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NCLEX NCLEX-RN Exam Syllabus Topics:

Section	Weight	Objectives
Health Promotion and Maintenance	6-12%	- Health Promotion and Maintenance 1. Health Screening 2. Growth and Development 3. Health Promotion Programs 4. Prenatal, Intrapartum and Postpartum Care 5. Disease Prevention 6. Aging Process 7. Newborn Care
Psychosocial Integrity	6-12%	- Psychosocial Integrity 1. Coping Mechanisms 2. Crisis Intervention 3. Family Dynamics 4. Behavioral Interventions 5. Mental Health Concepts 6. Support Systems 7. Therapeutic Communication 8. Substance Use Disorders
Basic Care and Comfort	6-12%	- Basic Care and Comfort 1. Nutrition and Oral Hydration 2. Elimination 3. Assistive Devices 4. Rest and Sleep 5. Mobility and Immobility 6. Personal Hygiene 7. Activities of Daily Living
Safety and Infection Control	10-16%	- Safety and Infection Control 1. Standard and Transmission-Based Precautions 2. Safe Use of Equipment 3. Home Safety 4. Infection Prevention and Control 5. Security Plans 6. Accident and Injury Prevention 7. Handling Hazardous Materials 8. Emergency Response Planning
Physiological Adaptation	11-17%	- Physiological Adaptation 1. Fluid and Electrolyte Imbalances 2. Hemodynamics 3. Medical Emergencies 4. Alterations in Body Systems 5. Pathophysiology 6. Unexpected Response to Therapies
Management of Care	15-21%	- Management of Care 1. Ethical Practice 2. Collaboration with Interdisciplinary Team 3. Confidentiality and Information Security 4. Performance Improvement and Quality Assurance 5. Advance Directives 6. Informed Consent 7. Case Management 8. Legal Rights and Responsibilities 9. Assignment, Delegation and Supervision 10. Continuity of Care 11. Client Rights 12. Priority Setting 13. Advocacy
Reduction of Risk Potential	9-15%	- Reduction of Risk Potential 1. Therapeutic Procedures 2. System-Specific Assessments 3. Potential Complications 4. Changes in Vital Signs 5. Diagnostic Tests 6. Monitoring and Assessment
Pharmacological and Parenteral Therapies	13-19%	- Pharmacological and Parenteral Therapies 1. Parenteral Therapies 2. Medication Administration 3. Central Venous Access Devices 4. Expected Actions and Outcomes 5. Adverse Effects and Contraindications 6. Dosage Calculations 7. Blood and Blood Products

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NCLEX National Council Licensure Examination(NCLEX-RN) 認定 NCLEX-RN 試験問題 (Q304-Q309):

質問 # 304
An 8-week-old infant has been diagnosed with gastroesophageal reflux. The nurse is teaching the infant's mother to care for the infant at home. Which one of the following statements by the nurse is appropriate regarding the infant's home care?

A. "Lay the infant flat on her left side after feeding."
B. "Antacids need to be given an hour before feeding."
C. "Play activities should be carried out before instead of after feedings."
D. "Feed the infant every 4 hours with half-strength formula."

正解：C

解説：
(A)
Elevating the child's head to a 30-degree angle is the recommended position for gastroesophageal reflux. The supine position predisposes the child to aspiration. (B) Small, frequent feedings with thickened formula are recommended to minimize vomiting. (C) Antacids should be given at the same time as the feeding to improve their buffering action.
(D)
The infant should be kept still after feedings to reduce the risk of vomiting and aspiration. Vigorous activities should be carried out before feedings.

質問 # 305
A 19-year-old client has sustained a C-7 fracture, which resulted in his spinal cord being partially transected. By 2 weeks' postinjury, his neck has been surgically stabilized, and he has been transferred from the intensive care unit. A potential life-threatening complication the nurse monitors the client for is:

A. Spinal shock
B. Autonomic dysreflexia
C. Bradycardia
D. Central cord syndrome

正解：B

解説：
Explanation/Reference:
Explanation:
(A) Autonomic dysreflexia is the exaggerated sympathetic nervous system response to various stimuli in the anesthetized area. Sympathetic stimulation results in severe, uncontrolled hypertension, which may result in myocardial infarction or cerebral hemorrhage. (B) Bradycardia occurs as a result of sympathetic blockade in the immediate postinjury period. After spinal shock recedes, cardiovascular stability returns, but the client will be bradycardiac for life. (C) Central cord syndrome is a specific type of spinal cord injury that occurs as a result of either hyperextension injuries or disrupted blood flow to the spinal cord. (D) Spinal shock occurs in the immediate postinjury phase and usually resolves in approximately 72 hours.

質問 # 306
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, there is delayed capillary refill
B. In neurogenic shock, the skin is warm and dry
C. In hypovolemic shock, capillary refill is less than 2 seconds
D. In hypovolemic shock, there is a bradycardia

正解：B

解説：
Section: Questions Set 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 is hypotensive 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.

質問 # 307
A client was not using his seat belt when involved in a car accident. He fractured ribs 5, 6, and 7 on the left and developed a left pneumothorax. Assessment findings include:

A. Rhonchi and frothy sputum
B. Wheezing and dry cough
C. Decreased breath sounds on the left and chest pain with movement
D. Crackles and paradoxical chest wall movement

正解：C

解説：
Explanation/Reference:
Explanation:
(A) Crackles are caused by air moving through moisture in the small airways and occur with pulmonary edema. Paradoxical chest wall movement occurs with flail chest when a segment of the thorax moves outward on inspiration and inward on expiration. (B) Decreased breath sounds occur when a lung is collapsed or partially collapsed. Chest pain with movement occurs with rib fractures. (C) Rhonchi are caused by air moving through large fluid-filled airways. Frothy sputum may occur with pulmonary edema.
(D) Wheezing is caused by fluid in large airways already narrowed by mucus or bronchospasm. Dry cough could indicate a cardiac problem.

質問 # 308
A 27-year-old primigravida stated that she got up from the chair to fix dinner and bright red blood was running down her legs. She denies any pain previously or currently. The client is very concerned about whether her baby will be all right. Her vital signs include P 120 bpm, respirations 26 breaths/min, BP 104/58 mm Hg, temperature 98.2_F, and fetal heart rate 146 bpm. Laboratory findings revealed hemoglobin 9.0 g/dL, hematocrit 26%, and coagulation studies within normal range. On admission, the peripad she wore was noted to be half saturated with bright red blood. A medical diagnosis of placenta previa is made. The priority nursing diagnosis for this client would be:

A. Potential for fluid volume excess related to fluid resuscitation
B. Decreased cardiac output related to excessive bleeding
C. Alteration in parenting related to potential fetal injury
D. Anxiety related to threat to self

正解：B

解説：
Explanation
(A) Based on the client's history, presence of bright red vaginal bleeding, and hemoglobin value on admission, the priority nursing diagnosis would be decreased cardiac output related to excessive bleeding. (B) This nursing diagnosis is a potential problem that does not exist at the present time, and therefore is not the priority problem. (C) The client's expressed anxiety is for her child. The fetus will remain physiologically safe if the decreased cardiac output is resolved. (D) Initial spontaneous bleeding with placenta previa is rarely life threatening to the mother or the fetus. Delivery of the fetus will be postponed until fetal maturity is achieved and survival is likely.

質問 # 309
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