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NCLEX-RN Practice QuestionsFifth EditionWilda RinehartDiann SloanClara Hurd800 East 96th Street, Indianapolis, Indiana 46240 USA

NCLEX-RN Practice Questions Exam Cram, Fifth Editionby Pearson Education, Inc.All rights reserved. No part of this book shall be reproduced, stored in a retrieval system,or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. No patent liability is assumed withrespect to the use of the information contained herein. Although every precaution hasbeen taken in the preparation of this book, the publisher and authors assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting fromthe use of the information contained herein.ISBN-13: 978-0-7897-5753-1ISBN-10: 0-7897-5753-2Library of Congress Control Number: 958162Printed in the United States of AmericaFirst Printing: December TrademarksAll terms mentioned in this book that are known to be trademarks or service markshave been appropriately capitalized. Pearson cannot attest to the accuracy of this information. Use of a term in this book should not be regarded as affecting the validity ofany trademark or service mark.NCLEX is a registered trademark of the National Council of State Boards of Nursing,Inc. (NCSBN), which does not sponsor or endorse this product.Warning and DisclaimerEvery effort has been made to make this book as complete and as accurate as possible,but no warranty or fitness is implied. The information provided is on an “as is” basis.The author and the publisher shall have neither liability nor responsibility to any personor entity with respect to any loss or damages arising from the information contained inthis book.Special SalesFor information about buying this title in bulk quantities, or for special sales opportunities(which may include electronic versions; custom cover designs; and content particular toyour business, training goals, marketing focus, or branding interests). TaubProduct LineManagerBrett BartowAcquisitions EditorMichelle NewcombDevelopment EditorChristopherClevelandManaging EditorSandra SchroederProject EditorMandie FrankCopy EditorBart ReedProofreaderThe WordsmitheryLLCTechnical EditorSteve PicrayPublishingCoordinatorVanessa EvansDesignerChuti PrasertsithPage LayoutStudio Galou

Contents at a GlanceIntroduction1CHAPTER 1 Practice Exam 1 and Rationales5CHAPTER 2 Practice Exam 2 and Rationales85CHAPTER 3 Practice Exam 3 and Rationales167CHAPTER 4 Practice Exam 4 and Rationales247CHAPTER 5 Practice Exam 5 and Rationales331CHAPTER 6 Alternative Items: Questions and Rationales415APPENDIX A Things You Forgot461APPENDIX B Need to Know More?467

Table of ContentsIntroduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Welcome to the NCLEX-RN Practice Questions Exam Cram. . . . . . . 1Taking the Computerized Adaptive Test . . . . . . . . . . . . . . . . . . . . . . . . . . . 2The Cost of the Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2How to Prepare for the Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3What You Will Find in This Book. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Hints for Using This Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Need Further Study? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Contact the Author. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Chapter 1:Practice Exam 1 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Quick Answers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61Chapter 2:Practice Exam 2 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141Chapter 3:Practice Exam 3 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223Chapter 4:Practice Exam 4 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304Chapter 5:Practice Exam 5 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 388Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390

Table of ContentsvChapter 6:Alternative Items: Questions and Rationales. . . . . . . . . . . . . . . . . . . . . . . . . . . . 415Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446Alternative Items Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . 447Appendix A:Things You Forgot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461Therapeutic Drug Levels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461Vital Signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461Anticoagulant Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 462Intrapartal Normal Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 462Standard Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463Airborne Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463Droplet Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464Contact Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464Revised Life Support Guidelines (American Heart Association) . . . . . 464Defense Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464Nutrition Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465Immunization Schedule for Children and Adults . . . . . . . . . . . . . . . . . 466Appendix B:Need to Know More? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467Care of the Client with Respiratory Disorders . . . . . . . . . . . . . . . . . . . 467Care of the Client with Genitourinary Disorders . . . . . . . . . . . . . . . . . 468Care of the Client with Hematological Disorders . . . . . . . . . . . . . . . . . 468Fluid and Electrolytes and Acid/Base Balances . . . . . . . . . . . . . . . . . . . 469Care of the Client with Burns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469Care of the Client with Sensory Disorders. . . . . . . . . . . . . . . . . . . . . . . 470Care of the Client with Neoplastic Disorders . . . . . . . . . . . . . . . . . . . . 470Care of the Client with Gastrointestinal Disorders. . . . . . . . . . . . . . . . 471Care of the Client with Musculoskeletal and Connective TissueDisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471Care of the Client with Endocrine Disorders . . . . . . . . . . . . . . . . . . . . 472Care of the Client with Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . 472Care of the Client with Neurological Disorders . . . . . . . . . . . . . . . . . . 473

