NCLEX øvingsspørsmål

Alle 15 spørsmål i oversikt

Vil du heller lese før du spiller? Alle spørsmålene i smakebiten står listet under. Svar og forklaringer er skjult til du åpner dem.

1. 1. A nurse receives report on four clients at the start of the shift. Which client should the nurse assess first?

   • A. A client with a fractured femur who rates pain as 7 out of 10
   • B. A client with asthma who has new audible wheezing and is using neck muscles to breathe
   • C. A client being discharged today who has questions about a new medication
   • D. A client one day after surgery with a temperature of 100.8 degrees F
   Vis svar og forklaring

   Svar: B. A client with asthma who has new audible wheezing and is using neck muscles to breathe

   Airway and breathing come before everything else, and accessory muscle use with new wheezing signals worsening airflow that can deteriorate quickly. Pain, discharge teaching and a low-grade fever on the first postoperative day all need attention, but none of them threatens the airway in the next few minutes.

2. 2. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?

   • A. Teaching a newly diagnosed client how to use an insulin pen
   • B. Assessing a surgical wound for signs of infection
   • C. Helping a stable client with a bed bath and recording intake and output
   • D. Writing the plan of care for a client admitted with heart failure
   Vis svar og forklaring

   Svar: C. Helping a stable client with a bed bath and recording intake and output

   The delegation rule is that assessment, teaching, evaluation and care planning stay with the nurse and cannot be handed off. UAP take routine tasks with predictable outcomes for stable clients, such as hygiene, positioning and recording intake and output.

3. 3. A client is admitted with suspected active pulmonary tuberculosis. Which precautions should the nurse put in place?

   • A. Standard precautions in any available room
   • B. Contact precautions with gown and gloves in a private room
   • C. Droplet precautions with a surgical mask in a private room
   • D. Airborne precautions in a negative pressure room, with a fitted N95 respirator for anyone entering
   Vis svar og forklaring

   Svar: D. Airborne precautions in a negative pressure room, with a fitted N95 respirator for anyone entering

   Tuberculosis spreads by droplet nuclei small enough to stay suspended in the air, so it requires airborne precautions: an airborne infection isolation room kept at negative pressure plus a fitted N95 respirator for staff. The surgical mask goes on the client, not on the nurse, and only when the client has to leave the room.

4. 4. A client with heart failure is receiving intravenous furosemide. Which findings require immediate follow-up? Select all that apply.

   Velg alle som passer.

   • A. Serum potassium 2.9 mEq/L
   • B. Urine output of 60 mL per hour
   • C. New muscle weakness with an irregular pulse
   • D. Weight loss of 1 kg since yesterday
   • E. The client reports new ringing in the ears
   Vis svar og forklaring

   Svar: A. Serum potassium 2.9 mEq/L, C. New muscle weakness with an irregular pulse, E. The client reports new ringing in the ears

   Furosemide wastes potassium, so a level of 2.9 mEq/L sits below the usual 3.5 to 5.0 mEq/L range, and new weakness with an irregular pulse suggests hypokalemia is already affecting the heart. New tinnitus points to ototoxicity, while good urine output and steady weight loss are exactly the response the drug is given to produce.

5. 5. A client who was just diagnosed with cancer says, "I do not see the point in starting treatment." Which response by the nurse is most therapeutic?

   • A. You should not give up. Many people do very well with treatment.
   • B. Tell me more about what you are thinking.
   • C. Your family would really want you to try.
   • D. I will ask the provider to come and explain your options.
   Vis svar og forklaring

   Svar: B. Tell me more about what you are thinking.

   An open-ended invitation keeps the conversation open and lets the nurse assess what sits behind the statement, including hopelessness or thoughts of self-harm. False reassurance, appeals to guilt and handing the conversation to someone else all shut the client down before anything is assessed.

6. 6. Complete the sentence.

   A client receiving intravenous morphine has a respiratory rate of 7 breaths per minute and is difficult to arouse. The nurse stops the infusion and anticipates giving _____.

