Verified Answers | Complete NCLEX Study Guide | A+ Graded
1. A nurse is providing teaching about fibrocystic breast tissue with a client. What information will the
nurse share about diagnostics used to confirm the diagnosis?
A) Mammogram is the only diagnostic tool needed
B) Breast ultrasound and fineneedle aspiration are used
C) MRI is the gold standard for diagnosis
D) Biopsy is always required
Correct Answer: B
Rationale: Diagnostics for fibrocystic breast tissue include breast ultrasound and fineneedle aspiration.
Mammography may be used but is not the sole diagnostic tool.
2. A client asks the nurse how often she should get a Papanicolaou (Pap) test. What is the correct
response?
A) Every year starting at age 18
B) Every 3 years for women ages 2129
C) Every 2 years for women ages 3065
D) Only if symptoms are present
Correct Answer: B
,Rationale: Women ages 2129 should have a Pap test every 3 years. For ages 3065, Pap and HPV testing
every 5 years is recommended. Screening can be discontinued after age 65 if previous results have been
negative.
3. Which of the following pH values of aspirated gastric fluid provides a good indication of correct NG
tube placement?
A) 7.0
B) 5.5
C) 2.0
D) 8.0
Correct Answer: C
Rationale: A pH between 0 and 4 indicates correct NG tube placement in the stomach. A pH above 5
may indicate placement in the respiratory tract or intestines.
4. A nurse is calculating the Glasgow Coma Scale (GCS) for a client with a closed head injury. When
pressure is applied to the client's nail beds, the client's eyes open, adduction of the arms with flexion of
the elbows and wrists is noted, and the client moans with stimulation. What is the GCS score?
A) 10
B) 8
C) 7
D) 6
Correct Answer: C
,Rationale: Eye opening to pain = 2; verbal response (moaning) = 2; motor response (abnormal
flexion/decorticate) = 3. Total = 7.
5. A nurse should teach which of the following clients requiring crutches about how to use a threepoint
gait?
A) A client with a sprained ankle who can bear partial weight
B) A client who has a right femur fracture with no weight bearing on the affected leg
C) A client with bilateral leg weakness
D) A client who is learning to use crutches for the first time
Correct Answer: B
Rationale: Threepoint gait is used when one leg is nonweightbearing. The client bears all weight on the
unaffected leg and crutches.
6. A nurse is providing teaching about the Mediterranean diet to a client newly diagnosed with
hypertension. Which statement indicates a need for further teaching?
A) "I will eat more fish and poultry."
B) "I will limit my intake of red meat to 2 times weekly."
C) "I will use olive oil for cooking."
D) "I will increase my intake of fruits and vegetables."
Correct Answer: B
, Rationale: Red meat should be limited to 2 times per month on the Mediterranean diet, not 2 times
weekly.
7. A nurse is providing dietary education to a client with cholecystitis who has been prescribed a lowfat
diet. Which meal selection indicates understanding?
A) Fried chicken, mashed potatoes with gravy, and coleslaw
B) Cheeseburger with fries
C) Roast turkey, rice pilaf, and green beans
D) Bacon and eggs with toast
Correct Answer: C
Rationale: Roast turkey, rice pilaf, and green beans are lowfat options appropriate for a client with
cholecystitis.
8. A client with cystocele is encouraged to exercise to strengthen pelvic floor muscles. What exercise
should the client perform?
A) Abdominal crunches
B) Kegel exercises
C) Leg lifts
D) Squats
Correct Answer: B