Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 23

1. The nurse observes that a client has difficulty chewing and swallowing her food. A nursing response designed to reduce this problem would include:

A) Ordering a full liquid diet for her
B) Ordering five small meals for her
C) Ordering a mechanical soft diet for her
D) Ordering a purÃ©ed diet for her

2. When a client with pancreatitis is discharged, the nurse needs to teach him how to prevent another occurrence of acute pancreatitis. Which of the following statements would indicate he has an understanding of his disease?

A) 'I will not eat any raw or uncooked vegetables.'
B) 'I will limit my alcohol to one cocktail per day.'
C) 'I will look into attending Alcoholics Anonymous meetings.'
D) 'I will report any changes in bowel movements to my doctor.'

3. A 54-year-old client is admitted to the hospital with a possible gastric ulcer. He is a heavy smoker. When discussing his smoking habits with him, the nurse should advise him to:

A) Smoke low-tar, filtered cigarettes
B) Smoke cigars instead
C) Smoke only right after meals
D) Chew gum instead

4. Iron dextran (Imferon) is a parenteral iron preparation.The nurse should know that it:

A) Is also called intrinsic factor
B) Must be given in the abdomen
C) Requires use of the Z-track method
D) Should be given SC

5. A nasogastric (NG) tube inserted preoperatively is attached to low, intermittent suctions. A client with an NG tube exhibits these symptoms: He is restless; serum electrolytes are Na 138, K 4.0, blood pH 7.53. This client is most likely experiencing:

A) Hyperkalemia
B) Hyponatremia
C) Metabolic acidosis
D) Metabolic alkalosis

1. Right Answer: C
Explanation: (A) Full liquids would be difficult to swallow if the muscle control of the swallowing act is affected; this is a probable reason for her difficulties, given her medical diagnosis of multiple sclerosis. (B) Five small meals would do little if anything to decrease her swallowing difficulties, other than assure that she tires less easily.(C) A mechanical soft diet should be easier to chew and swallow, because foods would be more evenly consistent. (D) A pureed diet would cause her to regress more than might be needed; the mechanical soft diet should be tried first.

2. Right Answer: C
Explanation: (A) Raw or uncooked vegetables are all right to eat postdischarge. (B) This client must avoid any alcohol intake. (C) The client displays awareness of the need to avoid alcohol. (D) This action would be pertinent only if fatty stools associated with chronic hepatitis were the problem.

3. Right Answer: C
Explanation: (A, B, D) Cigarettes, cigars, and chewing gum would stimulate gastric acid secretion. (C) Smoking on a full stomach minimizes effect of nicotine on gastric acid.

4. Right Answer: C
Explanation: (A) Intrinsic factor is needed to absorb vitamin B12.(B) Iron dextran is given parenterally, but Z-track in a large muscle. (C) A Ztrack method of injection is required to prevent staining and irritation of the tissue. (D) An SC injection is not deep enough and may cause subcutaneous fat abscess formation.

5. Right Answer: D
Explanation: (A) Sodium level is within normal limits. (B) Sodium level is within normal limits. (C) pH level is consistent with alkalosis. (D) With an NG tube attached to low, intermittent suction, acids are removed and a client will develop metabolic alkalosis.

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