RN Comprehensive Online Practice (NCLEX 1-5)

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1. A client presents to the emergency department with upper gastrointestinal bleeding and is in moderate distress. In planning care, what is the priority nursing action for this client?

a) Assessment of vital signs
b) Completion of abdominal examination
c) Insertion of the prescribed nasogastric tube
d) Thorough investigation of precipitating events

2. The nurse is performing an assessment on a client with dementia. Which data gathered during the assessment indicates a manifestation associated with dementia?

a) Uses confabulation
b) Improvement in sleeping
c) Absence of sundown syndrome
d) Presence of personal hygienic care

3. RN Comprehensive Online Practice test about the nurse who is caring for a client with anorexia nervosa. Which behavior is characteristic of this disorder and reflects anxiety management?

a) Engaging in immoral acts
b) Always reinforcing self-approval
c) Observing rigid rules and regulations
d) Having the need always to make the right decision

4. The nurse provides instructions to a malnourished pregnant client regarding iron supplementation. Which client statement indicates an understanding of the instructions?

a) “Iron supplements will give me diarrhea.”
b) “Meat does not provide iron and should be avoided.”
c) “The iron is best absorbed if taken on an empty stomach.”
d) “On the days that I eat green leafy vegetables or calf liver I can omit taking the iron supplement.”

5. Levothyroxine (Synthroid) is prescribed for a client diagnosed with hypothyroidism. Upon review of the client’s record, the nurse notes that the client is taking warfarin (Coumadin). Which modification to the plan of care should the nurse review with the client’s health care provider?

a) A decreased dosage of levothyroxine
b) An increased dosage of levothyroxine
c) A decreased dosage of warfarin sodium
d) An increased dosage of warfarin sodium





RN Comprehensive Online Practice
Answers and Rationale

1) A
- Rationale: The priority nursing action is to assess the vital signs. This would indicate the amount of blood loss that has occurred and provide a baseline by which to monitor the progress of treatment. The client may be unable to provide subjective data until the immediate physical needs are met. Although an abdominal examination and an assessment of the precipitating events may be necessary, these actions are not the priority. Insertion of a nasogastric tube is not the priority; in addition, the vital signs should be checked before performing this procedure.

- Test-Taking Strategy: Note the strategic word priority and use the ABCs— airway, breathing, and circulation. This will direct you to the correct option.

2) A
- Rationale: The clinical picture of dementia ranges from mild cognitive deficits to severe, life-threatening alterations in neurological functioning. For the client to use confabulation or the fabrication of events or experiences to fill in memory gaps is not unusual. Often, lack of inhibitions on the part of the client may constitute the first indication of something being “wrong” to the client’s significant others (e.g., the client may undress in front of others, or the formerly well-mannered client may exhibit slovenly table manners). As the dementia progresses, the client will have difficulty sleeping and episodes of wandering or sundowning.

- RN Comprehensive Online Practice Test-Taking Strategy: Focus on the client’s diagnosis and note the subject, a manifestation. Think about the characteristics of dementia to direct you to the correct option.

3) C
- Rationale: Clients with anorexia nervosa have the desire to please others. Their need to be correct or perfect interferes with rational decision-making processes. These clients are moralistic. Rules and rituals help these clients manage their anxiety.

- Test-Taking Strategy: Focus on the subject, managing anxiety. Eliminate options B and D because of the closed-ended word always. Option A is not characteristic of a client with anorexia.

4) C
- Rationale: Iron is needed to allow for transfer of adequate iron to the fetus and to permit expansion of the maternal red blood cell mass. During pregnancy, the relative excess of plasma causes a decrease in the hemoglobin concentration and hematocrit, known as physiological anemia of pregnancy. This is a normal adaptation during pregnancy. Iron is best absorbed if taken on an empty stomach. Iron supplements usually cause constipation. Meats are an excellent source of iron. The client needs to take the iron supplements regardless of food intake.

- RN Comprehensive Online Practice Test-Taking Strategy: Note the subject, iron supplementation during pregnancy. Focus on the words understanding of the instructions. Knowledge of basic principles related to nutrition during pregnancy will assist in eliminating options B and D. From the remaining options, remember that iron causes constipation.

5) C
- Rationale: Levothyroxine (Synthroid) accelerates the degradation of vitamin K–dependent clotting factors. As a result, the effects of warfarin (Coumadin) are enhanced. If thyroid hormone replacement therapy is instituted in a client who has been taking warfarin, the dosage of warfarin should be reduced.

- Test-Taking Strategy: Focus on the subject, the use of levothyroxine (Synthroid) concurrently with warfarin (Coumadin). Recalling that levothyroxine enhances the effects of warfarin will direct you to the correct option.


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RN Comprehensive Online Practice (NCLEX 6-10)

Mental Health Nursing NCLEX Questions 37-41

Increase your knowledge with this 5-item Mental Health Nursing NCLEX Questions.

