NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
A 67-year-old client will be undergoing a coronary arteriography in the morning. Client teaching about postprocedure nursing care should include that:
Correct Answer: D
Rationale: Keeping the leg straight for 8-12 hours minimizes bleeding risk at the arterial puncture site after coronary arteriography.
Question 2 of 5
A postoperative TURP client returns from the recovery room to the general surgery unit and is in stable condition. One hour later the nurse assesses him and finds him to be confused and disoriented. She recognizes that this is most likely caused by:
Correct Answer: D
Rationale: Early signs of hypovolemic shock include hypotension, tachycardia, tachypnea, pallor, and diaphoresis. Early signs of potassium depletion include muscular weakness or paralysis, tetany, postural hypotension, weak pulse, shallow respirations, apathy, weak voice, and electrocardiographic changes. Early signs of an elevated sodium level include dry oral mucous membranes, marked thirst, hypertension, tachycardia, oliguria or anuria, anxiety, and agitation. This answer is correct. Important early clinical findings of a decreased sodium concentration include confusion and disorientation. Hyponatremia can occur after a TURP because absorption during surgery through the prostate veins can increase circulating blood volume and decrease sodium concentration.
Question 3 of 5
A client with a diagnosis of Amyotrophic Lateral Sclerosis (ALS) has been prescribed riluzole (Rilutek). Which does the nurse include when teaching the client about this drug?
Correct Answer: A, C, D, E
Rationale: Riluzole teaching includes avoiding alcohol (
A), reporting fever (
C), consistent timing (
D), and regular lab monitoring (E). Taking with food (
B) is not required.
Question 4 of 5
The registered nurse is assigning staff for four clients on the 3-11 shift. Which client should be assigned to the LPN?
Correct Answer: C
Rationale: A pneumonia client expecting discharge is stable and suitable for an LPN’s scope (e.g., monitoring, discharge prep). ARDS (
A), recent surgery (
B), and bleeding varices (
D) require RN-level care.
Question 5 of 5
A client who is gravida 1 para 1 vaginally delivered a 7-lb girl. She received a midline episiotomy at delivery. When assessing the level of her uterus immediately following delivery, the nurse would expect the fundus to be located:
Correct Answer: D
Rationale: Within 12 hours of delivery, the fundus of the uterus rises to, or slightly above or below, the umbilicus. Fundal height generally decreases 1 fingerbreadth, or 1 cm/day. The uterus descends into the pelvic cavity at approximately 10-12 postpartal days and can no longer be palpated abdominally. Within 12 hours of delivery, the fundus of the uterus rises to, or slightly above or below, the umbilicus. Fundal height generally decreases 1 fingerbreadth, or 1 cm/day. An enlarged uterus may indicate subinvolution or postpartal hemorrhage. Immediately following delivery, the uterus lies midline, about midway between the umbilicus and the symphysis pubis.