NCLEX Questions, NCLEX-RN Exam Practice Questions, NCLEX-RN Questions, Nurselytic

Questions 157

NCLEX-RN

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NCLEX-RN Exam Practice Questions

Extract:


Question 1 of 5

A 7-year-old girl has been diagnosed with juvenile arthritis and has been placed on daily aspirin. Which statement made by the parent indicates a need for further teaching?

Correct Answer: B

Rationale: Aspirin should not be given on an empty stomach because it is irritating to the mucosa. Bleeding from decreased clotting capacity may be caused by aspirin toxicity. A regular schedule of aspirin administration is important to maintain a satisfactory drug level in the body. Aspirin toxicity may affect cranial nerve VIII, leading to tinnitus (ringing in the ears).

Question 2 of 5

The nurse is assessing the vital signs of a client with pancreatic cancer. In addition to routine vital signs, the nurse assesses the fifth vital sign of:

Correct Answer: B

Rationale: Pain is considered the fifth vital sign, alongside temperature, pulse, respiration, and blood pressure. It is routinely assessed, especially in conditions like pancreatic cancer, which often causes significant pain due to tumor invasion or obstruction.

Question 3 of 5

A nurse is caring for a client with a myocardial infarction. The nurse recognizes that the most common complication in the client following a myocardial infarction is:

Correct Answer: B

Rationale: Cardiac dysrhythmias are the most common complication post-MI due to ischemic damage to the conduction system. Hypertrophy develops later, and hyperkalemia is less common.

Question 4 of 5

A client with a history of a burn injury is receiving Silvadene (silver sulfadiazine). The nurse should monitor the client for:

Correct Answer: A

Rationale: Silver sulfadiazine can cause neutropenia, requiring monitoring of white blood cell counts. Hyperkalemia, hypoglycemia, and hypertension are not typical side effects.

Question 5 of 5

A 2-year-old child with a scalp laceration and subdural hematoma of the temporal area as a result of falling out of bed should be prevented from:

Correct Answer: A

Rationale: A child with a subdural hematoma has increased ICP. Crying may significantly increase this pressure.

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