RN Comprehensive Online Practice (NCLEX 1-5)

This RN Comprehensive Online Practice quiz has been designed for you to study and refresh everything you need to pass your NCLEX exam.

1. The nursing instructor asks a nursing student to identify the priorities of care for an assigned client. Which statement indicates that the student correctly identifies the priority client needs?

a) Actual or life-threatening concerns are the priority.
b) Completing care in a reasonable time frame is the priority.
c) Time constraints related to the client’s needs are the priority.
d) Obtaining needed supplies to care for the client is the priority.

2. RN Comprehensive Online Practice question about a client who arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Hypothyroidism is diagnosed, and levothyroxine (Synthroid) is prescribed. What is an expected outcome of the medication?

a) Alleviate depression
b) Increase energy levels
c) Increase blood glucose levels
d) Achieve normal thyroid hormone levels

3. The community health nurse is preparing a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster? Select all that apply. 

a) Multiparity
b) Early menarche
c) Early menopause
d) Family history of breast cancer
e) High-dose radiation exposure to chest
f) Previous cancer of the breast, uterus, or ovaries

4. The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which assessment data should alert the nurse to this occurrence?

a) Inability to pass flatus
b) Loss of anal sphincter control
c) Severe, constant pain with rapid onset
d) Firm, nontender mass palpable at the lower right costal margin

5. The nurse inspects the color of the drainage from a nasogastric tube on a postoperative client approximately 24 hours after gastric surgery. Which finding indicates the need to notify the health care provider?

a) Dark red drainage
b) Dark brown drainage
c) Green-tinged drainage
d) Light yellowish brown drainage

RN Comprehensive Online Practice
Answers and Rationale

1) A
- Rationale: Setting priorities means deciding which client needs or problems require immediate action and which can be delayed until a later time because they are not urgent. Client problems that involve actual or life-threatening concerns are always considered first. Although completing care in a reasonable time frame, time constraints, and obtaining needed supplies are components of time management, these items are not the priority in planning care for the client, based on the options provided.

- RN Comprehensive Online Practice Test-Taking Strategy: Note the strategic word priority. Recall the principles related to prioritizing to answer the question. Noting the words life-threatening in the correct option will assist in directing you to this option.

2) D
- Rationale: Laboratory determinations of the serum thyroid-stimulating hormone (TSH) level are an important means of evaluation. Successful therapy causes elevated TSH levels to decline. These levels begin their decline within hours of the onset of therapy and continue to decrease as plasma levels of thyroid hormone build up. If an adequate dosage is administered, TSH levels remain suppressed for the duration of therapy. Although energy levels may increase and the client’s mood may improve following effective treatment, these are not noted until normal thyroid hormone levels are achieved with medication therapy. An increase in the blood glucose level is not associated with this condition.

- Test-Taking Strategy: Focus on the subject, therapeutic effects of this medication. Note the words expected outcome. Relate the diagnosis of hypothyroidism with thyroid hormone levels in the correct option.

3) B, D, E, F
- Rationale: Risk factors for breast cancer include nulliparity or first child born after age 30 years; early menarche; late menopause; family history of breast cancer; high-dose radiation exposure to the chest; and previous cancer of the breast, uterus, or ovaries.

- RN Comprehensive Online Practice Test-Taking Strategy: Focus on the subject, the risk factors associated with breast cancer. Thinking about the physiology associated with the reproductive system and the most common causes of cancer will assist in answering the question.

4) A
- Rationale: An inflammatory reaction such as acute pancreatitis can cause paralytic ileus, the most common form of nonmechanical obstruction. Inability to pass flatus is a clinical manifestation of paralytic ileus. Loss of sphincter control is not a sign of paralytic ileus. Pain is associated with paralytic ileus, but the pain usually manifests as a more constant generalized discomfort. Option D is the description of the physical finding of liver enlargement. The liver may be enlarged in cases of cirrhosis or hepatitis. Although this client may have an enlarged liver, an enlarged liver is not a sign of paralytic ileus or intestinal obstruction.

- Test-Taking Strategy: Focus on the subject, clinical manifestations of paralytic ileus. Noting the word paralytic will assist in directing you to the correct option.

5) A
- Rationale: For the first 12 hours after gastric surgery, the nasogastric tube drainage may be dark brown to dark red. Later, the drainage should change to a light yellowish brown color. The presence of bile may cause a green tinge. The health care provider (HCP) should be notified if dark red drainage, a sign of hemorrhage, is noted 24 hours postoperatively.

- Test-Taking Strategy: Focus on the subject, the need to notify the HCP. Recall that bleeding is a concern in the postoperative client. This concept will direct you to the correct option.

After you reviewed your answers through its rationale, you can now proceed to the next set of questions:

RN Comprehensive Online Practice (NCLEX 1-5)

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