NCLEX Questions, NCLEX RN Practice Test Questions, NCLEX-RN Questions, Nurselytic

Questions 149

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Extract:


Question 1 of 5

A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:

Correct Answer: B

Rationale: Fetal heart tones are a definitive, objective sign of pregnancy, detectable around 20 weeks.

Question 2 of 5

A young adult who was in a motorcycle accident is brought to the emergency room with a closed head injury with suspected subdural hematoma. Although the client complains of a severe headache, he is alert and answers questions appropriately. The nurse would question which of the following orders?

Correct Answer: B

Rationale: narcotic analgesic, causes CNS and respiratory depression, contraindicated in head injury because it masks signs of increased intracranial pressure

Question 3 of 5

The nurse cares for two children brought into an emergency shelter. Law enforcement suspects the children have been neglected. The nurse should assess

Correct Answer: C

Rationale: Height and weight assess for failure to thrive, a key indicator of neglect. Bruises on knees/elbows are common in children and less specific.

Question 4 of 5

During morning assessments, the nurse finds that a client's nephrostomy tube has been clamped. The nurse's first action should be to:

Correct Answer: C

Rationale: Unclamping the nephrostomy tube is the priority to restore urine flow and prevent obstruction or infection.

Question 5 of 5

The nurse is talking with a client who has been diagnosed with thyroid cancer. The client is asking about different treatment options. Which response by the nurse is most appropriate?

Correct Answer: C

Rationale: This response encourages open communication and assesses the client's current knowledge, facilitating a patient-centered discussion about treatment options.

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