NCLEX-RN
NCLEX RN Nursing Exam Questions
Extract:
Question 1 of 5
A 55-year-old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:
Correct Answer: C
Rationale: Straining urine provides for assessment of calculi and evaluation of calculi descent through ureters and urethra.
Question 2 of 5
Which of the following findings would be abnormal in a postpartal woman?
Correct Answer: D
Rationale: Frequently the mother experiences a shaking chill immediately after delivery, which is related to a nervous response or to vasomotor changes. If not followed by a fever, it is clinically innocuous. The pulse rate during the immediate postpartal period may be low but presents no cause for alarm. The body attempts to adapt to the decreased pressures intra-abdominally as well as from the reduction of blood flow to the vascular bed. Urinary output increases during the early postpartal period (12-24 hours) owing to diuresis. The kidneys must eliminate an estimated 2000-3000 mL of extracellular fluid associated with a normal pregnancy. A temperature of 100.4°F (38°
C) may occur after delivery as a result of exertion and dehydration of labor. However, any temperature greater than 100.4°F needs further investigation to identify any infectious process.
Question 3 of 5
The nurse is performing discharge teaching on a client with polycythemia vera. Which would be included in the teaching plan?
Correct Answer: D
Rationale: Polycythemia vera increases blood viscosity, raising thrombosis risk. Teaching to recognize thrombosis symptoms (e.g., pain, swelling) is critical. Avoiding crowds (
A) is for neutropenia, elevating the bed (
B) is for reflux, and socks/gloves (
C) are for Raynaud’s.
Question 4 of 5
Which of the following electrolyte imbalances is likely to result in a shortened QT interval?
Correct Answer: A
Rationale: Hypercalcemia shortens the QT interval on an ECG by accelerating cardiac repolarization. Hyponatremia hypomagnesemia and hyperphosphatemia are more likely to prolong the QT interval or have other ECG effects.
Question 5 of 5
A client was exhibiting signs of mania and was recently started on lithium carbonate. She has no known physical problems. A teaching plan for this client would include which of the following?
Correct Answer: A
Rationale: This answer is correct. A balanced diet with adequate salt intake is necessary. This answer is incorrect. The client must drink six to eight full glasses of fluid per day (2000-3000 mL/day). This answer is incorrect. The client should be instructed to avoid fluctuations of sodium intake. Diet should be balanced, with an adequate salt intake. This answer is incorrect. Nausea is a frequent side effect that can be minimized with administration of drug with meals or after eating food.