 37. The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority nursing intervention should the nurse include in the plan of care?

a) One-to-one suicide precautions
b) Suicide precautions with 30-minute checks
c) Checking the whereabouts of the client every 15 minutes
d) Asking the client to report suicidal thoughts immediately

38. Mental Health Nursing NCLEX Questions about the emergency department nurse who is caring for an adult client who is a victim of family violence. Which priority instruction should be included in the discharge instructions?

a) Information regarding shelters
b) Instructions regarding calling the police
c) Instructions regarding self-defense self-defense classes
d) Explaining the importance of leaving the violent situation

39. A female victim of a sexual assault is being seen in the crisis center. The client states that she still feels “as though the rape just happened yesterday,” even though it has been a few months since the incident. What is the most appropriate nursing response?

a) “You need to try to be realistic. The rape did not just occur.”
b) “It will take some time to get over these feelings about your rape.”
c) “Tell me more about the incident that causes you to feel like the rape just occurred.”
d) “What do you think that you can do to alleviate some of your fears about being raped again?”

40. A client is admitted to the mental health unit after an attempted suicide by hanging. The nurse can best ensure client safety by which action?

a) Requesting that a peer remain with the client at all times
b) Removing the client’s clothing and placing the client in a hospital gown
c) Assigning a staff member to the client who will remain with the client at all times
d) Admitting the client to a seclusion room where all potentially dangerous articles are removed

41. A client is admitted with a recent history of severe anxiety following a home invasion and robbery. During the initial assessment interview, which statement by the client would indicate to the nurse the possible diagnosis of posttraumatic stress disorder? Select all that apply.

a) “I’m afraid of spiders.”
b) “I keep reliving the robbery.”
c) “I see his face everywhere I go.”
d) “I don’t want anything to eat now.”
e) “I might have died over a few dollars in my pocket.”
f) “I have to wash my hands over and over again many times.”






Mental Health Nursing NCLEX Questions
Answers and Rationale

37) A
- Rationale: One-to-one suicide precautions are required for a client who has attempted suicide. Options B and C may be appropriate, but not at the present time, considering the situation. Option D also may be an appropriate nursing intervention, but the priority is identified in the correct option. The best intervention is constant supervision so that the nurse may intervene as needed if the client attempts to harm himself or herself.

- Test-Taking Strategy: Focus on the strategic word priority, noting the words attempted suicide. The correct option is the only one that provides a safe environment.

38) A
- Rationale: Tertiary prevention of family violence includes assisting the victim after the abuse has already occurred. The nurse should provide the client with information regarding where to obtain help, including a specific plan for removing the self from the abuser and information regarding escape, hotlines, and the location of shelters. An abused person is usually reluctant to call the police. Teaching the victim to fight back is not the appropriate action for the victim when dealing with a violent person. Explaining the importance of leaving the violent situation is important, but a specific plan is necessary.

- Mental Health Nursing NCLEX Questions Test-Taking Strategy: Note the strategic word priority. Focus on the subject of the question, which relates to providing the client with a safe environment. The correct option provides a specific plan for safety.

39) C
- Rationale: The correct option allows the client to express her ideas and feelings more fully and portrays a nonhurried, nonjudgmental, supportive attitude on the part of the nurse. Clients need to be reassured that their feelings are normal and that they may express their concerns freely in a safe, caring environment. Option A immediately blocks communication. Option B places the client’s feelings on hold. Option D places the problem-solving totally on the client.

- Test-Taking Strategy: Note the strategic words most appropriate. Also, focus on the subject, the most appropriate response to the client. Use therapeutic communication techniques. The correct option is the only one that addresses the client’s feelings. Always address the client’s feelings first.

40) C
- Mental Health Nursing NCLEX Questions Rationale: Hanging is a serious suicide attempt. The plan of care must reflect action that ensures the client’s safety. Constant observation status (one-to-one) with a staff member is the best choice. Placing the client in a hospital gown and requesting that a peer remain with the client would not ensure a safe environment. Seclusion should not be the initial intervention, and the least restrictive measure should be used.

- Test-Taking Strategy: Note the strategic word best. Focus on the subject, care of the client at risk for suicide. Eliminate option D because seclusion should not be the initial intervention. Eliminate option A next because the responsibility to safeguard a client is not the peer’s responsibility. Eliminate option B because removing one’s clothing would not maximize all possible safety strategies.

41) B, C, E
- Rationale: Reliving an event, experiencing emotional numbness (facing possible death), and having flashbacks of the event (seeing the same face everywhere) are all common occurrences with posttraumatic stress disorder. The statement. “I’m afraid of spiders,” is more relative to having a phobia. The statement “I have to wash my hands over and over again many times” describes ritual compulsive behaviors to decrease anxiety for someone with obsessive compulsive disorder. Stating “I don’t want anything to eat now” is vague and could relate to numerous conditions.

- Test-Taking Strategy: Focus on the subject, post traumatic stress disorder. There is no indication about a fear of spiders being part of the problem. There is no information in the question to support that the client has ritual behaviors. The client stating he doesn’t want anything to eat at the time is not relative to this client’s situation. Responses B, C, and E all indicate the client is experiencing post traumatic stress disorder from a recent home invasion and robbery event.


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Mental Health Nursing NCLEX Questions 42-45

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