NCLEX-RN
NCLEX RN Exam Questions Questions
Extract:
Question 1 of 5
A 74-year-old client seen in the emergency room is exhibiting signs of delirium. His family states that he has not slept, eaten, or taken fluids for the past 24 hours. The planning of nursing care for a delirious client is based on which of the following premises?
Correct Answer: A
Rationale: This answer is correct. If the cause is removed, the delirious client will recover completely. This answer is incorrect. The demented client is incapable of returning to previous level of functioning. The delirious client is capable of returning to previous functioning. This answer is incorrect. The demented client, not the delirious client, has progressive intellectual and behavioral deterioration. This answer is incorrect. Delirium develops rapidly, whereas dementia is insidious.
Question 2 of 5
A client is admitted with a ruptured spleen following a four-wheeler accident. In preparation for surgery, the nurse suspects that the client is in the compensatory stage of shock because of which clinical manifestation?
Correct Answer: A
Rationale: Compensatory shock involves normal BP (120/70), tachycardia (HR 120), and early neurological changes (confusion). Options B, C, and D indicate progressive or irreversible shock with severe symptoms.
Question 3 of 5
A schizophrenic client who is experiencing thoughts of having special powers states that 'I am a messenger from another planet and can rule the earth.' The nurse assesses this behavior as:
Correct Answer: D
Rationale: Clients experiencing ideas of reference believe that information from the environment (e.g., the television) is referring to them. Clients experiencing delusions of persecution believe that others in the environment are plotting against them. Clients experiencing thought broadcasting perceive that others can hear their thoughts. Clients experiencing delusions of grandeur think that they are omnipotent and have superhuman powers.
Question 4 of 5
Which of the following combinations of foods is appropriate for an eight-month-old infant?
Correct Answer: C
Rationale: Rice cereal, bananas, and strained carrots are developmentally appropriate, easily digestible foods for an eight-month-old, unlike the other options, which include choking hazards or inappropriate items like whole milk.
Question 5 of 5
The nurse is caring for a client with a history of bipolar disorder. The nurse should expect the client to have:
Correct Answer: A
Rationale: Bipolar disorder is characterized by mood swings, including manic and depressive episodes, a hallmark of the condition.