NCLEX-RN
Free NCLEX RN Exam Questions
Extract:
Question 1 of 5
A client with a head injury has an order for dexamethasone (Decadron) 10 mg IV; push every 6 hours. The dose is available Decadron 4 mg/mL. How much will the nurse administer?
Correct Answer: 2.5 mL
Rationale: Dose: 10 mg ÷ 4 mg/mL = 2.5 mL.
Question 2 of 5
The nurse is caring for a client following a cerebral vascular accident. Which portion of the brain is responsible for changes in the client's vision?
Correct Answer: C
Rationale: The occipital lobe processes visual information. A cerebral vascular accident affecting this area can cause visual deficits such as hemianopia or visual agnosia. The temporal lobe manages auditory and memory functions, the frontal lobe controls behavior and motor skills, and the parietal lobe handles sensory integration.
Question 3 of 5
A client is admitted to the hospital for an induction of labor owing to a gestation of 42 weeks confirmed by dates and ultrasound. When she is dilated 3 cm, she has a contraction of 70 seconds. She is receiving oxytocin. The nurse's first intervention should be to:
Correct Answer: C
Rationale: FHT should be monitored continuously with an induction of labor; this is an accepted standard of care. The physician should be notified, but this is not the first intervention the nurse should do. The standard of care for an induction according to the Association of Women's Health, Obstetric, and Neonatal Nurses and American College of Obstetrics and Gynecology is that contractions should not exceed 60 seconds in an induction. Inductions should simulate normal labor; 70-second contractions during the latent phase (3 cm) are not the norm. The next contractions can be longer and increase risks to the mother and fetus. Contractions lasting 60-90 seconds during transition are typical; this provides a good distractor. The nurse needs to be knowledgeable of the phases and stages of labor.
Question 4 of 5
A 23-year-old college student seeks medical attention at the college infirmary for complaints of severe fatigue. Her skin is pale, and she reports exertional dyspnea. She is admitted to the hospital with possible aplastic anemia. Laboratory values reflect anemia, and the client is prepared for a bone marrow biopsy. She refuses to sign the biopsy consent and states, 'Can't you just get the doctor to give me a transfusion and let me go. This weekend begins spring break, and I have plans to go to Florida.' At this time the nurse's greatest concern is that:
Correct Answer: B
Rationale: The client could contract an infection, but at this point it is not the most pertinent issue. The client's statement indicates that she does not grasp the full impact of her illness. Further client education must be given, along with allowing her to express her feelings regarding her illness. The client may require a transfusion, but this is a temporary measure because the causative agent has not been identified. Her feelings regarding her illness must be addressed in order for care to continue. A bone marrow is done first to make a definitive diagnosis; then treatment may begin.
Question 5 of 5
The nurse is caring for an older client hospitalized with dehydration. Which site should be used to check for skin turgor?
Correct Answer: C
Rationale: In older adults the abdomen is the most reliable site for assessing skin turgor due to age-related changes in skin elasticity on the hands and arms. The forehead is not a standard site for this assessment.