NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
A 9-month-old infant is being examined in the general pediatric clinic for a routine well-child checkup. His immunizations are up to date, and his mother reports that he has had no significant illnesses or injuries. Which of the following signs would lead the nurse to believe that he has had a cerebral injury?
Correct Answer: D
Rationale: Infants older than 6 months of age should not have significant head lag. This is a sign of cerebral injury and should be referred for further evaluation.
Question 2 of 5
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:
Correct Answer: B
Rationale: Asking 'why' questions may put the child on the defensive and may not elicit useful information, especially in a young child who may struggle to articulate reasons. This approach is open-ended and encourages the child to describe her experiences in a non-confrontational way, which may reveal underlying issues while building trust. This question is too specific and may feel confrontational, potentially causing the child to shut down. While encouraging expression of feelings is appropriate, it is less specific and may not help uncover the specific event or change that led to her refusal to attend.
Question 3 of 5
A normal 3-year-old child is suspected of having meningitis. The doctor has ordered a lumbar puncture. In light of this procedure and developmental characteristics of this age group, which nursing measure is most appropriate?
Correct Answer: A
Rationale: The nurse should emphasize what is required to elicit cooperation and help to develop a sense of autonomy. The child may express discomfort verbally and should be encouraged to express his feelings. Selecting nonthreatening words to explain a procedure will prevent misinterpretation. When explaining the procedure to the parent with the child present, the nurse should use words that the child can understand to avoid misunderstanding.
Question 4 of 5
A 26-year-old client is diagnosed with an astrocytoma, a benign brain tumor. From the nurse's knowledge of the central nervous system, the nurse knows that benign tumors:
Correct Answer: A
Rationale: Both a benign and a malignant tumor can displace or destroy nearby structures or increase intracranial pressure.
Question 5 of 5
A 3-year-old child has had symptoms of influenza including fever, productive cough, nausea, vomiting, and sore throat for the past several days. In caring for a young child with symptoms of influenza, the mother must be cautioned about:
Correct Answer: A
Rationale: Aspirin should never be given to children with influenza because of the possibility of causing Reye's syndrome. Pepto-Bismol is also classified as a salicylate and should be avoided. Depending on the severity of symptoms, the child may be receiving IV therapy or clear liquids. The disease has a 1-3 day incubation period and affected children are most infectious 24 hours before and after the onset of symptoms. Although viral pneumonia can be a complication of influenza, this would not be an initial priority.