Hundreds of Questions to Match the NCLEX Exam Blueprint

Core Concepts ~ Answer Rationale Section ~ Performance Indicators ~ Supporting References

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Sample NCLEX-RN Question 1

When attempting to communicate with a stroke patient with aphasia, the nurse wants to do all EXCEPT which of the following:

Speak slowly
Pause between sentences
Give thorough directions all at one time
Eliminate distractions

Answer: C

Rationale:

It is important to keep directions and questions simple in order to allow the patient time to process the information, as well as to form a response.
The left hemisphere of the brain controls a person’s expressive and receptive language skills. The loss of ability to understand or express speech is referred to as “aphasia”. Aphasia may affect the ability to read, write, and deal with numbers.
It may affect a person's ability to understand what is being said to them or asked of them (auditory comprehension).

High-Yield Core Concept:

Stroke is one of the main causes of disability worldwide. About 20% of stroke patients experience aphasia, and 20-30% of these individuals exhibit severe communication deficits for at least a portion of their recovery period.

High-Yield Fast Fact(s):

About 87% of all strokes are ischemic, and 13% are hemorrhagic.

References:

BMJ 2012;345:e4407.
BMJ Open 2017;7(10):e17944.
Mater Sociomed 2014;26(1):65-67.

Sample NCLEX-RN Question 2

The nurse understands that the probable effect of a client choosing to continue to breast feed only twice a day without pumping breasts will be what?

Milk supply will increase
Decrease in milk supply
Milk supply will remain unaffected
Client will stop producing milk

Answer: B

Rationale:

T To maintain breastfeeding, the alveolar lumen (milk production/storage glands) must be emptied on a regular basis.
Newborns eat approximately 8-12 times per day.

High-Yield Core Concept:

Health promotion and maintenance in ante/ intra/ and postpartum care.

High-Yield Fast Fact(s):

Suckling by the infant stimulates release of oxytocin and prolactin.

Increased oxytocin in blood results in contraction of the myoepithelial cells and emptying of the alveolar lumen of the breast. Also increases uterine contractions accelerating uterine involution.
Prolactin is a hormone release by the anterior pituitary gland that stimulates milk production.

Frequently emptying the breast increases milk production.

Reference:

Beckman CRB et al. Obstetrics and Gynecology. Philadelphia, PA: Lippincott Williams & Wilkins.

Sample NCLEX-RN Question 3

The nurse reviews the orders which state that a post-operative patient is to receive an infusion of 1000 mL Lactated Ringer’s to infuse at 125 mL/hr via infusion pump. How many hours will the Lactated Ringer’s solution run?

0.04 hours
0.13 hours
3 hours
8 hours

Answer: D

Rationale:

Volume (mL) x Time (hrs)/(Flow Rate in mL) = Y (hrs)

1000 mL x hrs/125 mL = 8 hrs

If one calculates the schedule based on the number of hours in the day (24 hrs):

24 hrs ÷ 1000mL = 0.0416 hrs/mL, rounded to 0.04 hrs/mL

If one calculates the schedule based on the number of hours in the day (24 hrs):

125 mL x (24 hrs ÷1000mL)= 3 hrs

If one calculates the schedule by inverting the formula:

125 mL x hrs/1000 mL = 0.125 hrs, rounded to 0.13 hrs

High-Yield Core Concept:

Postoperative fluid management plays a key role in providing adequate tissue perfusion, stable hemodynamics and reducing morbidities related with hemodynamics..

High-Yield Fast Fact:

IV Infusion pumps are utilized to deliver IV fluids accurately and are set at milliliters per hour.

Reference:

World J Crit Care Med 2015;4(3):192-201.

Sample NCLEX-RN Question 4

A patient has had a central venous access device (CVAD) inserted, creating a surgical wound. To decontaminate the wound and minimize infections, what evidence-based management strategy for dressing application has been developed by international organizations such as the Centers for Disease Control and Prevention?

Apply Chlorhexidine gluconate (CHG) impregnated sterile dressing
Apply a wet antiseptic solution directly to the skin and leave it moist when applying the film
Apply sterile normal saline
Apply a non-medicated sterile dressing

Answer: A

Rationale:

Securing a central venous catheter (CVC) with a dressing impregnated with a medication (chlorhexidine gluconate or silver) reduces catheter-related bloodstream infection compared with a dressing without medication. Chlorhexidine gluconate is the preferred antiseptic solution for CVAD sites
It is crucial to allow an antiseptic solution to dry completely before covering the skin to prevent a reaction due to the interaction of the wet solution and the barrier film or adhesive agent.
Sterile saline or water solutions are not antiseptic solutions. They should only be used to clean the skin of gross contaminants prior to applying antiseptic solution. Sterile normal saline may be considered only when a patient seems to be reacting to the antiseptic choices.
The use of antiseptics is associated with a significantly lower risk of intravenous line-associated (and surgical site) infections compared with the use of aqueous solutions.

High-Yield Core Concept:

Venous access devices (VADs) are strongly implicated in healthcare acquired infections. There is high-quality evidence that medication-impregnated dressings reduce the incidence of catheter-related bloodstream infection relative to all other dressing types.

High-Yield Fast Fact:

The subclavian vein has the lowest rates of infection compared with other CVAD sites.

Reference:

AJN 2016;116(6):49.
Am Fam Physician 2010;82(3):249-255.
J Wound Ostomy Continence Nurs 2017;44(3):211-220.
NICE Guidelines.

Sample NCLEX-RN Questions

Check Out a Few Sample Practice Test Questions from Our NCLEX Q-Bank

Hundreds of Questions to Match the NCLEX Exam Blueprint

Core Concepts ~ Answer Rationale Section ~ Performance Indicators ~ Supporting References

Click on "Show More" to see what you also get access to while studying.

Sample NCLEX-RN Question 1

Answer: C

Rationale:

High-Yield Core Concept:

High-Yield Fast Fact(s):

References:

Sample NCLEX-RN Question 2

Answer: B

Rationale:

High-Yield Core Concept:

High-Yield Fast Fact(s):

Reference:

Sample NCLEX-RN Question 3

Answer: D

Rationale:

High-Yield Core Concept:

High-Yield Fast Fact:

Reference:

Sample NCLEX-RN Question 4

Answer: A

Rationale:

High-Yield Core Concept:

High-Yield Fast Fact:

Reference:

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