NCLEX-PN
NCLEX Practice Test PN Questions
Extract:
Question 1 of 5
A client admitted with acute myocardial infarction suddenly displays air hunger, dyspnea, and coughing with frothy, pink-tinged sputum. What would the nurse anticipate when auscultating the breath sounds of this client?
Correct Answer: C
Rationale: Frothy, pink-tinged sputum and dyspnea indicate pulmonary edema, a complication of myocardial infarction. Diffuse bilateral crackles are heard due to fluid in the alveoli.
Question 2 of 5
The nurse is caring for a client with cirrhosis who has ascites, peripheral edema, shortness of breath, fatigue, and generalized discomfort. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: C,D,E
Rationale: Semi-Fowler position helps alleviate shortness of breath by reducing pressure on the diaphragm. An alternating air pressure mattress reduces the risk of pressure injuries due to immobility. Music can help reduce discomfort and anxiety, providing a non-pharmacological distraction.
Question 3 of 5
The nurse is caring for assigned clients. The nurse should first check the client
Correct Answer: D
Rationale: Fever, redness, and pain around pin sites suggest a possible infection at the external fixation site, which is a priority due to the risk of osteomyelitis or systemic infection.
Question 4 of 5
The best method of evaluating the amount of peripheral edema is:
Correct Answer: B
Rationale: Measuring the extremity provides a direct and quantifiable assessment of peripheral edema by tracking changes in circumference. Daily weighing can indicate fluid retention but is less specific, so answer A is incorrect. Intake and output monitoring does not directly measure edema, so answer C is incorrect. Checking for pitting assesses the presence of edema but not its amount, so answer D is incorrect.
Question 5 of 5
The mother of a boy who has recently been diagnosed with sickle cell anemia is pregnant and asks the nurse if her unborn baby will have sickle cell anemia. What information should the nurse include in the answer?
Correct Answer: B
Rationale: Sickle cell anemia is autosomal recessive; if both parents are carriers, each child has a 25% chance of inheriting the disease, regardless of sex or birth order.