viNCLEX-RN Practice Questions, Fifth EditionCare of the Client with Psychiatric Disorders . . . . . . . . . . . . . . . . . . . . 473Maternal-Newborn Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474Care of the Pediatric Client . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474Emergency Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474Cultural Practices Influencing Nursing Care . . . . . . . . . . . . . . . . . . . . . 475Legal Issues in Nursing Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475

About the AuthorsWilda Rinehart Gardner received an Associate Degree in Nursing in 1973 fromNortheast Mississippi Community College in Booneville, Mississippi. Afterworking as a staff nurse and charge nurse, she became a public health nurse andserved in that capacity for a number of years. In 1975, she received her certification as a family planning nurse practitioner from the midwifery program atthe University of Mississippi Medical Center in Jackson, Mississippi. She completed her BSN in 1979 and MSN in 1980 from Mississippi University forWomen. She retired after 26 years as nursing instructor at Northeast MississippiCommunity College where she taught medical-surgical nursing and maternalnewborn nursing. From 1982 to, she operated Rinehart and AssociatesNursing Review to assist graduate nurses to pass the National Council ofLicensure Exam. She also worked as a curriculum consultant with nursing faculty in the improvement of test construction. Ms. Rinehart has served as a convention speaker in several states in the southeast and has been a reviewer ofmedical-surgical and obstetric texts.Dr. Diann Sloan received an Associate Degree in Nursing from NortheastMississippi Community College, a Bachelor of Science degree in Nursing fromthe University of Mississippi, and a Master of Science degree in Nursing fromMississippi University for Women. In addition to her nursing degrees, she holdsa Master of Science in Counseling Psychology from Georgia State Universityand a Doctor of Philosophy in Counselor Education, with minors in bothPsychology and Educational Psychology, from Mississippi State University. Shehas completed additional graduate studies in healthcare administration atWestern New England College and the University of Mississippi. Dr. Sloan hastaught pediatric nursing, psychiatric mental health nursing, and medical surgical nursing in both associate degree and baccalaureate nursing programs. Dr.Sloan has conducted test construction workshops for both RN and PN facultyand is coauthor of the Pearson Online Review.

viiiNCLEX-RN Practice Questions, Fifth EditionClara Hurd received an Associate Degree in Nursing from Northeast MississippiCommunity College in Booneville, Mississippi (1975). Her experiences in nursing are clinically based, having served as a staff nurse in medical-surgical nursing. She has worked as an oncology, intensive care, orthopedic, neurological,and pediatric nurse. She received her Bachelor of Science degree in Nursingfrom the University of North Alabama in Florence, Alabama, and her Master ofScience degree in Nursing from the Mississippi University for Women inColumbus, Mississippi. Ms. Hurd is a certified nurse educator. She currentlyserves as a nurse educator consultant and an independent contractor. Ms. Hurdhas taught in both associate degree and baccalaureate degree nursing programs.She was a faculty member of Mississippi University for Women; Austin PeayState University in Clarksville, Tennessee; Tennessee State University inNashville, Tennessee; and Northeast Mississippi Community College. Ms.Hurd joined Rinehart and Associates in 1993. She has worked with students inpreparing for the National Council Licensure Exam and with faculty as a consultant in writing test items. Ms. Hurd has also been a presenter at nursing conventions on various topics, including item-writing for nursing faculty. Her primary professional goal is to prepare the student and graduate for excellence inthe delivery of healthcare.

DedicationWe would like to thank our families for tolerating our late nights and long hours.Special thanks to all the graduates who have attended Rinehart and Associates ReviewSeminars. Thanks for allowing us to be a part of your success.We are also delighted that Jessica Rinehart Wentz, RN, Whitney Hurd Miller, RN,and Brad Sloan, RN, chose nursing as their profession above so many other professions.

AcknowledgmentsOur special thanks to our editors, support staff, and nurse reviewers for helpingus to organize our thoughts and experiences into a text for students and practicing professionals. You made the task before us challenging and enjoyable.

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