Question

A client requiring prolonged mechanical ventilation has the following arterial blood gas (ABG) results: pH: 7.49; PaO₂: 85 mm Hg; PaCO₂: 30 mm Hg; HCO₃: 25 mEq/L. The nurse interprets these results as

Answer 1

Correct Answers:

respiratory alkalosis.

Rationale :

🧪The pH of 7.49 is above the normal range (7.35–7.45), indicating an alkalotic state.

🫁The PaCO₂ is low at 30 mm Hg (normal 35–45 mm Hg), reflecting hyperventilation and excessive CO₂ elimination.

⚖️The HCO₃⁻ is within normal limits (22–26 mEq/L), showing no primary metabolic disturbance.

🔍These values point to a primary respiratory origin for the alkalosis rather than a metabolic cause.

📌Core Message

Low PaCO₂, elevated pH, normal HCO₃⁻ → respiratory alkalosis.

Answer 2

Correct Answers:

as the child is inhaling.

Rationale :

🫁Using a chamber allows the medication to be suspended for easy inhalation and reduces oropharyngeal deposition.

💨Actuation during inhalation ensures maximum drug delivery to the lower airways.

⚖️Timing the spray with the breath improves lung deposition and therapeutic effect.

🏥Proper coordination between actuation and inhalation decreases wasted medication and side effects.

📌Core Message

Synchronize actuation with inhalation using a chamber.

Answer 3

Correct Answers

Bullying at school [ NOT ASSOCIATED WITH CANCER ]
Cigarette smoking [ ASSOCIATED WITH CANCER ]
Poor personal hygiene [ NOT ASSOCIATED WITH CANCER ]
Texting while driving [ NOT ASSOCIATED WITH CANCER ]
Unprotected sex [ ASSOCIATED WITH CANCER ]
Use of tanning beds [ ASSOCIATED WITH CANCER ]

Rationale :

🚭Cigarette smoking exposes tissues to carcinogens that directly damage DNA, significantly elevating cancer risk.

🌞Use of tanning beds subjects the skin to intense UV radiation, which induces cellular mutations leading to malignancy.

🦠Unprotected sex increases the likelihood of contracting oncogenic viruses such as HPV, a major cause of cervical cancer.

🚫Bullying at school, poor personal hygiene, and texting while driving do not involve exposure to known carcinogens or oncogenic agents and therefore are not associated with cancer risk.

📌Core Message

Carcinogen exposure and oncogenic viruses increase cancer risk.

Answer 4

Correct Answers:

Exaggerating mouth movements when speaking to the client

Rationale :

🗣️Exaggerated mouth movements distort natural lip patterns, making it harder for clients to read lips accurately.

👁️Clients rely on a combination of auditory input and visual cues, and natural facial expressions support comprehension.

🚫Overemphasis of mouth shapes can confuse speech-reading and reduce effective communication.

💡Maintaining natural mouth movements preserves the clarity of lip-reading for hearing-impaired clients.

📌Core Message

Natural mouth movements aid lip reading for clients with hearing impairment.

Answer 5

Correct Answers:

Avoidance-avoidance

Rationale :

🚫Avoidance-avoidance conflict occurs when individuals face two undesirable options with no acceptable choice.

⚖️Approach-approach involves choosing between two desirable options, which does not fit this scenario.

❓Approach-avoidance involves a single option with pros and cons, not two equally unacceptable ones.

✅Identifying the correct conflict stage guides appropriate resolution strategies.

📌Core Message

Avoidance-avoidance arises when choosing between two undesirable options.

Answer 6

Correct Answers:

notify the appropriate authorities of suspected child abuse.

Rationale :

🚨Suspected child abuse must be reported immediately to authorities per legal and ethical obligations.

🩺The nurse’s role includes mandatory reporting to protect the child and initiate an investigation.

⚖️Confronting the caregiver without following proper channels can jeopardize safety and legal procedures.

📋Timely notification ensures the child receives necessary protective services and support.

📌Core Message

Mandatory reporting protects the child by notifying authorities of suspected abuse.

Answer 7

Correct Answers:

“Since I am 8 months postpartum, I need to find a different form of family planning.”
“I do understand that I will have ovulated before my first menstrual cycle returns.”

Rationale :

🍼The lactational amenorrhea method is only reliable during the first six months postpartum due to sustained high prolactin levels.

🤱Exclusive breastfeeding on demand maintains elevated prolactin and suppresses ovulation.

🔄Because ovulation typically occurs before the first menstrual cycle, fertility can return even without noticeable bleeding.

⚠️Recognizing this physiology ensures timely adoption of an alternative contraceptive method when risk increases.

📌Core Message

Limited to first 6 months postpartum, requires exclusive breastfeeding, and ovulation precedes menses.

Answer 8

Correct Answers:

The client should be maintained on complete bed rest with bathroom privileges only.

Rationale :

🛌Sealed implants must remain in a fixed position to deliver precise radiation doses, so restricting movement is essential.

🚽Allowing in-room bathroom privileges prevents unnecessary travel and reduces risk of implant displacement.

⚛️While bodily fluids are not radioactive, implant position integrity is critical for treatment efficacy.

👁️Continuous monitoring ensures patient safety and accurate radiation delivery.

