NCLEX-RN
RN NCLEX Practice Test Questions
Extract:
Question 1 of 5
A client is placed in five-point restraints after exhibiting sudden violence after illegal drug use, and haloperidol (Haldol) 5 mg IM is administered. After 1 hour, his behavior is more subdued, but he tells the nurse, 'The devil followed me into this room, I see him standing in the corner with a big knife. When you leave the room, he's going to cut out my heart.' The nurse's best response is:
Correct Answer: A
Rationale: The nurse is the client's link to reality. This response validates the authenticity of the client's experience by casting doubt on his belief and reinforcing reality.
Question 2 of 5
The client is admitted to the ER with multiple rib fractures on the right. The nurse's assessment reveals that an area over the right clavicle is puffy and that there is a "crackling" noise with palpation. The nurse should further assess the client for which of the following problems?
Correct Answer: B
Rationale: Puffy skin and crackling (crepitus) over the clavicle suggest subcutaneous emphysema, where air escapes into tissues, often with rib fractures. Flail chest (
A) involves paradoxical chest movement, infiltrated IV (
C) is unrelated, and pneumothorax (
D) causes absent breath sounds.
Question 3 of 5
As soon as a child has been diagnosed as 'hearing impaired,' special education should begin. Which of the following special education tasks is the most difficult for a severely hearing-impaired child?
Correct Answer: B
Rationale: With the slight and mild hard of hearing, auditory training is beneficial. Speech is the most difficult task because it is learned by visual and auditory stimulation, imitation, and reinforcement. (C,
D) Lip reading and signing are aimed at establishing communicative skills, but they are learned more easily by visual stimulation.
Question 4 of 5
A client with a history of Addison's disease is admitted with complaints of nausea and vomiting. The nurse should expect the client to have:
Correct Answer: A
Rationale: Addison's disease causes adrenal insufficiency, reducing aldosterone, which leads to hyperkalemia due to impaired potassium excretion.
Question 5 of 5
A client with a history of colorectal cancer is admitted with complaints of abdominal pain. The nurse should give priority to:
Correct Answer: A
Rationale: Abdominal pain in colorectal cancer may indicate obstruction, a serious complication requiring immediate monitoring.