NCLEX Questions, ATI NCLEX-RN Practice Questions Questions, NCLEX-RN Questions, Nurselytic

Questions 158

NCLEX-RN

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Question 1 of 5

A 35-year-old client is admitted to the hospital for elective tubal ligation. While the nurse is doing preoperative teaching, the client says, 'The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?' The best explanation for the nurse to give the client would be that balanced anesthesia:

Correct Answer: D

Rationale: Regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. Varying amounts of anesthetic agents are used when employing balanced anesthesia. Amounts depend on age, weight, condition of the client, and surgical procedure. General anesthesia is a drug-induced depression of the central nervous system that produces loss of consciousness and decreased muscle activity. Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.

Question 2 of 5

To prevent deformities of the knee joints in a client with an exacerbation of rheumatoid arthritis, the nurse should:

Correct Answer: C

Rationale: Encouraging joint motion within pain limits prevents stiffness and deformities in rheumatoid arthritis. Bed rest, discouraging motion, or prolonged immobilization can worsen contractures.

Question 3 of 5

A client had a ruptured abdominal aortic aneurysm that was repaired surgically. Her postoperative recovery progressed without complications, and she is ready for discharge. Client education in preparation for discharge began 7 days ago on her admission to the nursing unit. Evaluation of nursing care related to client education is based on evaluation of expected outcomes. Which statement made by the client would indicate that she is ready for discharge?

Correct Answer: C

Rationale: Postoperatively, clients with major abdominal surgery are instructed to avoid driving, riding in the front seat, and wearing seat belts because any sudden impact may injure a fresh incision. She should ride in back seat without a seat belt. Clients should not sit in the tub and allow the incision to soak in water because this may predispose the client to infection. A short, cool shower would be preferable. Allowing soap to come in contact with the incision would not harm it and is frequently used as postoperative wound care at home on discharge from the hospital. Activity instructions include: avoid sitting for long periods and get exercise by walking. Lifting more than 5 lb of weight is also prohibited. The client must also learn her diet. Her husband cooking is probably a temporary measure unless he did the cooking prior to her hospitalization. A statement such as this may indicate the need for further exploration of feelings regarding her illness, dependence, and self-care expectations.

Question 4 of 5

The nurse is caring for a client with a history of a mastectomy. The client complains of arm swelling. The nurse should:

Correct Answer: B

Rationale: Arm swelling post-mastectomy suggests lymphedema, and elevating the arm reduces fluid accumulation. Warm compresses and massage may worsen swelling, and notification is secondary.

Question 5 of 5

The nurse is caring for a client with a diagnosis of preeclampsia. Which vital sign change is most concerning?

Correct Answer: A

Rationale: A blood pressure of 160/110 in preeclampsia indicates severe hypertension increasing the risk of stroke or eclampsia and requires immediate intervention. The other vital signs are within normal limits.

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