   Alternativer for luke 1: flumazenil, naloxone, protamine sulfate, vitamin K

   Vis svar og forklaring

   Svar: naloxone

   Naloxone is the opioid antagonist that reverses respiratory depression, and under the ABCs breathing is treated before anything else on the list. Flumazenil reverses benzodiazepines, protamine sulfate reverses heparin and vitamin K reverses warfarin.

7. 7. Which nursing actions reduce an older adult client's risk of falling in the hospital? Select all that apply.

   Velg alle som passer.

   • A. Keep the bed in the lowest position with the wheels locked
   • B. Place the call light and personal items within the client's reach
   • C. Apply a vest restraint at night so the client stays in bed
   • D. Make sure the client wears nonskid footwear when walking
   • E. Turn off all lighting at night so the room stays completely dark
   Vis svar og forklaring

   Svar: A. Keep the bed in the lowest position with the wheels locked, B. Place the call light and personal items within the client's reach, D. Make sure the client wears nonskid footwear when walking

   A low locked bed, items within reach and nonskid footwear are standard fall precautions because they remove the reasons a client climbs out unassisted. Restraints are a last resort and raise the risk of injury rather than lowering it, and a fully dark room makes an unassisted trip to the bathroom more dangerous, so a night light is the safer choice.

8. 8. A nurse teaches a postmenopausal client about lowering the risk of osteoporosis. Which statement shows the teaching was effective?

   • A. I will add walking or other weight-bearing exercise on most days of the week.
   • B. I should cut dairy out of my diet.
   • C. Swimming laps is the best exercise for my bones.
   • D. I only need to worry about calcium after I break a bone.
   Vis svar og forklaring

   Svar: A. I will add walking or other weight-bearing exercise on most days of the week.

   Bone rebuilds in response to load, so weight-bearing exercise such as walking, together with adequate calcium and vitamin D, is the core of prevention. Swimming is good for the heart but does not load the skeleton, and dairy is a useful calcium source rather than something to avoid.

9. 9. A client has a chest tube connected to a water seal drainage system. Which finding requires immediate follow-up?

   • A. Continuous bubbling in the water seal chamber
   • B. Fluid in the water seal chamber that rises and falls with breathing
   • C. 50 mL of serosanguineous drainage over the past 8 hours
   • D. A dressing around the insertion site that is dry and intact
   Vis svar og forklaring

   Svar: A. Continuous bubbling in the water seal chamber

   Continuous bubbling in the water seal chamber means air is entering the system, so the nurse checks the tubing connections and the insertion site right away. Tidaling with respiration, modest serosanguineous drainage and a dry intact dressing are all expected findings.

10. 10. A client is going home on warfarin. Which client statements show that the teaching was effective? Select all that apply.

    Velg alle som passer.

    • A. I will keep the amount of green leafy vegetables I eat about the same each week.
    • B. I will use a soft toothbrush and an electric razor.
    • C. I will take ibuprofen whenever I get a headache.
    • D. I will call the clinic if my stools look black or tarry.
    • E. I can stop taking it once my INR reaches the target range.
    Vis svar og forklaring

    Svar: A. I will keep the amount of green leafy vegetables I eat about the same each week., B. I will use a soft toothbrush and an electric razor., D. I will call the clinic if my stools look black or tarry.

    Warfarin blocks vitamin K dependent clotting factors, so a steady weekly vitamin K intake keeps the INR stable, gentle grooming limits bleeding, and black tarry stools are reported because they suggest gastrointestinal bleeding. Ibuprofen adds to the bleeding risk, and the drug is never stopped just because the INR has reached target.

11. 11. Complete the sentence.

    Before giving digoxin to an adult client, the nurse counts the apical pulse for one full minute and holds the dose if the rate is below _____ beats per minute.

    Alternativer for luke 1: 50, 60, 70, 80

    Vis svar og forklaring

    Svar: 60

    The standard rule is to hold digoxin and notify the prescriber when an adult's apical pulse is under 60, because the drug already slows conduction through the heart. Nausea, vomiting and visual changes such as yellow or green halos suggest toxicity, and a low potassium level makes toxicity more likely.

