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

Questions 149

NCLEX-RN

NCLEX-RN Test Bank

NCLEX RN Practice Exam Questions

Extract:


Question 1 of 5

A client has been diagnosed with immune thrombocytic purpura (ITP). Which of the following signs and symptoms indicate increased thrombocytopenia? Select all that apply.

Correct Answer: A,B

Rationale: ITP causes low platelets, leading to nosebleeds (
A) and petechiae/bruising (
B). Vision changes (
C), numbness (
D), and confusion (E) are not typical.

Question 2 of 5

The nurse is caring for a client with a wound that presents with full-thickness tissue loss and eschar covering the wound bed. The nurse would record this wound as which stage?

Correct Answer: E

Rationale: Eschar covering the wound bed makes it unstageable, as the depth cannot be assessed until debridement.

Question 3 of 5

A 15-year-old client was involved in an auto accident and requires emergency surgery to control bleeding, but both parents are out of town and unable to sign the consent form. Which of the following is the most appropriate action?

Correct Answer: D

Rationale: In an emergency where a minor requires life-saving surgery and parents are unavailable, the physician can proceed without consent (
D) to save the client's life. Client consent (
A), telephone consent (
B), or email consent (
C) are not appropriate in this urgent situation.

Question 4 of 5

The nurse is reviewing the lab results of four clients. Which finding should be reported to the physician?

Correct Answer: C

Rationale: A hematocrit of 52% in gastroenteritis suggests dehydration, which requires immediate reporting.

Question 5 of 5

The nurse caring for a client with chest tubes notes that the Pleuravac's collection chambers are full. The nurse should:

Correct Answer: D

Rationale: When the Pleuravac collection chambers are full, a new unit is needed to continue effective drainage and maintain the closed system.

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