NCLEX REVIEW QUESTIONS
Summer 2010 Set 1
(Answers follow all questions)
Fundamentals of Nursing
1. The registered nurse is planning the clinical assignments for a geriatric mental
health unit. Which of the following assignments should the nurse delegate to a
licensed practical nurse?
A. Develop a plan of care for a client with dementia
B. Perform a physical assessment on a client with Alzheimer’s disease
C. Administer donepezil hydrochloride (Aricept) to a client newly
diagnosed with Alzheimer’s disease
D. Provide education to the family of a client with dementia
Maternity
2. A client who is pre-eclamptic complains of blurred vision and scotomata to the
nurse. The nurse should report this as indicating which of the following?
A. Glaucoma
B. Cerebral edema
C. Spinal cord injury
D. Hydrocephalus
Pediatrics
3. When caring for a child with meningitis, it is essential that the nurse evaluate
for a positive Brudzinski’s sign, which would indicate which of the following?
A. Increased intracranial pressure
B. Meningeal irritation
C. Encephalitis
D. Intraventricular hemorrhage
Neurological Disorders (Adult)
4. Which of the following is a priority when suctioning a client with increased
intracranial pressure?
A. Limit the suction passes to 30 seconds
B. Suction the client as needed
C. Suction the client at least every hour
D. Schedule the suctioning with other nursing tasks
Musculoskeletal/Integumentary Disorders (Adult)
5. The nurse is caring for a client with gout. Which of the following dietary
selections should the nurse include in the dietary instructions?
Select all that apply:
A. Salmon
B. Macaroni
C. Sardines
D. Cheese
E. Spinach
F. Venison
Oncological/Immune Disorders (Adult)
6. The client states, “I heard that all men get prostate cancer sometime in their
lives.” In teaching the client about cancer incidence, the best response is based on
the understanding that:
A. Lung cancer is the most frequently diagnosed cancer in men
B. Prostate cancer is the most frequently diagnosed cancer in men
C. Prostate cancer is the most prevalent in Caucasian men
D. There is no way to screen for prostate cancer, so it is the most common
cause of cancer death in men
Cardiovascular Disorders (Adult)
7. The nurse is caring for a client on a heparin infusion when the client expresses
concern over a progressively painful headache. Which of the following is the
priority nursing action?
A. Stop the heparin infusion
B. Administer protamine
C. Notify the physician
D. Administer morphine
Respiratory Disorders (Adult)
8. A client with left-sided heart failure is progressing to pulmonary edema. The
nurse assesses the client and reports which of the following manifestations?
A. Dry, hacking cough
B. Bilateral crackles
C. Fever above 36.8 degrees C or 101.5 degrees F
D. Peripheral pitting edema
Endocrine Disorders (Adult)
9. The nurse develops a plan of care for the immediate postoperative period for a
client who had a thyroidectomy. The plan should include measures to:
A. Correct fluid and electrolyte balance
B. Administer medications to decrease vascularity of the thyroid glands
C. Promote range-of-motion exercises to the neck
D. Prevent complications of respiratory obstruction
GI/GU Disorders (Adult)
10. The nurse is caring for a client who is jaundiced. The nurse should implement
which of the following in the plan for the client’s pruritus?
A. Monitor the client’s temperature and assess the client’s color
B. Instruct the client to scratch with knuckles instead of nails
C. Administer prescribed analgesic and assist the client to bathe frequently
D. Encourage the client to eat a high-protein, low-cholesterol diet
Sensory Disorders (Adult)
11. The nurse is admitting a client in the emergency room with a foreign body in
the ear identified as an insect. Which of the following interventions is a priority
for the nurse to perform?
A. Irrigate the affected ear
B. Instill diluted alcohol in the affected ear
C. Instill an antibiotic ointment into the affected ear
D. Instill a cortisone ointment into the affected ear
Psychiatric and Mental Health (Adult)
12. Which of the following is the most critical component leading to the client’s
ability to adapt to a somatoform disorder?
A. The client’s psychological makeup
B. The etiology of the stress
C. The nurse’s ability to manipulate the environment
D. The establishment of a medical etiology
Answers
1. C: A licensed practical nurse may administer donepezil hydrochloride (Aricept) to a
client with Alzheimer’s disease. Developing a plan of care, performing a physical
assessment, and providing education on dementia to a client’s family are tasks that should
be performed by a registered nurse.
2. B: Visual disturbances may reflect cerebral edema in the pre-eclamptic client.
3. B: Brudzinski’s sign, when the legs flex at both hips and knees in response to flexing
the head and neck, indicates meningeal irritation.
4. A: Suctioning can cause an increase in intracranial pressure and should be used
cautiously. The client must be closely assessed during suctioning, and suction passes
should be limited to 30 seconds. The client should be allowed to rest for several minutes
between suction passes, manually hyperventilated, and preoxygenated with 100% oxygen
prior to suctioning.
5. B, D: Foods high in purine are limited for a client with gout. Gout is repeat arthritic
episodes associated with high levels of serum uric acid. Uric acid is the end product of
purine catabolism. Liver, salmon, sardines, venison, and sweetbreads are high in purine
content. Macaroni and cheese are lower purine food choices.
6. B: Prostate cancer is the most common cancer in men in the U.S., with lung cancer
being second. The incidence of prostate cancer is significantly higher in AfricanAmerican men worldwide. Screening is available for prostate cancer.
7. C: The priority nursing action is to notify the physician. Headache, although rare, is an
adverse reaction to heparin hypersensitivity. The nurse may anticipate stopping the
heparin infusion or administering protamine sulfate, a heparin antagonist, but the priority
intervention is to notify the physician of a potential hypersensitivity.
8. B: A client with left-sided heart failure and pulmonary edema presents primarily with
respiratory symptoms. Because of the fluid accumulation in the pulmonary vascular bed
there may be a productive cough with pink, frothy sputum. There is no fever associated
with pulmonary edema and peripheral pitting edema is more associated with right-sided
heart failure.
9. D: A thyroidectomy is removal of the thyroid gland through a neck incision.
Immediately postoperatively there is the potential complication of airway obstruction by
edema formation. Fluid and electrolyte balance would be monitored during the operative
period and would not be imbalanced immediately post-op. Medications to decrease the
vascularity of the thyroid glands would be done preoperatively. Range-of-motion
exercises to the neck are not started until several days postoperatively.
10. B: Pruritus occurs as a result of an accumulation of bile salts under the skin.
Scratching with the knuckles instead of the nails maintains the skin’s integrity and
prevents tearing.
11. B: Insects are killed before they can be removed unless a flashlight can coax them
out. Mineral oil or diluted alcohol will suffocate the insect so that removal by forceps is
possible. If the foreign object is vegetable matter it is not irrigated because this would
cause the object to expand and cause a worse impaction. Instilling an antibiotic or
cortisone ointment into the affected ear may be done if an infection or inflammation is
present.
12. A: A psychological makeup determines the client’s ability to recognize the
dysfunctional manifestations of a somatoform disorder and take corrective action. The
etiology of the stress is outside the nurse’s control. The ability to manipulate the
environment also depends on external sources for control. The somatoform disorder does
not have a medical etiology.
Reference
Gauwitz, D. (2007). Complete Review for the NCLEX-RN Examination. Clifton, NY: Thomson Delmar
Learning.