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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q85-Q90):

NEW QUESTION # 85
A physician tells the nurse that he wants to orally intubate a client with a No. 8 endotracheal tube. The finding of normal breath sounds on the right side of the chest and diminished, distant breath sounds on the left side of the chest of a newly intubated client is probably due to:

A. An inadequate mechanical ventilator
B. A right hemothorax
C. A left hemothorax
D. Intubation of the right mainstem bronchus

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) Although a left hemothorax could cause diminished and distant breath sounds, it is irrelevant to this situation. (B) A right hemothorax will not cause diminished and distant breath sounds on the left side of the chest. (C) The right mainstem bronchus is most frequently intubated in error because the angle of the right mainstem bronchus is very small as compared with that of the left mainstem bronchus. Because ventilation is only occurring on the right side, the nurse would auscultate diminished and distant breath sounds on the left. (D) An inadequate mechanical ventilator has no relationship to this situation.

NEW QUESTION # 86
Priapism may be a sign of:

A. Reproductive dysfunction
B. Altered neurological function
C. Urinary incontinence
D. Imminent death

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) Priapism in the trauma client is due to the neurological dysfunction seen in spinal cord injury. Priapism is an abnormal erection of the penis; it may be accompanied by pain and tenderness. This may disappear as spinal cord edema is relieved. (B) Priapism is not associated with death. (C) Urinary retention, rather than incontinence, may occur. (D) Reproductive dysfunction may be a secondary problem.

NEW QUESTION # 87
In planning daily care for a client with multiple sclerosis, the nurse would take into consideration that multiple sclerosis:

A. Is rapidly fatal
B. Responds quickly to antimicrobial therapy
C. Becomes progressively debilitating without remission
D. Has unpredictable remissions and exacerbations

Answer: D

Explanation:
Explanation
(A) Multiple sclerosis eventually becomes debilitating, but it is characterized by remission of symptoms. (B) Remissions and exacerbations are unpredictable with multiple sclerosis. The client experiences progressive dysfunction after each exacerbation episode. (C) Multiple sclerosis is usually slowly progressive. (D) Multiple sclerosis is an autoimmune disease. Antimicrobial therapy has no effect on its course.

NEW QUESTION # 88
A client tells the nurse that he has been hearing voices that tell him to kill his girlfriend because she is a spy.
He further states that he is having difficulty not obeying the voices because, if he does not, his house will be burned down. The highest priority nursing diagnosis for him at this time is:

A. Sensory-perceptual alteration: auditory command hallucinations
B. Alteration in thought processes: paranoid delusions
C. Potential for violence directed at others
D. Impaired verbal communication: loose associations

Answer: C

Explanation:
Explanation
(A) Although the client is having command hallucinations, this is second in priority to real or potential violence, which can be a threat to life itself. (B) Although the client is experiencing delusions, this is also a lower priority than his potential or actual loss of control. (C) Whether real or potential, violence directed at self or others is always high priority. (D) There is no evidence of loosening of associations.

NEW QUESTION # 89
The nurse is admitting a client with folic acid deficiency anemia. Which of the following questions is most important for the nurse to ask the client?

A. "Do you take aspirin on a regular basis?"
B. "Have your stools been normal?"
C. "Do you eat red meat?"
D. "Do you drink alcohol on a regular basis?"

Answer: D

Explanation:
Section: Questions Set G
Explanation:
(A) Aspirin does not affect folic acid absorption. (B) Folic acid deficiency is strongly associated with alcohol abuse. (C) Because folic acid is a coenzyme for single carbon transfer purines, calves liver or other purines are the meat sources. (D) Folic acid does not affect stool character.

NEW QUESTION # 90
......

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