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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q432-Q437):

NEW QUESTION # 432
The mother of a child taking phenytoin will need to plan appropriate mouth care and gingival stimulation. When tooth-brushing is contraindicated, the next most effective cleansing and gingival stimulation technique would be:

A. Rinsing with water
B. Rinsing with baking soda
C. Rinsing with hydrogen peroxide
D. Using a water pik

Answer: D

Explanation:
(A) This technique provides effective rinsing and gingival stimulation. (B) This technique does not provide gingival stimulation. (C) This technique provides effective rinsing but not gingival stimulation. Using peroxide is not pleasant for the child. (D) This technique provides effective rinsing but not gingival stimulation.

NEW QUESTION # 433
When evaluating a client with symptoms of shock, it is important for the nurse to differentiate between neurogenic and hypovolemic shock. The symptoms of neurogenic shock differ from hypovolemic shock in that:

A. In hypovolemic shock, there is a bradycardia
B. In hypovolemic shock, capillary refill is less than 2 seconds
C. In neurogenic shock, the skin is warm and dry
D. In neurogenic shock, there is delayed capillary refill

Answer: C

Explanation:
Explanation/Reference:
Explanation:
(A) Neurogenic shock is caused by injury to the cervical region, which leads to loss of sympathetic control.
This loss leads to vasodilation of the vascular beds, bradycardia resulting from the lack of sympathetic balance to parasympathetic stimuli from the vagus nerve, and the loss of the ability to sweat below the level of injury. In neurogenic shock, the client is hypotensive but bradycardiac with warm, dry skin. (B) In hypovolemic shock, the client ishypotensive and tachycardiac with cool skin. (C) In hypovolemic shock, the capillary refill would be>5 seconds. (D) In neurogenic shock, there is no capillary delay, the vascular beds are dilated, and peripheral flow is good.

NEW QUESTION # 434
A nurse is performing a vaginal exam on a client in active labor. An important landmark to assess during labor and delivery are the ischial spines because:

A. They measure pelvic floor
B. Ischial spines are the narrowest diameter of the pelvis
C. They represent the inlet of birth canal
D. Ischial spines are the widest diameter of the pelvis

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) The fetal descent, or station, is determined by the relationship of the presenting part to the spine. (B) Ischial spines are the narrowest measurement. (C) Ischial spines measure the pelvic outlet. (D) Pelvic floor measurement is not related to fetal descent.

NEW QUESTION # 435
Dietary planning is an essential part of the diabetic client's regimen. The American Diabetes Association recommends which of the following caloric guidelines for daily meal planning?

A. 60% complex carbohydrate, 12%-15% protein, 20%-25% fat
B. 70% complex carbohydrate, 20%-30% protein, 10%-20% fat
C. 50% complex carbohydrate, 20%-25% protein, 20%-25% fat
D. 45% complex carbohydrate, 25%-30% protein, 30%-35% fat

Answer: A

Explanation:
Explanation
(A) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney as it is metabolized. (B) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney. (C) The percentage of carbohydrates is too high; the percent range of protein is too high, and of fat, too low. (D) This combination provides enough carbohydrates to maintain blood glucose levels, enough protein to maintain body repair, and enough fat to ensure palatability.

NEW QUESTION # 436
A female client is seeking counseling for personal problems. She admits to being very unhappy lately at both home and work. During the nursing assessment, she uses many defense mechanisms. Which statement or action made by the client is an example of adaptive suppression?

A. "I did not get the raise because my boss does not like me."
B. "I felt a lump in my breast 2 weeks ago. I put off getting it checked until after my sister's wedding."
C. "My son died 3 years ago. I still cannot bring myself to clean out his room."
D. "My husband told me this morning that he wants a divorce. I am upset, but I cannot discuss the matter with him until after my company's board meeting today."

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) This statement is an example of adaptive rationalization. She is coping with her disappointment by rationalizing. This is adaptive because no harm is done to self or others. It is used to protect her ego. (B) This is an example of maladaptive suppression. She is suppressing the seriousness of the lump. It is maladaptive because delaying treatment will cause harm to her. (C) The client's actions are an example of maladaptive denial. She is denying her son's death by not facing his possessions. Until she faces his death, she cannot face reality. (D) This is an example of adaptive suppression. She realizes the impact of her husband's statement but delays discussion until she can devote her full attention to the matter.

NEW QUESTION # 437
......

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