NCLEX Webinar Sigma March 2021 LM
Answers to Practice Questions
1. D: The point of this question is to determine how you respond effectively in a therapeutic
manner. For these types of questions, the guiding principles are reflection, paraphrasing,
restatement, and no whys or closed ended, unless the options all are written that way. In this
question, the most appropriate response is option D. You want the patient to continue
expressing the fears and/or concerns they have about administering their insulin injections.
Option A is condescending and not true. Option B is not known. Option C is punting to someone
else and not addressing the patient’s concern for self-care.
2. A: The key to this question is an understanding of hypothyroidism, whether in infant or adult,
the pathophysiology is similar and thus the assessment is similar as in both, the thyroid gland,
which controls BMR (basal metabolic rate) is under functioning, thus the body systems are
slowed. Of the 4 options given, the only assessment where the body system is slowed in option
A and that is the correct answer. Options B-D indicate increases in body systems, thus more
reflective of hyperthyroidism.
3. C: The key in this question is the phrase IMMEDIATE CARE. When a victim states that an
assailant knows where they live and will kill them if they report the incident, this is a cause for
immediate care as their SAFETY and SECURITY is in danger. Option A reflects a degree of denial
by the client. Option B reflects the client’s state of shock. Option D is a declarative statement
that gives information but is not cause for immediate care, simply factual information.
4. In this question, you must order the steps in performing oropharyngeal suctioning. The correct
order is: 4, 1, 3, 2, 6, 5, 7……….Before any procedure begins by a nurse, washing hands is step 1.
Once that is done, a clean glove should be put on the dominant hand. This glove does not need
to be sterile as the oral area is not sterile (different than if suctioning in a tracheostomy which is
sterile). Then the procedure continues to connect the catheter to the connection tubing,
remove the patient’s oxygen mask, suction the patient, then have the patient cough to bring up
the secretions that might have left in oral cavity, and then put the oxygen mask back on. If you
missed any of the steps in this correct order, review.
5. C: FIRST=ABC; other physiological including pain; safety and security; love and belonging. If you
use this guidance whenever a question has FIRST, IMMEDIATE, PRIORTY, MOST IMPORTANT,
and similar you will get these types of questions right. A, B, and D are not appropriate for FIRST
post treatment.
6. B: When answering questions with lab values, remember to think broadly as not every lab will
have same norms and use process of elimination whenever possible to narrow down the
choices. A normal Thrombin time is 15-20 so even though 20 is essentially WNL, it is on high
limit so before you choose, make sure you review the other options. Option A is WNL as
platelets is 150,000-350,000 so not at high or low end. Option C is WNL as hematocrit is 35-45
so again, not at high or low end. Option d is WNL as hemoglobin is 12-16 so again, not at high or
low end. So when looking at all options, Option B is the most concerning thus the doctor should
be contacted.
