NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Extract:
Question 1 of 5
A client is admitted to the unit two hours after an explosion causes burns to the face. The nurse would be most concerned with the client developing which of the following?
Correct Answer: B
Rationale: Facial burns can cause swelling and laryngeal edema compromising the airway within hours. This is the most immediate life-threatening concern. Hypovolemia hypernatremia and hyperkalemia are also risks but are less urgent in the first two hours.
Question 2 of 5
A client has begun to exhibit signs of alcohol withdrawal. Her blood pressure has risen from 120/60 to 190/100, pulse is increased from 88 to 110 bpm, and she is irritable and agitated and has gross motor tremors of the hands. The nurse notifies the doctor. The nurse can anticipate that the doctor will order which of the following?
Correct Answer: B
Rationale: This answer is incorrect. Benzodiazepines are drugs of choice for alcohol withdrawal. This answer is correct. The drug has a sedative effect, is safe, and has an anticonvulsant effect. This answer is incorrect. Amitriptyline is an antidepressant. This answer is incorrect. Chlorpromazine is most effective in psychotic disorders.
Question 3 of 5
A psychotic client who believes that he is God and rules all the universe is experiencing which type of delusion?
Correct Answer: B
Rationale: These delusions are related to the belief that an individual has an incurable illness. These delusions are related to feelings of self-importance and uniqueness. These delusions are related to feelings of being conspired against. These delusions are related to denial of self-existence.
Question 4 of 5
The nurse is caring for a client with a radium implant for the treatment of cervical cancer. While caring for the client with a radioactive implant, the nurse should:
Correct Answer: D
Rationale: Wearing a radiation badge monitors exposure during care of a client with a radium implant, ensuring safety. Prolonged time, standing at the bed's foot, or avoiding items is less practical.
Question 5 of 5
A 5-year-old has just had a tonsillectomy and adenoidectomy. Which of these nursing measures should be included in the postoperative care?
Correct Answer: D
Rationale: The nurse should discourage the child from coughing, clearing the throat, or putting objects in his mouth. These may induce bleeding. Cool, clear liquids may be given when child is fully alert. Warm liquids may dislodge a blood clot. The nurse should avoid red- or brown-colored liquids to distinguish fresh or old blood from ingested liquid should the child vomit. Gargles and vigorous toothbrushing could initiate bleeding. Postoperative hemorrhage, though unusual, may occur. The nurse should observe for bleeding by looking directly into the throat and for vomiting of bright red blood, continuous swallowing, and changes in vital signs.