2024-2025 NCLEX Rationals and Study Guide with Answers (168 Solved Questions)

Name: 2024-2025 NCLEX Rationals and Study Guide with Answers (168 Solved Questions)
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2024-2025 NCLEX Rationals and Study Guide with Answers helps you familiarize yourself with previous exam formats.

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Nclex rationals and study
guide 100% VERIFIED
CORRECT ANSWERS
2024/2025
right occiput posterior position
will have back pains with labor "back labor" positioning woman and hands and knees
will relive some of the pressure and help facilitate rotation into an anterior position.
Right occiput anterior
optimal for birth
Predisposing factors for delirium are?
advanced age
neurodegenerative disease (stroke, dementia)
polypharmacy
infection
ABG imabalance
Surgery
untreated pain
occipital transverse
when fetus remains in OP or OT position labor is prolonged. fetus will usually reposition
to OA. manual rotation may be required if this position persist.
Agoraphobia

fear or anxiety about being in certain situations or any physical spaces. they are highly
concerned about having trouble escaping or being able to get help in the event of a
panic attack.
Hypertensive medications Contraindicated in Pregnancy that can have tetragenic
affects are?
ACE inhibitors and ARB's
Acceptable abbreviation for documentation
c/o
ac
pc
QID
cm
Unacceptable abbreviations for documentation
q1d
qd
qod
SSRI
u
Must have a zero before decimal 0.05
No trailing zeros after decimal 1.000
Major complications of oligohydramnios are;
Pulmonary hypoplasia
Umbilical cord compression
*** additional staff will be needed during delivery in case of CPR

Major complications of TNF inhibitor(inhibits inflammatory response) drugs are;
type of drugs?
infections
bone marrow suppression
type of drugs include; infliximab, entanercept,
side effects of furosemide in pt's chronic kidney disease would be ?
ototoxicity
what are the s/s of abstinence syndrome ?
ANS: stuffy nose, sweating, stuffy nose, sneezing, tachycardia, tachypnea
CNS: irritability, high pitched crying, restless, abnormal sleep pattern, hypertonicity
GI: poor feeding, vomiting, diarrhea,
what are the 4 s/s of nephrotic syndrome?
massive proteinuria
hypoalbuminemia
edema
hyperlipidemia
what instruction do you give your patient prior to their colonoscopy procedure?
Clear liquid diet the day before
NPO 8-12 hours before exam
take bowel cleansing agent day before (GoLYTELY)
uterine fundus location during prenatal exam
after 20 weeks gestation the fundus location = gestational age.

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intussesception is when one part of the intestine prolapses and then telescopes
into another part of the intestine. It is also the most frequent cause of bowel
obstruction during infancy. what are the signs and symptoms to look out for.
intermitten pain with legs drawn up.
severe progressive pain with inconolable crying.
ongoing obstruction leads to mucosal ischemia, and current jelly stools (mucus and
bleeding mixed)
pregnant women have a blood volume that increases between 40-45% to meet
increased O2 demands and nutritional demands for the fast growing fetus. what
is the normal hemoglobin, hematocrit, WBC, RBC and platelet count ?
what are the signs of uterine rupture?
abnormal FHR patter
constant abdominal pain
loss of fetal station
sudden cessation of uterine contraction
severe signs are hemorrhage, hypovolemic shock and maternal tachycardia
Polycythemia Vera is a chronic myloproliferation disorder in which the bone
marrow produces abnormal high amounts of RBC's. What is the danger with this
disease and what is the treatment for it?
the danger with this disease is blood clotting r/t increase viscosity of the blood
tx: periodic phlebotomy to remove 300-500 millimeters of blood until hematocrit and
hemoglobin levels are meet.
what are the common causes of bilateral neuropathy?

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Diabetic neuropathy *** most common
alcohol
auto immune ( Guillian Barre syndrome)
**always establish if the neuropathy pain was present before surgery to rule out if this is
a surgical complication
lymph nodes are not normally palpable in adults... however what type of palpable
node would be considered a normal finding and why?
lmyph nodes that are 05.-1 cm in size, firm, mobile and non-tender - this could be r/t
some type of trauma ie. masectomy
what is NOT considered a normal finding when palpating a lymph node?
firm, hard, fixed nodes - r/t malignancy
tender node - r/t inflammation
Purpura:
a reddish-purple blotch on the skin that do not blanch with pressure due to bleeding
underneath the skin. this finding is significant and requires further assessment.
S/S of hypoglycemia are?
shakiness/trembling, palpitations, anxiety/arousal, restlessness, diaphoresis and pallor.
-during hypoglycemia the body relates epinephrine ... in addition the brain is deprived of
glucose therefore LOC is altered with possible seizures, confusion, coma.
what are the standard heparin doses when flushing CVC lines?
2-3 mL containing 10 units/mL - 100 units/mL
what is the normal CVP?

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if CVP is Low or High what does that indicate?
Proximal port lumen is used to measure CVP since it is located in the right atrium
2-6 mm Hg normal CVP
Low CVP = hypovolemia
High CVP= right ventricular failure of fluid volume overload
Leoapolds maneuver
used to detect fetal presentation by palpating the abdomen
McRoberts maneuver
sharply pressing the thigh into the abdomen to straighten out the sacrum. used for
shoulder dystocia
abciximab
eptifibatide
tirofiban
what type of drugs are these and why are they used?
what are the common side effects? contraindications? nursing interventions?
Glycoprotein (GB) IIb/IIIa receptor inhibitors
platelet inhibitors and are used to prevent occlusion of treated coronary artery
procedures. they are also used to prevent ischemia.
common side effects are bleeding and thrombocytopenia
contraindicated with traumatic procedures, IV lines and IM injections

