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NCLEX NCLEX-RN Exam Syllabus Topics:

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

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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q455-Q460):

NEW QUESTION # 455
A female client at 10 weeks' gestation complains to her physician of slight vaginal bleeding and mild cramps.
On examination, her physician determines that her cervix is closed. The client is exhibiting signs of:

A. A missed abortion
B. An inevitable abortion
C. A threatened abortion
D. An incomplete abortion

Answer: C

Explanation:
Explanation
(A) An inevitable abortion includes the signs of cervical dilation and effacement as well as pain and bleeding.
(B) A threatened abortion is a condition in which intrauterine bleeding occurs early in pregnancy, the cervix remains undilated, and the uterine contents are not necessarily expelled. (C) An incomplete abortion occurs when some portions of the products of conception are expelled from the uterus. (D) A missed abortion occurs when the embryo dies in utero and is retained in the uterus.

NEW QUESTION # 456
The physician orders haloperidol 5 mg IM stat for a client and tells the nurse that the dose can be repeated in 1-2 hours if needed. The most likely rationale for this order is:

A. The medication will sedate the client until the physician arrives
B. The client will settle down more quickly if he thinks the staff is medicating him
C. Rapid neuroleptization is the most effective approach to care for the violent or potentially violent client
D. Haloperidol is a minor tranquilizer and will not oversedate the client

Answer: C

Explanation:
(A) If the client could think logically, he would not be paranoid. In fact, he is probably suspicious of the staff, too. Newly admitted clients frequently experience high levels of anxiety, which can contribute to delusions. (B) The goal of pharmacological intervention is to calm the client and assist with reality-based thinking, not to sedate him. (C) Haloperidol is a neuroleptic and antipsychotic drug, not a minor tranquilizer. (D) Haloperidol is a high-potency neuroleptic and first-line choice for rapid neuroleptization, with low potential for sedation.

NEW QUESTION # 457
On admission to the postpartal unit, the nurse's assessment identifies the client's fundus to be soft, 2 fingerbreadths above the umbilicus, and deviated to the right. This is most likely an indication of:

A. A full bladder
B. A hemorrhage
C. Normal involution
D. An infection pain

Answer: A

Explanation:
(A) Immediately after expulsion of the placenta, the fundus should be in the midline and remain firm. (B) A boggy displaced uterus in the immediate postpartum period is a sign of urinary distention. Because uterine ligaments are stretched, a full bladder can displace the uterus. (C) Symptoms of infection may include unusual uterine discomfort, temperature elevation, and foul-smelling lochia. The stem of this question does not address any of these factors. (D) While excessive bleeding is associated with a soft, boggy uterus, the stem of this question includes displacement of the uterus, which is more commonly associated with bladder distention.

NEW QUESTION # 458
A female client has been hospitalized for several months following major abdominal surgery for a ruptured colon. A colostomy was created, and the large abdominal wound was left open and allowed to heal through granulation. She is receiving gentamicin IV for treatment of wound infection. Knowing this drug is ototoxic, the nurse would implement which of the following measures?

A. Advise the client to discontinue the drug at the first sign of dizziness.
B. Instruct the client in Valsalva's maneuver to equalize middle ear pressure and to prevent hearing loss.
C. Order audiometric testing in order to determine if hearing loss is caused by an ototoxic drug or other cause.
D. Instruct the client to report any signs of tinnitus, dizziness or difficulty hearing.

Answer: D

Explanation:
Explanation
(A) The first nursing measure is to instruct the client in which drug side effects to report. (B) Discontinuing the drug is not an independent nursing intervention and may compromise client care. (C) Audiometric testing will detect hearing loss, but it does not indicate a potential cause. (D) Equalizing middle ear pressure will not prevent hearing loss.

NEW QUESTION # 459
A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:

A. Hang Ringer's lactate as the companion fluid
B. Have the registered nurse in charge assume responsibility for verifying the client and blood product information
C. Take a baseline set of vital signs
D. Use microdrip tubing for the blood administration

Answer: C

Explanation:
(A) A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. (B) The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringer's lactate can cause clotting. (C) Only a blood administration set should be used. A microdrip tube would cause lysis of the red blood cells. (D) Proper identification of the recipient and the blood product must be validated by at least two people.

NEW QUESTION # 460
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