1
NCLEX RN NEXT GENERATION EXAM
NCLEX RN NEXT GENERATION EXAM 3
PREDICTOR VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
DETAILED RATIONALES GRADED A+
GUARANTEED PASS ACE
A clinic nurse is preparing to evaluate the peripheral vision of a client by the confrontational
method. Which method describes the accurate procedure to perform this test?
1.The client is asked to discriminate numbers from a chart composed of colored dots.
2.The room is darkened, and the client is asked to identify colored blocks and shapes when
they appear in the visual field.
3.The examiner and client cover their right eyes and stare at each other's left eyes, and a
small object is brought into the visual field.
, 2
NCLEX RN NEXT GENERATION EXAM
4.The examiner and client cover the eyes directly opposite to one another and stare at each
other's uncovered eye, and a small object is brought into the visual field.
Correct: 4
Rationale:
The confrontational method assumes that the examiner has normal peripheral vision. The
client sits facing the examiner, approximately 2 ft (60 cm) away. The eyes of the client and
the examiner should be at the same level. Both the examiner and the client cover the eyes
directly opposite each other and stare at each other's uncovered eye. A small object is
brought from the peripheral visual field and tests the superior, temporal, inferior, and nasal
field. The client states when he or she sees the object.
The nurse is preparing to perform an otoscopic examination on an adult client. Which action
should the nurse take to perform this examination?
1.Pull the pinna up and back before inserting the speculum.
2.Pull the earlobe down and back before inserting the speculum.
3.Tilt the client's head forward and down before inserting the speculum.
4.Use the smallest speculum available to decrease the discomfort of the exam.
Correct: 1
Rationale:
The nurse tilts the client's head slightly away and holds the otoscope upside down as if it
were a large pen. The pinna is pulled up and back, and the nurse visualizes the external canal
while slowly inserting the speculum. The remaining options are incorrect procedures.
, 3
NCLEX RN NEXT GENERATION EXAM
After performing an initial abdominal assessment on a client, the nurse documents that the
bowel sounds are normal. Which description best describes normal bowel sounds?
1.Waves of loud gurgles auscultated in all 4 quadrants
2.Low-pitched swishing auscultated in 1 or 2 quadrants
3.Relatively high-pitched clicks or gurgles auscultated in all 4 quadrants
4.Very high-pitched loud rushes auscultated especially in 1 or 2 quadrants
Correct: 3
Rationale:
Although frequency and intensity of bowel sounds vary depending on the phase of
digestion, normal bowel sounds are relatively high-pitched clicks or gurgles. Loud gurgles
(borborygmi) indicate hyperperistalsis. Bowel sounds will be more high-pitched and louder
(hyperresonance) when the intestines are under tension, such as in intestinal obstruction. A
swishing or buzzing sound represents turbulent blood flow associated with a bruit. Bruits
are not normal sounds
The nurse is performing an abdominal assessment and inspects the skin on the client's
abdomen. Which assessment technique should the nurse perform next?
1.Palpate the abdomen for size.
2.Palpate the liver at the right rib margin.
3.Listen to bowel sounds in all 4 quadrants.
4.Percuss the right lower abdominal quadrant.
, 4
NCLEX RN NEXT GENERATION EXAM
Correct: 3
Rationale:
The appropriate sequence for abdominal examination is inspection, auscultation,
percussion, and palpation. Auscultation is performed after inspection to ensure that the
motility of the bowel and bowel sounds are not altered by percussion or palpation.
Therefore, after inspecting the skin on the abdomen, the nurse should listen for bowel
sounds.
The nurse assesses a client for the presence of Homans' sign. Which could be an indication
that this sign is positive?
1.Absent bowel sounds
2.Client complaints of wound pain
3.Pain with dorsiflexion of the foot
4.Crackles on auscultation of the lungs
Correct: 3
Rationale:
To elicit Homans' sign, the nurse would dorsiflex the client's foot and assess for pain in the
calf area. The presence of pain may indicate a positive Homans' sign. Wound pain and absent
bowel sounds are unrelated findings. Crackles on auscultation of the lungs may indicate a
respiratory complication.
A nursing student is asked about the procedure used to elicit Homans' sign. Which response
by the student indicates an understanding of this assessment technique?
1."I will ask the client to raise the legs up to the waist and then to lower the legs slowly."
