NCLEX-RN
Practice NCLEX RN Questions Questions
Extract:
Question 1 of 5
A client is receiving an opioid per patient-controlled analgesia (PCA) pump to control postoperative pain; however, when the nurse assesses the client, she finds the client is pale and hypotensive, and has a respiratory rate of 6 breaths per minute. The PCA pump record shows that the limit for maximum dosage was set far too high, resulting in an overdose. The client is very somnolent and barely responsive. What interventions does the nurse anticipate? Select all that apply.
Correct Answer: A,C,D,E
Rationale: Opioid overdose requires stopping the infusion (
A), administering naloxone (
C) to reverse effects, providing oxygen (
D) for respiratory depression, and filing an incident report (E). Discontinuing the PCA (
B) is not immediate.
Question 2 of 5
The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should:
Correct Answer: B
Rationale: Covering exposed viscera with sterile saline gauze keeps the tissue moist and prevents infection until surgical intervention, as replacing contents or using non-sterile dressings risks contamination.
Question 3 of 5
An elderly preoperative client seems very anxious but denies concerns when the nurse asks; however, the client's son confides that the client is very superstitious and believes it is bad luck that he is in room 113. Which of the following actions is the best response?
Correct Answer: B
Rationale: Reassigning the client to a different room (
B) addresses the client's anxiety by respecting his superstitious beliefs, promoting comfort. Reassurance (
A), medication (
C), or family presence (
D) may not fully alleviate the specific concern.
Question 4 of 5
Which of the following are common neurological changes associated with aging? Select all that apply.
Correct Answer: B,D
Rationale: Aging commonly increases sensory input threshold (
B), making stimuli harder to perceive, and impairs short-term memory (
D). Dementia (
A) is not universal, perspiration reduction (
C) is not neurological, and muscle atrophy (E) is musculoskeletal.
Question 5 of 5
A 52-year-old female with mitral valve stenosis is admitted to the floor. She asks the nurse why she got this condition because it does not run in her family. The nurse explains most cases of mitral stenosis are due to a history of
Correct Answer: C
Rationale: Rheumatic fever is the primary cause of mitral valve stenosis, leading to valve scarring years later.