NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
A 33-year-old client is diagnosed with bipolar disorder, acute phase. This is her first psychiatric hospitalization, and she is being evaluated for treatment with lithium. Which of the following diagnostic tests are essential prior to the initiation of lithium therapy with this client?
Correct Answer: B
Rationale: These are general diagnostic blood studies (usually done on admission), but they are not reliable indicators of lithium therapy clearance. These are the primary diagnostic tests to determine kidney functioning. Because lithium is excreted through the kidneys and because it can be very toxic, adequate renal function must be ascertained before therapy begins. These are diagnostic blood tests used to determine the presence of endocrine (not renal) dysfunction. These are other types of diagnostic procedures used to determine musculoskeletal, neural, and cardiac (rather than renal) functioning.
Question 2 of 5
A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has:
Correct Answer: A
Rationale: Acute adrenal crisis (Addisonian crisis) causes hypotension due to cortisol and aldosterone deficiency, leading to shock. Pulse is typically rapid, skin is cool, and urination decreases.
Question 3 of 5
A 20-year-old client presents to the obstetrics-gynecology clinic for the first time. She tells the nurse that she is pregnant and wants to start prenatal care. After collecting some initial assessment data, the nurse measures her fundal height to be at the level of the umbilicus. The nurse estimates the fetal gestational age to be approximately:
Correct Answer: C
Rationale: At 10 weeks, the fundus is located slightly above the symphysis pubis. At 16 weeks, the fundus is halfway between the symphysis pubis and the umbilicus. At 20 weeks, the fundus is located approximately at the umbilicus. At 30 weeks, the fundal height is about 30 cm, or 10 cm above the umbilicus.
Question 4 of 5
The client is admitted with a diagnosis of gestational trophoblastic disease. Which vital sign change is most likely to be observed?
Correct Answer: A
Rationale: Gestational trophoblastic disease can cause maternal tachycardia due to elevated hCG or bleeding. Fetal bradycardia is not relevant (no viable fetus) and hypotension is less common unless hemorrhage occurs.
Question 5 of 5
A client is being discharged after lithotripsy for removal of a kidney stone. Which statement by the client indicates understanding of the nurse's instructions?
Correct Answer: C
Rationale: Straining urine and saving stone fragments post-lithotripsy allows analysis and confirms stone passage. Starting in the morning (
A) is incorrect, saving all urine (
B) is unnecessary, and not straining (
D) misses stone collection.