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NURSING EXAM NCLEX QUESTIONS WITH ANSWERS GRADED A+ 2022/2023 UPDATE, Exams of Nursing

NURSING EXAM NCLEX QUESTIONS WITH ANSWERS GRADED A+ 2022/2023 UPDATE

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2022/2023

Available from 04/24/2023

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NURSING EXAM NCLEX QUESTIONS WITH
ANSWERS GRADED A+ 2022/2023 UPDATE
A 7 year old girl with type 1 insulin-dependent diabetes mellitus (IDDM) has been home sick for several
days and is brought to the ED by her parents. If the child is experiencing ketoacidosis, the nurse would
expect to see which of the
following lab results?
1.
Serum glucose 140 mg/dL
2.
Serum creatinine 5.2 mg/dL
3.
Blood pH 7.28
4.
Hematocr
it 38% 3. Blood
pH 7.28
The nurse delivers external cardiac compressions to a client while performing cardiopulmonary
resuscitation (CPR).
Which of the following actions by the nurse is BEST?
1.
Maintain a position close the client's side with the nurse's knees apart
2.
Maintain vertical pressure on the client's chest through the heel of the nurse's hand
3.
Re-check the nurse's hand position after every 10 chest compressions
4.
Check for a return of the client's pulse after every 8 breaths by the nurse
2. Maintain vertical pressure on the client's chest through the heel of the nurse's hand
The nurse obtains a health history form a client admitted with acute glomerulonephritis that is
associated with beta- hemolytic Streptococcus., The nurse expects which of the following to be significant
in the health history?
1.
The client had a sore throat 3 weeks earlier
2.
There is a family history of glomerulonephritis
3.
The client had a renal calculus 2 year earlier
4.
The client had an accident involving renal trauma
several years ago 1. The client had a sore throat 3 weeks
earlier
00:0201:27
The nurse plans care for a client diagnosed with an acute myocardial infarction (MI). An appropriate
nursing diagnosis is decreased cardiac output secondary to which of the following?
1.
Ventricular dysrhythmias
2.
Congestive heart failure
3.
Recurrent myocardial infarction
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ANSWERS GRADED A+ 2022/2023 UPDATE

A 7 year old girl with type 1 insulin-dependent diabetes mellitus (IDDM) has been home sick for several days and is brought to the ED by her parents. If the child is experiencing ketoacidosis, the nurse would expect to see which of the following lab results?

  1. Serum glucose 140 mg/dL
  2. Serum creatinine 5.2 mg/dL
  3. Blood pH 7.
  4. Hematocr it 38% 3. Blood pH 7. The nurse delivers external cardiac compressions to a client while performing cardiopulmonary resuscitation (CPR). Which of the following actions by the nurse is BEST?
  5. Maintain a position close the client's side with the nurse's knees apart
  6. Maintain vertical pressure on the client's chest through the heel of the nurse's hand
  7. Re-check the nurse's hand position after every 10 chest compressions
  8. Check for a return of the client's pulse after every 8 breaths by the nurse
  9. Maintain vertical pressure on the client's chest through the heel of the nurse's hand The nurse obtains a health history form a client admitted with acute glomerulonephritis that is associated with beta- hemolytic Streptococcus., The nurse expects which of the following to be significant in the health history?
  10. The client had a sore throat 3 weeks earlier
  11. There is a family history of glomerulonephritis
  12. The client had a renal calculus 2 year earlier
  13. The client had an accident involving renal trauma several years ago 1. The client had a sore throat 3 weeks earlier 00:0201: The nurse plans care for a client diagnosed with an acute myocardial infarction (MI). An appropriate nursing diagnosis is decreased cardiac output secondary to which of the following?
  14. Ventricular dysrhythmias
  15. Congestive heart failure
  16. Recurrent myocardial infarction

