NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy of fluid resuscitation in the burned child?
Correct Answer: C
Rationale: Blood pressure can remain normotensive even in a state of hypovolemia. Serum potassium is not reliable for determining adequacy of fluid resuscitation. Urine output, alteration in sensorium, and capillary refill are the most reliable indicators for assessing adequacy of fluid resuscitation. Pulse rate may vary for many reasons and is not a reliable indicator for assessing adequacy of fluid resuscitation.
Question 2 of 5
A 7-year-old girl has been diagnosed with juvenile arthritis and has been placed on daily aspirin. Which statement made by the parent indicates a need for further teaching?
Correct Answer: B
Rationale: Aspirin should not be given on an empty stomach because it is irritating to the mucosa. Bleeding from decreased clotting capacity may be caused by aspirin toxicity. A regular schedule of aspirin administration is important to maintain a satisfactory drug level in the body. Aspirin toxicity may affect cranial nerve VIII, leading to tinnitus (ringing in the ears).
Question 3 of 5
The nurse is preparing a client for cervical uterine radiation implant insertion. Which will be included in the teaching plan?
Correct Answer: B
Rationale: A Foley catheter is inserted during cervical radiation implants to keep the bladder empty, reducing radiation exposure. TV/phone use (
A) is allowed, high-fiber diet (
C) is not specific, and excretions (
D) are not radioactive with internal implants.
Question 4 of 5
The nurse is preparing to administer a dose of nitroglycerin sublingual to a client with chest pain. Which instruction should be given to the client?
Correct Answer: B
Rationale: Nitroglycerin sublingual tablets are placed under the tongue to dissolve, allowing rapid absorption to relieve angina. Swallowing, chewing, or taking with milk reduces effectiveness or delays onset.
Question 5 of 5
A client has been diagnosed with congestive heart failure. His fluid intake and output are strictly regulated. For lunch, he drank 8 oz of milk, 4 oz of tea, and 6 oz of coffee. His intake would be recorded as:
Correct Answer: B
Rationale: 1 oz = 30 mL; therefore, 18 oz = 540 mL.