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Monitor: blood counts (hemoglobin and platelet), heart rate and rhythm and sings of
bleeding.
what do you do once the waveform on a Pulmonary artery catheter has been
"wedged" ?
once the waveform is "wedged" the ballot can be inflated. Do not inflate for more than
10-15 seconds to avoid damage. lock the ballon port.
What medications should be avoided in patients with chronic kidney disease?
NSAID's = nephrotoxic
alendronate (Fosamax)
risedronate (Actonel)
ibandronate (Boniva)
what are the classifications of these medications? SE?
Biophosphonates
MOA: decrease bone resorption to minimize the loss of bone density.
Teaching: take this med with a full glass of water and remain in an upright position for at
least 30 min.
what are the clinical manifestations of bacterial meningitis for infants <2 yrs
fever or hypothermia
irritability, frequent seizures
high pitched cry
poor feeding and vomiting
nuchal rigidity
possible bulging fontenells

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what is the most common acute complications of bacterial meningitis?
hydrocephalus - fluid in brain --> brain damage.
long term complications include hearing loss, brain damage, learning disabilities.
what are the immunization for a 6 month old child?
use the mnemonic (Be DR HIP)
Hep B
Dtap
RV(rotovirus)
Hib (hamephilus influenza)
IPV (inactivated polio virus)
PVC (pneumococcal conjugate virus)
how often should IV catheters be removed or replaced?
Q 76 -96 hrs unless complications occur then remove sooner.
explain the steps to a low pressure huff cough for patients with COPD
1. position upright
2. inhale through nose, then prolonged exhale through pursed lips for 3 breaths
3. hold breath for 2 to 3 seconds while keeping throat open
4. deeply inhale, lean forward then force out breath making a "ha!" sound: repeat 2X
5. breath in deeply and give the last forced "ha!" cough
nursing measures after tonsillectomy ;
1. apply ice on neck
2. analgesics (rectal/IV)
3. Place on abdomen or side lying position
nursing teaching to parents after tonsillectomy;

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1. a low grade fever is expected
2. child may report ear pain 5 -10 days post op
3. chewing gum can reduce muscle spasms
4. observe for s/s of hemorrhage : irritable, constant swallowing, throat clearing ***
contact HCP stat
5. pt should not participate in strenuous activity up to 14 days post op r/t increase risk
for hemorrhage!
6.. throat might be white with foul odor for the first 5-10 days post op... this is an
expected finding.
interventions to manage lymphedema include;
-massage are to help mobilize fluid
-use intermittent compression sleeve
-elevate arm above heart
-isometric exercise
-avoid IV on affected side
low T4, and low T3 while TSH compensates and is elevated is indicative of what
disorder?
what are the s/s of this disorder?
Hypothyroidism
SS: weight gain, confusion, hair loss, forgetfulness and cold intolerance, bradycardia,
joint and muscle aches.
what are some non-modifiable breast cancer risk factors?
What are some modifiable breast cancer risk factors?
non-modifiable:
- hx of 1st degree relative with breast cancer

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- BRACA genetic mutation
- hx of endometrial canver
-menarche before age 12 and menopause after age 55
modifiable:
- hormone therapy
-dietary fat intake
- smoking, alcohol
- postmenopausal weight gain
- sedentary lifestyle
what of the signs when nearing death?
mottling of the extremities (coolness/paleness)
relaxed jaw (open mouth)
difficulty maintaining body posture
eyelids half open
chyenne stokes (uneven respirations with apnea)
clinical manifestations of asthma aspiration include;
accessory muscle use
chest tightness
diminished breath sounds
high pitched wheezing on expiration
tachypnea
cough and hyper sections of mucus
splenic sequestration crisis
when a large # of sickle cells get trapped in the spleen --> splenomegaly
***this is an emergency that can lead to hypovolemic and hypotensive shock

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Nursing interventions to reduce the risk for aspiration for pt. with ENT feeding
include;
1. assess GI intolerance to tube feeding in regular intervals q4h (abd distention,
2. assess tube placement
3. keep hob >or equal to 30 degrees
4. keep endotracheal cuff inflated
5. suction any secretions
6. use caution with sedatives
7. avoid bolus tube feeding
hirshburg's disease clinical manifestations of disease? and the fatal
complications? what is the tx?
occurs when a child is born with some sections of the distal large intestine missing
nerve cells --> the anal splinter unable to relax. onset manifestations include; not able to
pass meconium within the expected 24-48 hrs. difficulty feeding, vomit of green bile.
fatal complications include; enterocolitis, sepsis, death. enterocolitis --> fever, lethargy,
explosive foul smelling diarrhea, rapidly worsening abdominal distention.
tx: surgical removal of the affected area.
reducing the risk for Diverticular episodes include the following;
since the etiology of this disease has been linked to chronic constipation- preventing
constipation would reduce the risk for diverticula forming and becoming inflamed.
constipation prevention include, drinking lots of water, exercise, and increase in fibers
foods/supplements.
Risk factors for cervical cancer inlude?
- HPV infection
-hx of STD's

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-early onset of sexual activity
-multiple or high risk sexual partners
-immunosuppression
- low socioeconomic status
-tobacco use
causes for respiratory alkalosis
fever
hyperventilation
hypoxia
hysteria
over ventilation by ventilators
pain
*** if the pt. condition causes overstimulation of the respiratory system monitory pt. for
respiratory alkalosis.
causes for respiratory acidosis
asthma
atelectasis
brain trauma
bronchitis
CNS depressants
emphysema
hypoventilation
pulmonary infections, edema, emboli
*** if the pt. conditions causes an obstruction of the airway or depresses the respiratory
system monitor pt for respiratory acidosis.
causes for metabolic acidosis

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2024-2025 NCLEX Rationals and Study Guide with Answers (168 Solved Questions)

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