NCLEX-RN
NCLEX RN Practice Questions Questions
Extract:
Question 1 of 5
A client is brought to the emergency room by the police. He is combative and yells, 'I have to get out of here. They are trying to kill me.' Which assessment is most likely correct in relation to this statement?
Correct Answer: C
Rationale: The client's statement reflects paranoid delusions, a belief that others intend harm, common in psychotic disorders.
Question 2 of 5
The nurse is performing discharge instruction for a client with an implantable permanent pacemaker. What discharge instruction is an essential part of the plan?
Correct Answer: C
Rationale: Clients with pacemakers must monitor their pulse to ensure the device is functioning correctly and to detect irregularities, making pulse-taking an essential discharge instruction.
Question 3 of 5
The nurse is teaching a new breastfeeding mother about breast care, but the mother has engorgement and asks if she should quit breastfeeding. Which information should the nurse include? Select all that apply.
Correct Answer: A,B,D,E
Rationale: Continue nursing (
A), massaging breasts (
B), using pain relievers (
D), and noting engorgement resolution in 24-48 hours (E) manage engorgement. Hot compresses (
C) may worsen swelling.
Question 4 of 5
The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus (MRSA). Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
Correct Answer: A
Rationale: Leaving the stethoscope in the room prevents MRSA transmission, as it avoids contaminating other areas or clients.
Question 5 of 5
A nurse is preparing to administer a MMR vaccine to a 35-year-old male. The nurse should
Correct Answer: D
Rationale: MMR is an intramuscular vaccine, requiring a 90-degree angle injection (typically deltoid). Dorsogluteal is not preferred, and pinching is for subcutaneous injections.