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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q685-Q690):

NEW QUESTION # 685
A client presents to the emergency room with cyanosis, coughing, tachypnea, and tachycardia. She has a history of asthma. Arterial blood gas values are pH 7.28, PaO2 54, PaCO2 60, and HCO3 24. The nursing assessment of arterial blood gases indicate the presence of:

A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis

Answer: D

Explanation:
(A) Respiratory alkalosis is determined by elevated pH and low PaCO2. (B) Respiratory acidosis is determined by low pH and elevated PaCO2. (C) Metabolic alkalosis is determined by elevated pH and HCO3. (D) Metabolic acidosis is determined by low pH and HCO3.

NEW QUESTION # 686
A 16-month-old infant is being prepared for tetralogy of Fallot repair. In the nursing assessment, which lab value should elicit further assessment and requires notification of physician?

A. Hematocrit 60%
B. Bleeding time of 4 minutes
C. White blood cell (WBC) count 10,000 WBCs/mm3
D. pH 7.39

Answer: A

Explanation:
(A) Normal pH of arterial blood gases for an infant is 7.35-7.45. (B) Normal white blood cell count in an infant is 6,000-17,500 WBCs/mm3. (C) Normal hematocrit in infant is 28%-42%. A 60% hematocrit may indicate polycythemia, a common complication of cyanotic heart disease. (D) Normal bleeding time is 2-7 minutes.

NEW QUESTION # 687
With a geriatric client, the nurse should also assess whether he has been obtaining a yearly vaccination against influenza. Why is this assessment important?

A. Influenza is growing in our society.
B. Older clients generally are sicker than others when stricken with flu.
C. Older clients have more exposure to the causative agents.
D. Older clients have less effective immune systems.

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) Although influenza is common, the elderly are more at risk because of decreased effectiveness of their immune system, not because the incidence is increasing. (B) Older clients have the same degree of illness when stricken as other populations. (C) As people age, their immune system becomes less effective, increasing their risk for influenza. (D) Older clients have no more exposure to the causative agents than do school-age children, for example.

NEW QUESTION # 688
A woman diagnosed with multiple sclerosis is disturbed with diplopia. The nurse will teach her to:

A. Take more frequent naps
B. Limit activities which require focusing (close vision)
C. Use artificial tears
D. Wear a patch over one eye

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) Limiting activities requiring close vision will not alleviate the discomfort of double vision. (B) Frequent naps may be comforting, but they will not prevent double vision. (C) Artificial tears are necessary in the absence of a corneal reflex, but they have no effect on diplopia. (D) An eye patch over either eye will eliminate the effects of double vision during the time the eye patch is worn. An eye patch is safe for a person with an intact corneal reflex.

NEW QUESTION # 689
A client is being discharged and will continue enteral feedings at home. Which of the following statements by a family member indicates the need for further teaching?

A. "I should anticipate that he will gain about 1 lb/day now that he is on continuous feedings."
B. "It is important to keep the head of his bed elevated or sit him in the chair during feedings."
C. "If he develops diarrhea lasting for more than 2-3 days, I will contact the doctor or nurse."
D. "I should use prepared or open formula within 24 hours and store unused portions in the refrigerator."

Answer: A

Explanation:
Section: Questions Set B
Explanation:
(A) Diarrhea is a complication of tube feedings that can lead to dehydration. Diarrhea may be the result of hypertonic formulas that can draw fluid into the bowel. Other causes of diarrhea may be bacterial contamination, fecal impaction, medications, and low albumin. (B) A consistent weight gain of more than 0.22 kg/day (1ꢀ2 lb/day) over several days should be reported promptly. The client should be evaluated for fluid volume excess. (C) Elevating the client's head prevents reflux and thus formula from entering the airway. (D) Bacteria proliferate rapidly in enteral formulas and can cause gastroenteritis and even sepsis.

NEW QUESTION # 690
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