12. 12. A client returns to the unit after a bronchoscopy with moderate sedation. Which action must the nurse take before giving the client anything to drink?

    • A. Check the client's temperature
    • B. Confirm that the gag reflex has returned
    • C. Listen for bowel sounds in all four quadrants
    • D. Have the client sit up for 30 minutes
    Vis svar og forklaring

    Svar: B. Confirm that the gag reflex has returned

    The throat is anesthetized for a bronchoscopy, so fluids can pass into the airway until sensation comes back. The client stays NPO until the nurse confirms the gag reflex, which is airway protection taking priority over comfort.

13. 13. A client is having a panic attack and is pacing, breathing rapidly and unable to follow directions. Which action should the nurse take first?

    • A. Explore what may have triggered the attack
    • B. Stay with the client and speak calmly in short, simple sentences
    • C. Leave the client alone in a quiet room until the anxiety passes
    • D. Give detailed instructions on diaphragmatic breathing technique
    Vis svar og forklaring

    Svar: B. Stay with the client and speak calmly in short, simple sentences

    At panic level anxiety the ability to take in information collapses, so the nurse stays present, lowers stimulation and gives short direct sentences. Exploring triggers and teaching breathing techniques only work once the anxiety has come down, and leaving the client alone is unsafe.

14. 14. A charge nurse is making assignments on a medical unit. Which clients are appropriate to assign to a licensed practical nurse (LPN/LVN)? Select all that apply.

    Velg alle som passer.

    • A. A stable client with a healing surgical wound who needs a routine dressing change
    • B. A newly admitted client who needs the initial admission assessment
    • C. A client with pneumonia on oral antibiotics who needs vital signs monitored
    • D. A client whose first unit of packed red blood cells needs to be started
    • E. A client with a long-term indwelling urinary catheter who needs routine catheter care
    Vis svar og forklaring

    Svar: A. A stable client with a healing surgical wound who needs a routine dressing change, C. A client with pneumonia on oral antibiotics who needs vital signs monitored, E. A client with a long-term indwelling urinary catheter who needs routine catheter care

    LPNs care for stable clients with predictable outcomes, which covers routine dressing changes, ongoing monitoring and routine catheter care. The initial admission assessment and starting a blood transfusion stay with the RN, since both require nursing judgment on a client whose status is not yet established.

15. 15. Complete the sentence.

    To lower the risk of aspiration, the nurse feeds a client who has dysphagia after a stroke while the client is _____.

    Alternativer for luke 1: lying flat on the back, sitting fully upright at 90 degrees, side-lying with the head of the bed flat, in a semi-prone position

    Vis svar og forklaring

    Svar: sitting fully upright at 90 degrees

    Sitting fully upright with a slight chin tuck lets gravity carry food toward the esophagus rather than the airway, and the client stays upright for about 30 minutes after eating. Any reclined position raises the aspiration risk, and aspiration is an airway problem, which makes positioning a top priority rather than a comfort measure.

Dette er NCLEX-RN egentlig

NCLEX-RN er autorisasjonsprøven du tar etter sykepleierstudiet, og det å bestå den er det som gjør en sykepleiegrad om til en RN-lisens. Den er skrevet av National Council of State Boards of Nursing og gjennomføres på testsentre. I motsetning til en eksamen i et fag er den ikke laget for å sjekke om du har pugget en lærebok. Den sjekker om du kan jobbe trygt fra første dag, og det er derfor så mange spørsmål spør hva du ville gjort først i stedet for hva noe heter.

