NCLEX-PN
Free NCLEX-PN Practice Questions Questions
Extract:
Question 1 of 5
A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. Which of the following personnel can legally place the client in seclusion?
Correct Answer: D
Rationale: Only a registered nurse or higher (e.g., physician) can legally initiate seclusion due to the need for clinical judgment. LPNs, orderlies, and security lack this authority.
Question 2 of 5
A client is receiving nitroglycerin ointment (Nitrol) to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
Correct Answer: C
Rationale: Hypotension and headache are the most common adverse effects of nitroglycerin.
Therefore, blood pressure is the vital sign most likely to reflect an adverse effect of this drug. The nurse should check the client's blood pressure 1 hour after administering nitroglycerin ointment. A blood pressure decrease of 10 mm Hg is within the therapeutic range. If blood pressure falls more than 20 mm Hg below baseline, the nurse should remove the ointment and report the finding to the physician immediately. An above-normal heart rate (tachycardia) is a less common adverse effect of nitroglycerin. Respiratory rate and temperature don't change significantly after nitroglycerin administration.
Question 3 of 5
A 15 month-old child comes to the clinic for a follow-up visit after hospitalization for treatment of Kawasaki Disease. The nurse recognizes that which of the following scheduled immunizations will be delayed?
Correct Answer: A
Rationale: MMR. Medical management of Kawasaki involves administration of immunoglobulins. Measles, mumps, rubella (MMR) is a live virus vaccine, and its administration should be delayed to ensure the body’s ability to form antibodies.
Question 4 of 5
While installing electrical wiring in the intensive care unit, the workmen start an electrical fire. The nurse's first action when caring for a ventilator-dependent client should be to:
Correct Answer: C
Rationale: Removing the ventilator-dependent client with an Ambu bag ensures safety from the fire. Extinguishing, notifying, or activating the alarm are secondary.
Extract:
The nurse is reviewing laboratory results on a client with acute renal failure.
Question 5 of 5
Which one of the following lab values should be reported immediately?
Correct Answer: D
Rationale: A serum potassium of 5.9 mEq/L indicates hyperkalemia, which can cause life-threatening cardiac arrhythmias and requires immediate reporting.