Mock NCLEX RN Exam
Question 1 of 5.
A client develops an intestinal obstruction postoperatively. A nasogastric tube is attached to low, intermittent suction with orders to 'Irrigate NG tube with sterile saline q1h and prn.' The rationale for using sterile saline, as opposed to using sterile water to irrigate the NG tube is:
A. Water will deplete electrolytes resulting in metabolic acidosis.
B. Saline will reduce the risk of severe, colicky abdominal pain during NG irrigation.
C. Water is not isotonic and will increase restlessness and insomnia in the immediate postoperative period.
D. Saline will increase peristalsis in the bowel.
Explanation: Water is a hypotonic solution and will deplete electrolytes and cause metabolic acidosis when used for nasogastric irrigation. Irrigating with saline does not cause abdominal discomfort. Severe, colicky abdominal pain is a symptom of intestinal obstruction. Irrigating with water will not cause restlessness or insomnia in the postoperative client. Restlessness and insomnia can be emotional complications of surgery. A nasogastric tube placed in the stomach is used to decompress the bowel. Irrigating with saline ensures a patent, well-functioning tube. Irrigating with saline will not increase peristalsis.
Question 2 of 5.
The physician has ordered a low-residue diet for a client with Crohn's disease. Which food is not permitted in a low-residue diet?
A. Mashed potatoes
B. Smooth peanut butter
C. Fried fish
D. Rice
Explanation: A low-residue diet minimizes fiber and irritating foods; fried fish is high in fat and can irritate the gut, making it unsuitable for Crohn's disease.
Question 3 of 5.
The physician has ordered Eskalith (lithium carbonate) 500 mg three times a day and Risperdal (risperidone) 2 mg twice daily for a client admitted with bipolar disorder, acute manic episodes. The best explanation for the client's medication regimen is:
A. The client's symptoms of acute mania are typical of undiagnosed schizophrenia.
B. Antipsychotic medication is used to manage behavioral excitement until mood stabilization occurs.
C. The client will be more compliant with a medication that allows some feelings of hypomania.
D. Antipsychotic medication prevents psychotic symptoms commonly associated with the use of mood stabilizers.
Explanation: Risperidone, an antipsychotic, is used to control acute manic symptoms like agitation, while lithium stabilizes mood over time, addressing the immediate behavioral excitement.
Question 4 of 5.
Which one of the following situations represents a maturational crisis for the family?
A. A four-year-old entering nursery school
B. Development of preeclampsia during pregnancy
C. Loss of employment and health benefits
D. Hospitalization of a grandfather with a stroke
Explanation: A maturational crisis involves normal developmental transitions, such as a child entering nursery school, which can stress family dynamics.
Question 5 of 5.
The nurse is making room assignments for four obstetrical clients. If only one private room is available, it should be assigned to:
A. A multigravida with diabetes mellitus
B. A primigravida with preeclampsia
C. A multigravida with preterm labor
D. A primigravida with hyperemesis gravidarum
Explanation: Preeclampsia requires close monitoring due to risks like seizures or stroke, making a private room essential for a primigravida with this condition.