NCSBN NCLEX-RN 2018 Examinations. Over 1000 Questions and Answers plus Rationale Helpful to Students Preparing to Take NCLEX Exams. These Questions are Regularly Repeated.

2018 Exam 1 and

Rationales

1. A client with a diagnosis of passive-aggressive personality disorder

is seen at the local mental health clinic. A common characteristic

of

persons with passive-aggressive personality disorder is:

❍ A. Superior intelligence

❍ B. Underlying hostility

❍ C. Dependence on others

❍ D. Ability to share feelings

2. The client is admitted for evaluation of aggressive behavior and

diagnosed with antisocial personality disorder. A key part of the

care of such clients is:

❍ A. Setting realistic limits

❍ B. Encouraging the client to express remorse for behavior

❍ C. Minimizing interactions with other clients

❍ D. Encouraging the client to act out feelings of rage

3. An important intervention in monitoring the dietary compliance of

a client with bulimia is:

❍ A. Allowing the client privacy during mealtimes

❍ B. Praising her for eating all her meal

❍ C. Observing her for 1–2 hours after meals

❍ D. Encouraging her to choose foods she likes and to eat

in moderation

4. Assuming that all have achieved normal cognitive and emotional

development, which of the following children is at greatest risk for

accidental poisoning?

❍ A. A 6-month-old

❍ B. A 4-year-old

❍ C. A 12-year-old

❍ D. A 13-year-old

5. Which of the following examples represents parallel play?

❍ A. Jenny and Tommy share their toys.

❍ B. Jimmy plays with his car beside Mary, who is playing with

her doll.

❍ C. Kevin plays a game of Scrabble with Kathy and Sue.

❍ D. Mary plays with a handheld game while sitting in her

mother’s lap.

6. The nurse is ready to begin an exam on a 9-month-old infant. The child

is sitting in his mother’s lap. Which should the nurse do first?

❍ A. Check the Babinski reflex

❍ B. Listen to the heart and lung sounds

❍ C. Palpate the abdomen

❍ D. Check tympanic membranes

7. In terms of cognitive development, a 2-year-old would be expected to:

❍ A. Think abstractly

❍ B. Use magical thinking

❍ C. Understand conservation of matter

❍ D. See things from the perspective of others

8. Which of the following best describes the language of a 24-month-old?

❍ A. Doesn’t understand yes and no

❍ B. Understands the meaning of words

❍ C. Able to verbalize needs

❍ D. Asks “why?” to most statements

9. A client who has been receiving urokinase has a large bloody bowel movement. Which action would be best for the nurse to take immediately?

❍ A. Administer vitamin K IM

❍ B. Stop the urokinase

❍ C. Reduce the urokinase and administer heparin

❍ D. Stop the urokinase and call the doctor

2 Chapter 1

10. The client has a prescription for a calcium carbonate compound to neutralize stomach acid. The nurse should assess the client for:

❍ A. Constipation

❍ B. Hyperphosphatemia

❍ C. Hypomagnesemia

❍ D. Diarrhea

11. Heparin has been ordered for a client with pulmonary embolis. Which

statement, if made by the graduate nurse, indicates a lack of understanding of the medication?

❍ A. “I will administer the medication 1-2 inches away from the

umbilicus.”

❍ B. “I will administer the medication in the abdomen.”

❍ C. “I will check the PTT before administering the medication.”

❍ D. “I will need to aspirate when I give Heparin.”

12. The nurse is caring for a client with peripheral vascular disease. To correctly assess the oxygen saturation level, the monitor may be placed on the:

❍ A. Hip

❍ B. Ankle

❍ C. Earlobe

❍ D. Chin

13. While caring for a client with hypertension, the nurse notes the following

vital signs: BP of 140/20, pulse 120, respirations 36, temperature

100.8°F. The nurse’s initial action should be to:

❍ A. Call the doctor

❍ B. Recheck the vital signs

❍ C. Obtain arterial blood gases

❍ D. Obtain an ECG

14. The nurse is preparing a client with an axillo-popliteal bypass graft for

discharge. The client should be taught to avoid:

❍ A. Using a recliner to rest

❍ B. Resting in supine position

❍ C. Sitting in a straight chair

❍ D. Sleeping in right Sim’s position

2018 Exam 1 and Rationales

15. The doctor has ordered antithrombolic stockings to be applied to the

legs of the client with peripheral vascular disease. The nurse knows

antithrombolic stockings should be applied:

❍ A. Before rising in the morning

❍ B. With the client in a standing position

❍ C. After bathing and applying powder

❍ D. Before retiring in the evening

16. The nurse has just received the shift report and is preparing to make

rounds. Which client should be seen first?