📌Core Message

Limit movement and provide in-room bathroom privileges to prevent implant displacement.

Answer 9

Correct Answers:

Contact the provider for a corrected order.

Rationale :

📞“MS” is an ambiguous abbreviation that can mean morphine sulfate or magnesium sulfate, risking serious error.

🩺Clarifying the order with the prescriber ensures correct drug selection and dosage.

❌Administering without clarification may lead to adverse events or patient harm.

✅Following safe practice guidelines requires elimination of ambiguous medication orders.

📌Core Message

Clarify ambiguous orders to prevent medication errors.

Answer 10

Correct Answers:

Increase fluids to 1 L per day.

Rationale :

💧Adequate hydration softens stool and promotes bowel motility, addressing constipation conservatively.

🍎Lifestyle interventions are first-line before invasive measures like enemas or disimpaction.

🚫Decreasing fiber worsens constipation by reducing stool bulk and motility.

✅More invasive treatments are reserved for cases unresponsive to initial dietary and fluid changes.

📌Core Message

Increase fluid intake to facilitate bowel motility and soften stool.

NCLEX-RN Practice Exam 1

No.

1 :
A client requiring prolonged mechanical ventilation has the following arterial blood gas (ABG) results: pH: 7.49; PaO₂: 85 mm Hg; PaCO₂: 30 mm Hg; HCO₃: 25 mEq/L. The nurse interprets these results as

2 :
A nurse is teaching a client how to administer Proventil to the client’s child using a metered dose inhaler with a chamber. The nurse explains that the medication should be administered

3 :
A nurse is preparing to talk with a high school student about reducing the risk of developing cancer later in life.

Correct Answers

4 :
A nurse is observing a student perform care for a client with hearing aids in both ears. Which student action should be corrected by the nurse?

5 :
The nurse manager is made aware of conflict between two nurses. After speaking with the two nurses, the manager notes that there are no acceptable options to either person. Which stage of conflict is occurring?

7 :
The nurse is preparing for a yearly well-woman visit with a patient who is 8 months postpartum.

Answer Options

8 :
A client being treated for cervical cancer receives a sealed radiation implant. When caring for this client, the nurse implements care based on which of the following facts?

9 :
A nurse receives an order from the provider that states “MS 4mg IV prn severe pain.” Which is the best action by the nurse?

10 :
A client presents to a community clinic with constipation lasting 5 days. Which intervention should the nurse recommend first?

HIGH-RISK BEHAVIOR	ASSOCIATED WITH CANCER	NOT ASSOCIATED WITH CANCER
Bullying at school
Cigarette smoking
Poor personal hygiene
Texting while driving
Unprotected sex
Use of tanning beds

NCLEX-RN Practice Exam 1

No.

1 : A client requiring prolonged mechanical ventilation has the following arterial blood gas (ABG) results: pH: 7.49; PaO2: 85 mm Hg; PaCO2: 30 mm Hg; HCO3: 25 mEq/L. The nurse interprets these results as

2 : A nurse is teaching a client how to administer Proventil to the client’s child using a metered dose inhaler with a chamber. The nurse explains that the medication should be administered

3 : A nurse is preparing to talk with a high school student about reducing the risk of developing cancer later in life.

Correct Answers

4 : A nurse is observing a student perform care for a client with hearing aids in both ears. Which student action should be corrected by the nurse?

5 : The nurse manager is made aware of conflict between two nurses. After speaking with the two nurses, the manager notes that there are no acceptable options to either person. Which stage of conflict is occurring?

7 : The nurse is preparing for a yearly well-woman visit with a patient who is 8 months postpartum.

Answer Options

8 : A client being treated for cervical cancer receives a sealed radiation implant. When caring for this client, the nurse implements care based on which of the following facts?

9 : A nurse receives an order from the provider that states “MS 4mg IV prn severe pain.” Which is the best action by the nurse?

10 : A client presents to a community clinic with constipation lasting 5 days. Which intervention should the nurse recommend first?

1 :
A client requiring prolonged mechanical ventilation has the following arterial blood gas (ABG) results: pH: 7.49; PaO₂: 85 mm Hg; PaCO₂: 30 mm Hg; HCO₃: 25 mEq/L. The nurse interprets these results as

2 :
A nurse is teaching a client how to administer Proventil to the client’s child using a metered dose inhaler with a chamber. The nurse explains that the medication should be administered

3 :
A nurse is preparing to talk with a high school student about reducing the risk of developing cancer later in life.

4 :
A nurse is observing a student perform care for a client with hearing aids in both ears. Which student action should be corrected by the nurse?

5 :
The nurse manager is made aware of conflict between two nurses. After speaking with the two nurses, the manager notes that there are no acceptable options to either person. Which stage of conflict is occurring?

7 :
The nurse is preparing for a yearly well-woman visit with a patient who is 8 months postpartum.

8 :
A client being treated for cervical cancer receives a sealed radiation implant. When caring for this client, the nurse implements care based on which of the following facts?

9 :
A nurse receives an order from the provider that states “MS 4mg IV prn severe pain.” Which is the best action by the nurse?

10 :
A client presents to a community clinic with constipation lasting 5 days. Which intervention should the nurse recommend first?