)
10. After administering ursodiol (Actigall) to the client with gallbladder disease, the
nurse evaluates the priority outcome to be:
A. Decreased vomiting
B. Increased comfort
C. Reduced stone formation
D. Decreased bile production
Sensory Disorders (Adult)
11. The nurse administers which of the following drugs to a client who has keratitis?
A. Acyclovir (Zovirax)
B. Acetazolamide (Diamox)
C. Scopolamine (Isopto Hyoscine)
D. Idoxuridine (Stoxil)
Psychiatric and Mental Health (Adult)
12. Which of the following interventions is a priority and will help the older adult client
comply with the drug regimen?
A. Educate the family members about drug administration
B. Contact the client frequently as a reminder to take drugs
C. Educate the client on ways to manage adverse reactions
D. Count the number of pills left in the bottle at each visit
Answers
1. A: Although unlicensed assistive personnel should not perform any assessments on a
client with a restraint, they have been trained to apply the restraint. Administration of
medications through a nasogastric tube, assessment of a postoperative stoma, and
irrigation of a Foley catheter should be performed by a nurse.
2. C: Type O persons produce both anti-A and anti-B antibodies. Type AB persons
produce no antibodies. Type A and type B persons produce the antibody to the opposite
type. For example, a type B person would produce anti-A antibodies. No ABO
incompatibility occurs with a type AB mother regardless of the fetus’s blood type.
3. A: Jacksonian seizures begin with tonic contractions of the fingers in the left hand and
progress into tonic-clonic movements that proceed up the muscles of the left side of the
body. Rolandic seizures include tonic-clonic movements of the face, with increased
salivation and arrested speech; they commonly occur during sleep. Complex seizures
have an aura, and consciousness may not be completely lost. Children are rarely violent,
but may demonstrate confusion or purposeless behaviors. General seizures are secondary
to diffuse electrical activity throughout the cortex and into the brain.
4. B: Pridostigmine (Mestinon) is a cholinergic drug in the treatment of myasthenia
gravis. Adverse reactions include bradycardia, diarrhea, and hypotension.
5. A, B, C, D: Naprosyn is a nonsteroidal anti-inflammatory drug used in the treatment of
musculoskeletal and soft tissue inflammatory disorders, such as rheumatoid arthritis.
Adverse reactions include headache, dizziness, blurred vision, confusion, tinnitus, and
gastrointestinal upset. Naprosyn results in vasodilation and hyperkalemia.
6. B: Chemotherapy is a systemic treatment that affects normal as well as cancer cells.
Cells of any tissue that are actively dividing will be more susceptible to its effects. While
the adverse reactions experienced by any one client may vary somewhat, cancer cells and
normal cells are still both affected by the treatment.
7. D: Although hypertension, viral infection, or a genetic trait may all be possible reasons
for developing cardiomyopathy, the majority of cases are idiopathic (unknown reason).
8. B: A positive skin test with no other evidence of disease indicates exposure to the
disease. Isoniazid (INH) therapy for 12 months is the usual protocol. Once a client has a
positive skin test, it will always be positive and there is no value in repeating a test.
Multidrug therapy is used to treat active disease and streptomycin or Amikacin is often
added in the induction phase of treatment.
9. C: Addison’s disease is deficiency of adrenal glucocorticoids and mineralocorticoids
resulting in major disturbances in sodium (hyponatremia) and potassium (hyperkalemia).
These clients need lifelong replacement therapy of glucocorticoids and
mineralocorticoids. A high-carbohydrate, high-protein diet is ordered. With insufficient
glucocorticoids and mineralocorticoids, the client is at risk for developing Addisonian
crisis when under any stress, including self-care activities.
10. C: Gallstone dissolvers, such as ursodiol, are bile acids that reduce the cholesterol
content in bile and allow for the dissolution of cholesterol type gallstones. Decreased
vomiting may result from a decrease in pain, which more likely will occur with analgesic
use. Increased comfort will primarily occur with analgesic use and may be a secondary
effect of stone dissolution. Ursodiol reduces the cholesterol content of bile, but hepatic
production of bile is not affected.
11. D: Keratitis is inflammation of the cornea that is treated with topical idoxuridine
(Stoxil), which is an anti-infective. Acyclovir (Zovirax) is an antiviral used in the
treatment of herpes zoster ophthalmicus. Acetazolamide (Diamox) is a carbonic
anhydrase inhibitor used for a client who has glaucoma to decrease the aqueous fluid.
Scopolamine (Isopto Hyoscine) is a mydriatic that is used for cycloplegic refractions and
uveitis.
12. C: The priority intervention is to educate the client on how to manage the adverse
reactions of the drugs. Unpleasant adverse reactions are often the reason for
noncompliance with drugs. Educating the family members reinforces the education given
the client. It should not be the priority intervention because it takes away the control from
the client. Counting the number of pills left in the bottle at each appointment with the
physician and calling the client as a reminder to take the pills as prescribed also take
away the control from the client and display a sense of distrust.
Reference
Gauwitz, D. (2007). Complete Review for the NCLEX-RN Examination. Clifton, NY: Thomson
Delmar Learning.