❍ A. The client with a history of a cerebral aneurysm with an

oxygen saturation rate of 99%

❍ B. The client three days post–coronary artery bypass graft with

a temperature of 100.2°F

❍ C. The client admitted 1 hour ago with shortness of breath

❍ D. The client being prepared for discharge following a femoral

popliteal bypass graft

17. A client with a femoral popliteal bypass graft is assigned to a semiprivate

room. The most suitable roommate for this client is the client with:

❍ A. Hypothyroidism

❍ B. Diabetic ulcers

❍ C. Ulcerative colitis

❍ D. Pneumonia

18. The nurse is teaching the client regarding use of sodium warfarin. Which

statement made by the client would require further teaching?

❍ A. “I will have blood drawn every month.”

❍ B. “I will assess my skin for a rash.”

❍ C. “I take aspirin for a headache.”

❍ D. “I will use an electric razor to shave.”

19. The client returns to the recovery room following repair of an abdominal

aneurysm. Which finding would require further investigation?

❍ A. Pedal pulses regular

❍ B. Urinary output 20mL in the past hour

❍ C. Blood pressure 108/50

❍ D. Oxygen saturation 97%

4 Chapter 1

20. The nurse is doing bowel and bladder retraining for the client with paraplegia. Which of the following is not a factor for the nurse to consider?

❍ A. Diet pattern

❍ B. Mobility

❍ C. Fluid intake

❍ D. Sexual function

21. A 20-year-old is admitted to the rehabilitation unit following a motorcycle

accident. Which would be the appropriate method for measuring the

client for crutches?

❍ A. Measure five finger breadths under the axilla

❍ B. Measure 3 inches under the axilla

❍ C. Measure the client with the elbows flexed 10°

❍ D. Measure the client with the crutches 20 inches from the side

of the foot

22. The nurse is caring for the client following a cerebral vascular accident.

Which portion of the brain is responsible for taste, smell, and hearing?

❍ A. Occipital

❍ B. Frontal

❍ C. Temporal

❍ D. Parietal

23. The client is admitted to the unit after a motor vehicle accident with a

temperature of 102°F rectally. The most likely explanations for the elevated temperature is that:

❍ A. There was damage to the hypothalamus.

❍ B. He has an infection from the abrasions to the head and face.

❍ C. He will require a cooling blanket to decrease the temperature.

❍ D. There was damage to the frontal lobe of the brain.

24. The client is admitted to the hospital in chronic renal failure. A diet low in

protein is ordered. The rationale for a low-protein diet is:

❍ A. Protein breaks down into blood urea nitrogen and other

waste.

❍ B. High protein increases the sodium and potassium levels.

❍ C. A high-protein diet decreases albumin production.

❍ D. A high-protein diet depletes calcium and phosphorous.

2018 Exam 1 and Rationales 5

25. The client who is admitted with thrombophlebitis has an order for

heparin. The medication should be administered using a/an:

❍ A. Buretrol

❍ B. Infusion controller

❍ C. Intravenous filter

❍ D. Three-way stop-cock

26. The nurse is taking the blood pressure of the obese client. If the blood

pressure cuff is too small, the results will be:

❍ A. A false elevation

❍ B. A false low reading

❍ C. A blood pressure reading that is correct

❍ D. A subnormal finding

27. A 4-year-old male is admitted to the unit with nephotic syndrome. He is

extremely edematous. To decrease the discomfort associated with scrotal

edema, the nurse should:

❍ A. Apply ice to the scrotum

❍ B. Elevate the scrotum on a small pillow

❍ C. Apply heat to the abdominal area

❍ D. Administer an analgesic

28. The client with an abdominal aortic aneurysm is admitted in preparation

for surgery. Which of the following should be reported to the doctor?

❍ A. An elevated white blood cell count

❍ B. An abdominal bruit

❍ C. A negative Babinski reflex

❍ D. Pupils that are equal and reactive to light

29. If the nurse is unable to elicit the deep tendon reflexes of the patella, the

nurse should ask the client to:

❍ A. Pull against the palms

❍ B. Grimace the facial muscles

❍ C. Cross the legs at the ankles

❍ D. Perform Valsalva maneuver

6 Chapter 1

30. The physician has ordered atropine sulfate 0.4mg IM before surgery. The

medication is supplied in 0.8mg per milliliter. The nurse should administer how many milliliters of the medication?

❍ A. 0.25mL

❍ B. 0.5mL

❍ C. 1.0mL

❍ D. 1.25mL