NCLEX-RN Exam Questions - Part 15

Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions  - Part 15

NCLEX-RN Exam Questions - Part 15

1. Priapism may be a sign of:

A) Altered neurological function
B) Imminent death
C) Urinary incontinence
D) Reproductive dysfunction



2. When evaluating a client with symptoms of shock, it is important for the nurse to differentiate between neurogenic and hypovolemic shock. The symptoms of neurogenic shock differ from hypovolemic shock in that:

A) In neurogenic shock, the skin is warm and dry
B) In hypovolemic shock, there is a bradycardia
C) In hypovolemic shock, capillary refill is less than 2 seconds
D) In neurogenic shock, there is delayed capillary refill



3. Which of the following would have the physiological effect of decreasing intracranial pressure (ICP)?

A) Increased core body temperature
B) Decreased serum osmolality
C) Administration of hypo-osmolar fluids
D) Decreased PaCO2



4. A client who has sustained a basilar skull fracture exhibits blood-tinged drainage from his nose. After establishing a clear airway, administering supplemental O2, and establishing IV access, the next nursing intervention would be to:

A) Pass a nasogastric tube through the left nostril
B) Place a 4 X 4 gauze in the nares to impede the flow
C) Gently suction the nasal drainage to protect the airway
D) Perform a halo test and glucose level on the drainage



5. A client with a diagnosis of C-4 injury has been stabilized and is ready for discharge. Because this client is at risk for autonomic dysreflexia, he and his family should be instructed to assess for and report:

A) Dizziness and tachypnea
B) Circumoral pallor and lightheadedness
C) Headache and facial flushing
D) Pallor and itching of the face and neck



1. Right Answer: A
Explanation: (A) Priapism in the trauma client is due to the neurological dysfunction seen in spinal cord injury. Priapism is an abnormal erection of the penis; it may be accompanied by pain and tenderness. This may disappear as spinal cord edema is relieved. (B) Priapism is not associated with death. (C) Urinary retention, rather than incontinence, may occur. (D) Reproductive dysfunction may be a secondary problem.

2. Right Answer: A
Explanation: (A) Neurogenic shock is caused by injury to the cervical region, which leads to loss of sympathetic control. This loss leads to vasodilation of the vascular beds, bradycardia resulting from the lack of sympathetic balance to parasympathetic stimuli from the vagus nerve, and the loss of the ability to sweat below the level of injury. In neurogenic shock, the client is hypotensive but bradycardiac with warm, dry skin. (B) In hypovolemic shock, the client ishypotensive and tachycardiac with cool skin. (C) In hypovolemic shock, the capillary refill would be>5 seconds. (D) In neurogenic shock, there is no capillary delay, the vascular beds are dilated, and peripheral flow is good.

3. Right Answer: D
Explanation: (A) An increase in core body temperature increases metabolism and results in an increase in ICP. (B) Decreased serum osmolality indicates a fluid overload and may result in an increase in ICP. (C) Hypo-osmolar fluids are generally voided in the neurologically compromised. Using IV fluids such as D5W results in the dextrose being metabolized, releasing free water that is absorbed by the brain cells, leading to cerebral edema. (D) Hypercapnia and hypoventilation, which cause retention of CO2 and lead to respiratory acidosis, both increase ICP. CO2 is the most potent vasodilator known.

4. Right Answer: D
Explanation: (A) Basilar skull fracture may cause dural lacerations, which result in CSF leaking from the ears or nose. Insertion of a tube could lead to CSF going into the brain tissue or sinuses. (B) Tamponading flow could worsen the problem and increase ICP. (C) Suction could increase brain damage and dislocate tissue. (D) Testing the fluid from the nares would determine the presence of CSF. Elevation of the head, notification of the medical staff, and prophylactic antibiotics are appropriate therapy.

5. Right Answer: C
Explanation: (A) Tachypnea is not a symptom. (B) Circumoral pallor is not a symptom. (C) Autonomic dysreflexia is an uninhibited and exaggerated reflex of the autonomic nervous system to stimulation, which results in vasoconstriction and elevated blood pressure. (D) Pallor and itching are not symptoms.

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