NCLEX-RN
NCLEX RN Exam Questions Questions
Extract:
Question 1 of 5
A 30-year-old client has been admitted to the psychiatric service with the diagnosis of schizophrenia. He tells the nurse that when the woman he had been dating broke up with him, the CIA had replaced her with an identical twin. The client is experiencing:
Correct Answer: B
Rationale: There are no indications that the client's thoughts reflect special powers or talents characteristic of grandiosity. The client's thought content is fixed, false, persecutory, and suspicious in nature, which is characteristic of paranoid delusions. (C,
D) The client is not demonstrating a sensory experience.
Question 2 of 5
A client with a history of a colostomy is being discharged. The nurse should teach the client to:
Correct Answer: B
Rationale: High-fiber foods can cause blockages or excessive output in a colostomy. Bag changes depend on output, alcohol irritates the stoma, and irrigation is not always required.
Question 3 of 5
The nurse is teaching a client with a history of GERD about lifestyle modifications. The nurse should tell the client to:
Correct Answer: A
Rationale: Elevating the head of the bed prevents acid reflux in GERD, reducing esophageal irritation.
Question 4 of 5
The nurse writes the following nursing diagnosis for a client in acute renal failure--Impaired gas exchange related to:
Correct Answer: A
Rationale: Red blood cell production is impaired in renal failure owing to impaired erythropoietin production. This causes a decrease in the delivery of oxygen to the tissue and impairs gas exchange. The conversion of vitamin D to its physiologically active form is impaired in renal failure. In renal failure, a decrease in red blood cell production occurs owing to an impaired production of erythropoietin, leading to impaired gas exchange at the cellular level. The decreased production of renin in renal failure causes an increased production of aldosterone causing sodium and water retention.
Question 5 of 5
The nurse is caring for a client with a diagnosis of placenta previa. Which intervention is most appropriate?
Correct Answer: A
Rationale: Bedrest minimizes bleeding risk in placenta previa by reducing cervical pressure.
Tocolytics are not typically used vaginal delivery is contraindicated and antibiotics are not indicated unless infection is present.