NCLEX-RN
NCLEX RN Predictor Exam Questions
Extract:
Question 1 of 5
A client is in active labor and has been admitted to the labor and delivery unit. The RN has just done a sterile vaginal exam and determines that the client is dilated 5 cm, effaced 85%, and the fetus's head is at 0 station. She asks if she could have a lumbar epidural now. The epidural is started, and the anesthetic agent used is bupivacaine (Marcaine). After the client has received her lumbar epidural, it is important for the RN to monitor her for which of the following side effects:
Correct Answer: B
Rationale: Bupivacaine causes vasodilation, which can lead to hypotension, a common side effect that requires close monitoring.
Question 2 of 5
A four-year-old is admitted with acute leukemia. It will be most important to monitor the child for:
Correct Answer: C
Rationale: Acute leukemia causes bone marrow suppression, leading to bleeding (from low platelets) and pallor (from anemia). These are critical signs to monitor. Other symptoms are less immediate.
Question 3 of 5
A term neonate has experienced no distress at birth and has an Apgar score of 9. Her mother has asked to breastfeed her following delivery. Immediately after birth, the neonate was most susceptible to heat loss. The most appropriate intervention to conserve heat loss and promote bonding is to:
Correct Answer: C
Rationale: A radiant warmer maintains an optimal thermal environment by use of a thermal skin sensor taped to the infant. The warmer limits parental attachment, so, although appropriate, it is not an intervention that promotes infant attachment. Warmed blankets prevent heat loss in the neonate by conduction. In addition, tactile stimuli promote crying and lung expansion. This intervention does not promote attachment, however. Skin-to-skin contact is an effective way to conserve heat after delivery and promotes parental attachment following birth in the healthy term infant. The first period of reactivity lasts approximately 30 minutes following birth. A strong sucking reflex and an active, awake newborn characterize this period. Surfaces of objects warmer than the infant promote overheating by conduction, and neonatal hyperthermia may result.
Question 4 of 5
The nurse is teaching a client with a history of type 1 diabetes about insulin storage. The nurse should tell the client to:
Correct Answer: A
Rationale: Refrigerating unopened insulin vials preserves potency, ensuring effective diabetes management.
Question 5 of 5
The nurse is caring for a client with a diagnosis of placenta previa. Which physician order should the nurse question?
Correct Answer: B
Rationale: The Kleihauer-Betke test detects fetal blood in maternal circulation typically used in trauma or Rh sensitization not placenta previa. Fetal monitoring , CBC , and IV fluids are appropriate for managing placenta previa which involves painless vaginal bleeding.