Prøven er datatilpasset. Hvert svar endrer hva som kommer neste gang: svarer du riktig, blir det neste vanskeligere, bommer du, blir det neste lettere, så prøven sirkler inn nivået ditt. Det har to praktiske følger. Du kan ikke hoppe over et spørsmål eller gå tilbake for å endre et svar, og to kandidater som sitter side om side ser nesten aldri den samme prøven. Antall spørsmål varierer også. Alle svarer på minst et minimum antall, prøven kan gå opp til et maksimum, og den stopper så snart den kan avgjøre med sikkerhet om du ligger over eller under grensen for bestått, eller når tidsgrensen er nådd. Noen spørsmål er testspørsmål som ikke teller, og du kan ikke se hvilke. Gjeldende minimum, maksimum og tidsgrense settes av NCSBN og har endret seg gjennom årene, så sjekk kandidatbulletinen for versjonen som gjelder når du tar prøven. Resultatet er bestått eller ikke bestått, ikke en poengsum.

Next Generation NCLEX la til case-studier og flere nye spørsmålstyper oppå vanlig flervalg. En case-studie gir deg et pasientforløp som utfolder seg, med nye opplysninger for hvert steg, og spørsmålstypene omfatter extended multiple response, matrise- og rutenettspørsmål, drop-down cloze, highlight, bowtie og trend. Mange av dem gir delvis uttelling i stedet for alt eller ingenting. Poenget med omleggingen var klinisk skjønn: å fange opp signaler, analysere dem, sette en prioritering, handle og så vurdere resultatet.

Slik bruker du denne smakebiten

De 15 spørsmålene under dekker alle fire kategoriene av pasientbehov i miniatyr: delegering, prioritering og smittevern fra trygt og effektivt omsorgsmiljø, ett spørsmål om helsefremming, ett psykososialt spørsmål, og resten fra fysiologisk integritet, blant annet grunnleggende stell og velvære, legemiddelbehandling, redusert risiko og fysiologisk tilpasning. Dette er anvendelsesspørsmål, så det holder sjelden å kunne definisjonen. Smakebiten er ikke datatilpasset, og den vurderes ikke slik den ekte prøven gjør, så bruk den som en diagnose framfor en spådom.

Prioriteringsspørsmål fortjener sin egen metode, for det er de som føles urettferdige. Når et spørsmål spør hvilken pasient sykepleieren vurderer først, eller hvilket funn som krever oppfølging med en gang, gå ut fra at hvert alternativ beskriver et reelt problem. Du leter ikke etter det eneste som betyr noe, du leter etter det som vil skade noen raskest. Kjør ABC først: airway, så breathing, så circulation. Er ingenting et ABC-problem, spør hvilket funn som er nytt, uventet eller ustabilt, for et funn som er ventet ved den diagnosen kan vente. Maslow avgjør resten, med fysiske behov før sikkerhet og sikkerhet før psykososiale behov. Delegeringsspørsmål handler om ansvarsområde, ikke om hvor travelt noen har det: vurdering, undervisning, evaluering og alle ustabile pasienter blir hos RN, en LPN tar stabile pasienter med forutsigbart forløp, og ufaglærte pleiemedhjelpere tar rutineoppgaver som hygiene, leiring og registrering av væskeinntak og utskillelse.

Jobb deg gjennom alle 15 i én økt uten notater, og les så hver forklaring, også de til spørsmålene du svarte riktig på. En bom peker som regel på en kategori framfor på et faktum. Bommer du på to farmakologispørsmål, er overvåking av legemidler hullet, ikke de to legemidlene.

Slik bygger StudyPDF fullengdes øvingsprøver fra ditt eget materiale

Femten spørsmål kan vise deg hvor du vakler. De gjør deg ikke klar til en autorisasjonsprøve, og generelle spørsmålsbanker sklir bort fra innholdet ditt eget studium la vekt på.

StudyPDF jobber fra det du allerede har. Last opp NCLEX-repetisjonsboka, lysark fra forelesninger, pleieplaner eller notater fra timen, så bygger Bo, studieagenten, fullengdes øvingsprøver fra akkurat det materialet. Hvert spørsmål er forankret i dine sider, og hver forklaring viser hvor svaret kommer fra, så du kan bla rett til kilden når resonnementet ikke sitter. Du kan lage nye prøver så ofte du vil, snevre dem inn til ett område som farmakologi eller barsel og nyfødt, og følge med på hvilke begreper du stadig bommer på fra forsøk til forsøk. Gratis å komme i gang.