NCLEX RN NEXT GENERATION EXAM
NCLEX RN NEXT GENERATION EXAM 3
PREDICTOR VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
DETAILED RATIONALES GRADED A+
GUARANTEED PASS ACE
A clinic nurse is preparing to evaluate the peripheral vision of a client by the confrontational
method. Which method describes the accurate procedure to perform this test?
1.The client is asked to discriminate numbers from a chart composed of colored dots.
2.The room is darkened, and the client is asked to identify colored blocks and shapes when
they appear in the visual field.
3.The examiner and client cover their right eyes and stare at each other's left eyes, and a
small object is brought into the visual field.
, 2
NCLEX RN NEXT GENERATION EXAM
4.The examiner and client cover the eyes directly opposite to one another and stare at each
other's uncovered eye, and a small object is brought into the visual field.
Correct: 4
Rationale:
The confrontational method assumes that the examiner has normal peripheral vision. The
client sits facing the examiner, approximately 2 ft (60 cm) away. The eyes of the client and
the examiner should be at the same level. Both the examiner and the client cover the eyes
directly opposite each other and stare at each other's uncovered eye. A small object is
brought from the peripheral visual field and tests the superior, temporal, inferior, and nasal
field. The client states when he or she sees the object.
The nurse is preparing to perform an otoscopic examination on an adult client. Which action
should the nurse take to perform this examination?
1.Pull the pinna up and back before inserting the speculum.
2.Pull the earlobe down and back before inserting the speculum.
3.Tilt the client's head forward and down before inserting the speculum.
4.Use the smallest speculum available to decrease the discomfort of the exam.
Correct: 1
Rationale:
The nurse tilts the client's head slightly away and holds the otoscope upside down as if it
were a large pen. The pinna is pulled up and back, and the nurse visualizes the external canal
while slowly inserting the speculum. The remaining options are incorrect procedures.
, 3
NCLEX RN NEXT GENERATION EXAM
After performing an initial abdominal assessment on a client, the nurse documents that the
bowel sounds are normal. Which description best describes normal bowel sounds?
1.Waves of loud gurgles auscultated in all 4 quadrants
2.Low-pitched swishing auscultated in 1 or 2 quadrants
3.Relatively high-pitched clicks or gurgles auscultated in all 4 quadrants
4.Very high-pitched loud rushes auscultated especially in 1 or 2 quadrants
Correct: 3
Rationale:
Although frequency and intensity of bowel sounds vary depending on the phase of
digestion, normal bowel sounds are relatively high-pitched clicks or gurgles. Loud gurgles
(borborygmi) indicate hyperperistalsis. Bowel sounds will be more high-pitched and louder
(hyperresonance) when the intestines are under tension, such as in intestinal obstruction. A
swishing or buzzing sound represents turbulent blood flow associated with a bruit. Bruits
are not normal sounds
The nurse is performing an abdominal assessment and inspects the skin on the client's
abdomen. Which assessment technique should the nurse perform next?
1.Palpate the abdomen for size.
2.Palpate the liver at the right rib margin.
3.Listen to bowel sounds in all 4 quadrants.
4.Percuss the right lower abdominal quadrant.
, 4
NCLEX RN NEXT GENERATION EXAM
Correct: 3
Rationale:
The appropriate sequence for abdominal examination is inspection, auscultation,
percussion, and palpation. Auscultation is performed after inspection to ensure that the
motility of the bowel and bowel sounds are not altered by percussion or palpation.
Therefore, after inspecting the skin on the abdomen, the nurse should listen for bowel
sounds.
The nurse assesses a client for the presence of Homans' sign. Which could be an indication
that this sign is positive?
1.Absent bowel sounds
2.Client complaints of wound pain
3.Pain with dorsiflexion of the foot
4.Crackles on auscultation of the lungs
Correct: 3
Rationale:
To elicit Homans' sign, the nurse would dorsiflex the client's foot and assess for pain in the
calf area. The presence of pain may indicate a positive Homans' sign. Wound pain and absent
bowel sounds are unrelated findings. Crackles on auscultation of the lungs may indicate a
respiratory complication.
A nursing student is asked about the procedure used to elicit Homans' sign. Which response
by the student indicates an understanding of this assessment technique?
1."I will ask the client to raise the legs up to the waist and then to lower the legs slowly."
