NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
A client's admission history reveals complaints of fatigue, chronic sore throat, and enlarged lymph nodes in the axilla and neck.
Correct Answer: A
Rationale: A complete blood count (CB
C) detects abnormal white blood cell counts, supporting a leukemia diagnosis. Chest x-ray (
B), bone marrow aspiration (
C), and CT scan (
D) are confirmatory but not initial tests.
Question 2 of 5
A behavioral modification program is recommended by the multidisciplinary team working with a 15-year-old client with anorexia nervosa. A nursing plan of care based on this modality would include:
Correct Answer: B
Rationale: This answer is incorrect. Role playing is based on learning but is not based on the behavioral modification model. This answer is correct. The behavioral modification model is based on negative and positive reinforcers to change behavior. This answer is incorrect. Verbal catharsis is not an intervention based on behavioral modification. This answer is incorrect. Although an acceptable nursing intervention, it is not based on behavioral modification.
Question 3 of 5
The nurse is assessing the abdomen. The nurse knows the best sequence to perform the assessment is:
Correct Answer: A
Rationale: Abdominal assessment follows the sequence: inspection, auscultation, palpation. Auscultation is done before palpation to avoid altering bowel sounds. Inspection identifies visible abnormalities first.
Question 4 of 5
The nurse is assessing the vital signs of a client with pancreatic cancer. In addition to routine vital signs, the nurse assesses the fifth vital sign of:
Correct Answer: B
Rationale: Pain is considered the fifth vital sign, alongside temperature, pulse, respiration, and blood pressure. It is routinely assessed, especially in conditions like pancreatic cancer, which often causes significant pain due to tumor invasion or obstruction.
Question 5 of 5
A client has been instructed in how to take her nitroglycerin tablets. The nurse giving her instructions knows the client understands the information when she tells her:
Correct Answer: C
Rationale: Headaches may occur after taking nitroglycerin because of vasodilation. The tablets do not need to be refrigerated. The client should carry them with her. The client should contact the physician if repeated doses of nitroglycerin do not relieve the discomfort. Nitroglycerin tablets should be dissolved under the tongue, not swallowed.