NCLEX 451-500 QUESTIONS AND

NCLEX #451-500 QUESTIONS AND

ANSWERS LATEST UPDATE GRADED

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NO.451 A female patient arrives at the emergency room with severe right-sided abdominal pain and vaginal bleeding. She mentions her last period was about two months ago. A positive pregnancy test and ultrasound confirm an ectopic pregnancy. How should the nurse explain her condition?

• Abnormal embryo development
• A distended or ruptured fallopian tube
• A congenital defect in the tube

D. Placenta malfunction ✔✔Answer: B

Explanation:

(A) The embryo can develop normally during the early stages of an ectopic pregnancy. (B) An ectopic pregnancy in the fallopian tube leads to severe pain due to the growing embryo in the narrow tube, causing distention and eventual rupture within the first 12 weeks. (C) The fallopian tube may be normal or have adhesions from past pelvic inflammatory disease or surgeries, which are not congenital. (D) An ectopic pregnancy results from the blastocyst implanting outside the uterus, not a faulty placenta.

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NO.452 A chronic alcoholic's health worsens, showing signs of hepatic coma. What is an early indicator of impending hepatic coma?

• Hiccups
• Lack of appetite
• Mental confusion

D. Fetor hepaticus ✔✔Answer: C

Explanation:

(A) Hiccups are not an early sign of hepatic coma. (B) Lack of appetite is not an early sign of hepatic coma. (C) Mental confusion is one of the earliest signs of hepatic coma. Asterixis, a hand tremor, may also be seen. (D) Fetor hepaticus, a breath odor like acetone, appears in later stages of hepatic coma.

NO.453 A mother continues to breastfeed her 3-month-old baby. She tells the nurse that for the past 3 days she hasn't been producing enough milk to satisfy the infant. The nurse advises her to:

• "Start the baby on solid foods."
• "Breastfeed more often during this growth spurt."
• "Give supplements between breastfeeding to have enough milk."
• "Wait 4 hours between feedings so your breasts will refill." ✔✔Answer: B

Explanation: 2 / 4

(A) Solid foods are not suitable for infants younger than 4-6 months due to GI tract development and nutritional needs. (B) Milk production follows supply and demand. A growth spurt at 3 months increases nursing frequency, boosting milk supply. (C) Supplementing reduces the baby's appetite, decreasing milk supply. Less frequent or vigorous nursing leads to lower milk production. (D) Rigid feeding schedules decrease milk supply, while frequent nursing boosts production.

NO.454 The nurse teaches a client to perform monthly testicular self-examinations (TSE),

recommending doing it right after showering because:

• The client is more likely to remember when naked.
• The scrotum, exposed to cool temperatures, causes the testicles to enlarge.
• The scrotum will be softer and more relaxed after a warm shower, making the testicles easier

to feel.

D. The examination will be less painful at this time. ✔✔Answer: C

Explanation:

(A) Nudity isn't a reminder to perform TSE. (B) The testicles become firmer, not larger, in cool temperatures. (C) Warm temperatures cause the testicles to hang lower and be easier to palpate.The scrotum tightens to protect sperm production when exposed to cooler temperatures. (D) The exam should not be painful.

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NO.455 A young child is placed in a spica cast. What is the primary concern for the nurse in the first few hours?

• Preventing neurovascular complications
• Preventing muscle tone loss
• Keeping the affected limb immobilized

D. Using heated fans to dry the cast ✔✔Answer: A

Explanation:

(A) The extremity may swell, and the cast could restrict circulation. The nurse should elevate the limb and check for capillary refill, warmth, toe mobility, and circulation. (B) Muscle tone loss may occur over time but isn't the immediate concern. (C) The cast already immobilizes the limb.(D) Heated fans are discouraged as they dry the outer cast quickly while the inner area remains wet, risking burns.

NO.456 A client scheduled for a pneumonectomy in the morning has had a negative surgical experience before and is talking quickly with an increased pulse and respiratory rate. What should the nurse do?

• Provide chances to ask questions and discuss concerns
• Offer distractions like reading or watching TV
• Tell her not to be nervous and assure her everything will be fine
• Remind her that this surgery is less extensive than her previous one ✔✔Answer: A
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