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. Hypertensive crisis

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. 3 oz. roast beef, baked potatoes, salad with dressing, dill pickle, baked apple pie, and milk
  2. 3 oz. baked chicken, green beans, steamed rice, 1 slice of bread, banana, and milk
  3. Cheeseburger on a bun, french fries with catsup, chocolate chip cookie, apple, and milk
  4. 3 oz. baked fish, slice of bread, broccoli, ice cream, and pineapple drink taken 30-60 min after the meal
  5. 3 oz. baked chicken, green beans, steamed rice, 1 slice of bread, banana, and milk An adolescent is seen in the ER for a fracture of the left femur sustained in a sledding accident. The fracture is reduced and a cast is applied. The client is taught how to use crutches for ambulating without bearing weight on the left leg. The nurse would expect the client to learn which of the following crutch-walking gaits?
  6. Two-point gait
  7. Three-point gait
  8. Four-point gait
  9. Swing-through gait
  10. Three-point gait The nurse cares for a client diagnosed with a right-sided CVA with dysphagia. Which of the following actions by the nurse reflects appropriate care for the client? Select all that apply.
  11. The nurse assesses the client's ability to swallow
  12. the nurse positions the client at a 45-degree angle
  13. The nurse offers the client scrambled eggs
  14. The nurse instructs the client to place food on the left side of the mouth
  15. The nurse turns off the television 1, 3, 5 The nurse plans care for a 4 year old girl who has been sexually abused by her father. Play therapy is scheduled. The nurse knows that the PRIMARY goal of play therapy for a 4 year old is which of the following?
  16. Provide her with the opportunity to express anger and hostility by playing with dolls
  17. Promote communication because she may lack the emotional and intellectual capacity to express her perceptions verbally
  18. Assess whether she is functioning at an age-appropriate developmental level
  19. Reveal through direct observation of her at play what type of abuse has been experienced
  20. Promote communication because she may lack the emotional and intellectual capacity to express her perceptions verbally A client is being treated for heart failure with diuretic therapy. Which of the following assessments BEST indicates to the nurse that the client's condition is improving?
  21. The client's weight has remained stable since admission

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. The client's systolic blood pressure has decreased

ANSWERS GRADED A+ 2022/2023 UPDATE

a sterile container; the container must not touch the penis"

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. "You must void a few drops of urine, then stop; then void the remaining urine into a clean container, which should be immediately covered"
  2. "Before voiding, the urinary meatus is cleansed with an iodine solution and urine is voided into a sterile container; the container must not touch the penis" The physician orders an arterial blood gas for a client receiving oxygen at 6 L/min. Results show pH 7.37, HCO3 26 mmHg, pCO2 42 mmHg, pO2 90 mmHg. Which of the following should the nurse do FIRST?
  3. Increase the rate of oxygen flow the client is receiving
  4. Elevate the head of the bed
  5. Document the results in the chart
  6. Instruct the client to cough and deep breathe
  7. Document the results in the chart A client's brought to the emergency room reporting pressure in her chest. Her blood pressure is 150/90, pulse 88, respirations 20. The nurse administers nitroglycerin 0.4 mg SL as ordered. After five minutes her blood pressure is 100/60, pulse 96, respirations 20. Which of the following should the nurse do next?
  8. Notify the physician that the client has become hypotensive, and obtain an order to administer IV fluids.
  9. Place the client in semi-Fowler's position, and administer O2 at 4 L.
  10. Administer a second dose of nitroglycerin
  11. Document the results, and continue to monitor the client.
  12. Document the results, and continue to monitor the client. A client contacts his home care nurse and reports nausea and abdominal pain. He has type 1 diabetes. The nurse should advise the client to do which of the following?
  13. "Hold your regular dose of insulin"
  14. "Check your blood glucose level every 3-4 hrs"
  15. "Increase your consumption of foods containing simple sugars"
  16. "Increase your activity level"
  17. "Check your blood glucose level every 3-4 hrs" A client is being treated for Addison's disease. The physician orders cortisone 25 mg PO daily. The nurse should explain to the client that adjustment of the dosage may be required in which of the following situations?
  18. Dosage is increased when the blood glucose level increases
  19. Dosage is increased when dietary intake is increased
  20. Dosage is decreased when infection stimulates endogenous steroid secretion
  21. Dosage is increased relative to an increase in the level of stress
  22. Dosage is increased relative to an increase in the level of stress

ANSWERS GRADED A+ 2022/2023 UPDATE

indicates to the nurse that the client needs further instruction?

  1. "I'll pump my breasts and use warm packs to relieve breast pain"

