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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q122-Q127):

NEW QUESTION # 122
A client has developed congestive heart failure secondary to his myocardial infarction. Discharge diet instructions should emphasize the reduction or avoidance of:

A. Canned vegetables and fruitB. FishC. Breads, cereals, and riceD. Fresh vegetables and fruit

Answer: A

Explanation:
Explanation/Reference:
Explanation:
(A) Fresh vegetables and fruits are excellent sources of essential vitamins. (B) Canned and frozen foods have a high sodium content. Labels of all canned foods should be read to determine if sodium is used in any form. (C) Bread, cereal, and rice are excellent sources of carbohydrates. (D) Fish is an excellent source of protein.


NEW QUESTION # 123
A 70-year-old client is almost finished receiving her second unit of packed red blood cells. The client, who weighs 80 lb, has started complaining of being short of breath and now has crackles in the bases of her lungs.
After slowing or stopping the transfusion, the most appropriate initial nursing action would be to:

A. Place the client on 2 liters of O2 via nasal cannulaB. Notify the physicianC. Raise the client's head and place her feet in a dependent positionD. Administer furosemide (Lasix) 20 mg IV push

Answer: C

Explanation:
Section: Questions Set C
Explanation:
(A) Raising the client's head and placing her feet in a dependent position is an independent nursing action that can be taken to decrease venous return and to reduce pulmonary congestion. (B) Notifying the physician is an appropriate action that should be taken after the client is positioned to maximize her respiratory status. (C) Placing the client on O2may be done with a physician's order or according to an institution's standing orders; however, other actions should be taken first. (D) Furosemide 20 mg IV push is an appropriate medication for the client, but it must be ordered by her physician.


NEW QUESTION # 124
The mother of a 7-year-old mental health center client reports that the client has refused to attend gymnastics for the past 2 weeks. Prior to that time, the child liked going to this class and was attending 3 times a week. In talking with the client, the nurse would:

A. Ask her to describe how things were at gymnastics before she started refusing to goB. Tell her that it is OK to be afraid of this activityC. Ask her why she doesn't like gymnastics anymoreD. Reassure her that things will get better once she begins the classes again

Answer: A

Explanation:
Section: Questions Set D
Explanation:
(A) The child has not said that she dislikes gymnastics. (B) The nurse will be able to obtain information on what events occurred at gymnastics prior to her refusal to attend. The nurse will also gain information about the child's perception of the problem. (C) The child has not said she is afraid to go to gymnastics. (D) False reassurance is inappropriate.


NEW QUESTION # 125
A client had a vaginal delivery 3 days ago and is discharged from the hospital on the 2nd day postpartum. She told the RN, "I need to start exercising so that I can get back into shape. Could you suggest an exercise I could begin with?'' The RN could suggest which one of the following?

A. Leg liftsB. Push-upsC. Jumping jacksD. Kegel exercises

Answer: D

Explanation:
(A, B, C) This exercise is too strenuous at this time. (D) This exercise is recommended for the first few days after delivery. It helps to stimulate muscle tonus in the area of the perineum and the area around the urinary meatus and vagina.


NEW QUESTION # 126
A 3-year-old child was hospitalized for acute laryngotracheobronchitis. During her hospitalization, the child was placed under an oxygen mist tent. The nurse's frequent monitoring of the child's temperature frightened her parents. Which response by the nurse would be most appropriate?

A. Checking the temperature will prevent febrile seizures.B. Taking the child's temperature can prevent airway obstruction.C. Monitoring the temperature prevents undue chilling.D. Rapid temperature elevations can occur in children.

Answer: C

Explanation:
(A)
The refrigerated cool mist tent creates a cool, moist environment. The child as well as bedding and clothing may become dampened. Monitoring the temperature of the child will ensure warmth and prevent chilling. (B) Only a low-grade fever is expected in laryngotracheobronchitis. (C) Febrile seizures are not expected with the low-grade fever.
(D)
Inflammation of the mucosal lining in the respiratory tract can cause airway obstruction. However, monitoring the child's temperature would not prevent airway obstruction.


NEW QUESTION # 127
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