NCLEX-PN
NCLEX Practice Test PN Questions
Extract:
Question 1 of 5
A client complaining of severe shortness of breath is diagnosed with congestive heart failure. The nurse observes a falling pulse oximetry. The client's color changes to gray and she expectorates large amounts of pink frothy sputum. The first action of the nurse would be which of the following?
Correct Answer: D
Rationale: Administer oxygen. In a medical emergency, airway and breathing are prioritized. Oxygen administration addresses the immediate respiratory distress.
Question 2 of 5
A client hospitalized with mania is racing wildly about the unit trying to organize the other clients into a game of Ping-Pong. The nurse should:
Correct Answer: B
Rationale: Taking the client for a walk redirects energy safely and reduces stimulation. Art therapy may not engage, continuing the activity risks escalation, and video exercises lack supervision.
Question 3 of 5
The nurse is collecting data from a 30-month-old client. Which of the following findings would require follow-up?
Correct Answer: C
Rationale: Lack of nighttime bladder control at 30 months may indicate developmental delay or medical issues, requiring follow-up to assess for underlying causes.
Question 4 of 5
A 14-year old with leukemia tells the nurse, 'All I really want to eat is frozen yogurt.' The nurse should:
Correct Answer: C
Rationale: Providing the requested yogurt respects the client's preferences and encourages intake, which is critical in leukemia patients who may have reduced appetite.
Question 5 of 5
The nurse is screening clients for those at risk for developing a pressure injury. At highest risk for developing a pressure injury is the client
Correct Answer: D
Rationale: Clients with quadriplegia are at high risk due to immobility, which impairs circulation and increases pressure on skin. Moist skin increases the risk of skin breakdown, and elevated temperature may indicate infection or inflammation, further increasing risk.