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NCLEX NCLEX-RN Exam Syllabus Topics:

Section	Weight	Objectives
Physiological Integrity	43–67%	- Reduction of Risk Potential - Pharmacological and Parenteral Therapies - Physiological Adaptation - Basic Care and Comfort
Health Promotion and Maintenance	6–12%
Safe and Effective Care Environment	17–33%	- Safety and Infection Control - Management of Care
Psychosocial Integrity	6–12%

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NCLEX National Council Licensure Examination(NCLEX-RN) 認定 NCLEX-RN 試験問題 (Q702-Q707):

質問 # 702
A 55-year-old client is unconscious, and his physician has decided to begin tube feeding him using a smallbore silicone feeding tube (Keofeed, Duo-Tube). After the tube is inserted, the nurse identifies the most reliable way to confirm appropriate placement is to:

A. Obtain a chest x-ray
B. Place the tip of the tube under water and observe for air bubbles
C. Aspirate gastric contents
D. Auscultate air insufflated through the tube

正解：A

解説：
(A) Aspiration of gastric contents is usually a reliable way to verify tube placement. However, if the client has dark respiratory secretions from bleeding, tube feedings could be mistaken for respiratory secretions; in other words, aspirating an empty stomach is less reliable in this instance. In addition, it is common for small-bore feeding tubes to collapse when suction pressure is applied. (B) Insufflation of air into large-bore nasogastric tubes can usually be clearly heard. In small-bore tubes, it is more difficult to hear air, and it is difficult to distinguish between air in the stomach and air in the esophagus. (C) A chest x-ray is the most reliable means to determine placement of small-bore nasogastric tubes. (D) Observing for air bubbles when the tip is held under water is an unreliable means to determine correct tube placement for all types of nasogastric tubes. Air may come from both the respiratory tract and the stomach, and the client who is breathing shallowly may not force air out of the tube into the water.

質問 # 703
A 52-year-old client is scheduled for a small-bowel resection in the morning. In conjunction with other preoperative preparation, the nurse is teaching her diaphragmatic breathing exercises. She will teach the client to:

A. Inhale as deeply as possible and then immediately exhale as deeply as possible at a rate of approximately 20-24 times/min
B. Purse the lips and take quick, short breaths approximately 18-20 times/min
C. Inhale slowly and deeply through the nose until the lungs are fully expanded, hold the breath a couple of seconds, and then exhale slowly through the mouth. Repeat 2-3 more times to complete the series every 1-2 hours while awake
D. Take a large gulp of air into the mouth, hold it for 10-15 seconds, and then expel it through the nose.
Repeat 4-5 times to complete the series

正解：C

解説：
Explanation/Reference:
Explanation:
(A) This is the correct method of teaching diaphragmatic breathing, which allows full lung expansion to increase oxygenation, prevent atelectasis, and move secretions up and out of the lungs to decrease risk of pneumonia. (B) Quick, short breaths do not allow for full lung expansion and movement of secretions up and out of the lungs. Quick, short breaths may lead to O2 depletion, hyperventilation, and hypoxia. (C) Expelling breaths through the nose does not allow for full lung expansion and the use of diaphragmatic muscles to assist in moving secretions up and out of the lungs. (D) Inhaling and exhaling at a rate of 20-24 times/min does not allow time for full lung expansion to increase oxygenation. This would most likely lead to O2 depletion and hypoxia.

質問 # 704
A 23-year-old female client is brought to the emergency room by her roommate for repeatedly making superficial cuts on her wrists and experiencing wide mood swings. She is very angry and hostile. Her medical diagnosis is adjustment disorder versus borderline personality disorder. The client comments to the nurse, "Nobody in here seems to really care about the clients. I thought nurses cared about people!" The client is exhibiting the ego defense mechanism:

A. Sublimation
B. Reaction formation
C. Rationalization
D. Splitting

正解：D

解説：
(A) Reaction formation is the development and demonstration of attitudes and/or behaviors opposite to what an individual actually feels. The client's comment does reveal her anger and hostility. (B) Rationalization, another ego defense mechanism, is offering a socially acceptable or seemingly logical explanation to justify one's feelings, behaviors, or motives. The client's comment does not reflect rationalization. (C) Splitting, the viewing of people or situations as either all good or all bad, is frequently used by persons experiencing a disruption in self-concept. This ego defense mechanism is reflective of the individual's inability to integrate the positive and negative aspects of self. (D) Sublimation, the channeling of socially unacceptable impulses and behaviors into more acceptable patterns of behavior, is another ego defense mechanism. The client's comment reveals that she is not engaging in sublimation.

質問 # 705
The nurse and prenatal client discuss the effects of cigarette smoking on pregnancy. It would be correct for the nurse to explain that with cigarette smoking there is increased risk that the baby will have:

A. A birth defect
B. A low birth weight
C. Anemia
D. Nicotine withdrawal

正解：B

解説：
Explanation
(A) Women who smoke during pregnancy are at increased risk for miscarriage, preterm labor, and IUGR in the fetus. (B) Although smoking produces harmful effects on the maternal vascular system and the developing fetus, it has not been directly linked to fetal anomalies. (C) Smoking during pregnancy has not been directly linked to anemia in the fetus. (D) Smoking during pregnancy has not been linked to nicotine withdrawal symptoms in the newborn.

質問 # 706
Which of the following statements relevant to a suicidal client is correct?

A. A client who is unsuccessful at a first suicide attempt is not likely to make future attempts.
B. Nurses who care for a client who has attempted suicide should not make any reference to the word
"suicide" in order to protect the client's ego.
C. The more specific a client's plan, the more likely he or she is to attempt suicide.
D. A client who threatens suicide is just seeking attention and is not likely to attempt suicide.

正解：C

解説：
Explanation
(A) This is a high-risk factor for potential suicide. (B) A previous suicide attempt is a definite risk factor for subsequent attempts. (C) Every threat of suicide should be taken seriously. (D) The client should be asked directly about his or her intent to do bodily harm. The client is never hurt by direct, respectful questions.

質問 # 707
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