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. "I'll use a tight bra and ice packs to relieve engorgements discomfort"
  2. "I'll take the medication prescribed by the doctor for pain"
  3. "I'll take the pills ordered by my doctor to help stop the production of milk"
  4. "I'll pump my breasts and use warm packs to relieve breast pain" A client sustains a fractured left femur in a car accident. She is placed in balanced suspension skeletal traction using a Thomas splint and a Pearson attachment. The client tells the nurse that she has "terrible" pain in her left thigh. Which of the following should the nurse do FIRST?
  5. Determine that all the weights and ropes from the traction apparatus are in line and hanging free
  6. Ask the client for more information about the location and characteristics of her pain
  7. Check the Thomas splint and Pearson attachment to make sure they are appropriately positioned
  8. Explain to the client that the pain she is experiencing in the affected leg is a common occurrence
  9. Ask the client for more information about the location and characteristics of her pain A client is admitted to the hospital with flu-like symptoms. When taking the history, the nurse learns that the client has been taking digoxin 0.125 mg PO daily and furosemide 40 mg PO daily for 3 years. Last month her physician changed the prescription for digoxin to 0.25 mg qd. The nurse would expect the physician to order which of the following laboratory tests?
  10. Serum electrolytes and digoxin level
  11. White blood cell count, hemoglobin, and hematocrit
  12. Cardiac enzymes and an arterial blood gas
  13. Blood cultures and urinalysis
  14. Serum electrolytes and digoxin level The nurse plans care for a teenager admitted with fever, vomiting, and diarrhea. The nurse writes the following nursing diagnosis on the client's care plan: "fluid volume deficit." Which of the following changes in laboratory values would demonstrate an improvement in the client's condition?
  15. Urine specific gravity, 1.015; hematocrit, 37%
  16. Urine specific gravity, 1.020: hematocrit, 45%
  17. Urine specific gravity, 1.032: hematocrit. 52%
  18. Urine specific gravity, 1.025: hematocrit, 35%
  19. Urine specific gravity, 1.020: hematocrit, 45% A client is hospitalized with a diagnosis of atrial fibrillation. Heparin 5,000 units is ordered every 12 hrs to be given SQ. The health care provider orders daily partial thromboplastin time (PTT). The result of the client's most recent PTT is 55. Which of the following actions should be taken by the nurse?
  20. Document the results and administer the heparin
  21. Withhold the heparin

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. Refuse to discuss her friend's medical condition. Suggest that she visit her friend.

ANSWERS GRADED A+ 2022/2023 UPDATE

An hour after admission to the nursery, the nurse observes a newborn baby having spontaneous jerky movements of the limbs. The infant's mother had gestational diabetes mellitus during pregnancy. Which of the following actions should the nurse take FIRST?

  1. Give dextrose water
  2. Call the physician immediately
  3. Determine the blood glucose level
  4. Observe closely for other symptoms
  5. Determine the blood glucose level A woman is admitted to the hospital with a ruptured ectopic pregnancy. A laparotomy is scheduled. Preoperatively, which of the following goals is MOST important for the nurse to include on the client's plan of care?
  6. Fluid replacement
  7. Pain relief
  8. Emotional support
  9. Respiratory therapy
  10. Fluid replacement The nurse obtains a diet history from a pregnancy 16 year old girl. The girls tells the nurse that her typical daily diet includes cereal and milk for breakfast, pizza and soda for lunch, and a cheeseburger, milk shake, fries, and salad for dinner. Which of the following is the MOST accurate nursing diagnosis based on this data?
  11. Altered nutrition: more than body requirements related to high-fat intake
  12. Knowledge deficit: nutrition in pregnancy
  13. Altered nutrition: less than body requirements related to increased nutritional demands of pregnancy
  14. Risk for injury: fetal malnutrition related to poor maternal diet
  15. Altered nutrition: less than body requirements related to increased nutritional demands of pregnancy The nurse plans acre for a 14 year old girl admitted with an eating disorder. On admission, the girl weighs 82 lb. and is 5'4" tall. Lab tests indicate severe hypokalemia, anemia, and dehydration. The nurse should give which of the following nursing diagnosis the HIGHEST priority?
  16. Body image disturbance related to weight loss
  17. Self-esteem disturbance related to feelings of inadequacy
  18. Altered nutrition: less than body requirements related to decreased intake
  19. Decreased cardiac output related to the potential for dysrhythmias
  20. Decreased cardiac output related to the potential for dysrhythmias The mother of a boy with type 1 diabetes calls the physician's office to discuss the child's self-

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. "Continue with his medication regimen"
  2. "Check his blood sugar during the night"
  3. "Give his NPH insulin later in the evening"
  4. "Serve his bedtime snack earlier in the evening"
  5. "Check his blood sugar during the night" A boy was riding his bike to school when he hit the curb. He fell and hurt his leg. The school nurse was called and found him alert and conscious, but in severe pain with a possible fracture of the right femur. Which of the following is the FIRST action that the nurse should take?
  6. Immobilize the affected limb with a spinal split and ask him not to move
  7. Make a thorough assessment of the circumstances surrounding the accident
  8. Put him in semi-Fowler's position for comfort
  9. Check the pedal pulse and blanching sign in both legs
  10. Immobilize the affected limb with a spinal split and ask him not to move A child undergoes a tonsillectomy for treatment of chronic tonsillitis unresponsive to antibiotic therapy. After surgery, the child is brought to the recovery room. Which of the following actions should the nurse include in the child's plan of care?
  11. Institute measures to minimize crying
  12. Perform postural drainage every 2 hours
  13. Cough and deep breathe every hour
  14. Give ice cream as tolerated
  15. Institute measures to minimize crying A client is receiving intravenous cimetidine. After 20 minutes of the infusion, the client reports a headache and dizziness. Which of the following actions should the nurse take FIRST?
  16. Stop the infusion
  17. Take the client's vital signs
  18. Reposition the client
  19. Call the pharmacist
  20. Stop the infusion A client is admitted with a diagnosis of dementia. He attempts several times to pull out his nasogastric tubes. An order for cloth wrist restraints is received by the nurse. Which of the following actions by the nurse is MOST appropriate?
  21. Attach the ties of the restraints to the bed frame
  22. Perform range of motion to the restrained extremities once a shift

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. Remove the restraints when the client is up in a wheelchair
  2. Explain the need for restraints only to the family because the client is confused
  3. Attach the ties of the restraints to the bed frame The nurse cares for a client with a diagnosis of CVA. The nurse is feeding the client in a chair when he suddenly begins to choke. Which of the following actions should the nurse take FIRST?
  4. Check for breathlessness by placing an ear over the client's mouth and observing the chest
  5. Leave the client in the chair and apply vigorous abdominal or chest thrusts fro behind the client
  6. Ask the client, "Are you choking?'
  7. Return the client to the bed and apply vigorous abdominal chest thrusts while straddling the client's thighs
  8. Ask the client, "Are you choking?' A client with a history of bipolar disorder is admitted to the psychiatric hospital. She was found by the police attempting to climb onto the wing of a plane at the airport. Her husband reports that she has not eaten or slept in 2 days, and he suspects she has stopped taking lithium. On admission, the nurse should place the HIGHEST priority on which of the following client care needs?
  9. Teaching the client about the importance of taking lithium as prescribed
  10. Providing the client with safe environment with few distractions
  11. Arranging for food and rest for the client
  12. Setting limits on the client's behavior
  13. Arranging for food and rest for the client The physician orders a NG tube inserted and connected to low intermittent suction for a client with an intestinal obstruction. Two hours after insertion of the NG tube, the client vomits 200 mL. While irrigating the NG tube, the nurse notes resistance. Which of the following actions should the nurse take FIRST
  14. Replace the NG tube with a larger one
  15. Turn the client on his left side
  16. Change the suction from intermittent to continuous
  17. Continue the irrigation
  18. Turn the client on his left side A child with a compound fracture of the left femur is being admitted to a pediatric unit. Which of the following actions is BEST for the nurse to take?
  19. Ask the NAP to obtain the child's vital signs while the nurse obtains a history from the parents.
  20. ASK the LPN/LVN to assess the peripheral pulses of the child's left leg while the nurse completes the admission forms
  21. Ask the LPN/LVN to stay with the child and his parents while the nurse obtains phone orders from the physician

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. Ask the NAP to obtain equipment for the child's care while the nurse talks with the child and his parents Which of the following tasks is appropriate for the nurse to delegate to an experienced NAP?
  2. Obtain a 24 hr diet recall from a client recently admitted with anorexia nervosa
  3. Obtain a clean-catch urine specimen form a client suspected of having a urinary tract infection
  4. Observe the amount and characteristics of the returns from a continuous bladder irrigation for a client after a transurethral resection
  5. Observe a client newly diagnosed with diabetes mellitus practice injection techniques using an orange
  6. Obtain a clean-catch urine specimen form a client suspected of having a urinary tract infection Which of the following clients should the nurse on a pediatric unit assign to an LPN/LVN?
  7. a 3 year old admitted yesterday with laryngotracheobronchitis who has a tracheostomy
  8. A 6 year old girl admitted after a gastric lavage for acetaminophen ingestion
  9. A 6 year old boy admitted for a fracture of the femur, in balanced suspension traction
  10. A 10 year old boy admitted for observation after an acute asthmatic attack
  11. A 6 year old boy admitted for a fracture of the femur, in balanced suspension traction Immediately after a percutaneous liver biopsy, the nurse should place the client in which of the following positions?
  12. Supine
  13. Right side-lying
  14. Left side-lying
  15. Semi-Fowler's
  16. Right side-lying An angiogram is scheduled for a client with decreased circulation in her right leg. After the angiogram, the nurse should place the client in which of the following positions?
  17. Semi-Fowler's with right leg bent at the knee
  18. Side-lying with a pillow between the knees
  19. Supine with right leg extended
  20. High Fowler's with right leg elevated
  21. Supine with right leg extended The nurse cares for a client after a lumbar laminectomy. Which of the following statements BEST describes the method of turning a client following a lumbar laminectomy?

ANSWERS GRADED A+ 2022/2023 UPDATE

  1. The head of the bed is elevated 30 degrees; the client locks her knees when turning
  2. A pillow is placed between the client's legs; her body is turned as a unit
  3. The client straightens her back and grasps the side rail on the opposite side of the bed
  4. The head of the bed is flat; the client bends her knees and rolls to the side