Questions 150

NCLEX-RN

NCLEX-RN Test Bank

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Question 1 of 5

A client with a hip fracture is scheduled for surgery. Which preoperative teaching should the nurse include?

Correct Answer: C

Rationale: Incentive spirometry prevents postoperative pulmonary complications like atelectasis, critical for a client with limited mobility post-hip surgery.

Question 2 of 5

A school-age child diagnosed with attention deficit hyperactivity disorder is prescribed methylphenidate (Ritalin). Which of the following should alert the school nurse to the possibility that the child is experiencing a common side effect of the drug?

Correct Answer: A

Rationale: Loss of appetite is a common side effect of methylphenidate, often leading to weight loss. Vomiting and photosensitivity are less common, and weight gain is not typical.

Question 3 of 5

The nurse is assessing a client with irreversible shock. The nurse should document which of the following?

Correct Answer: B

Rationale: Irreversible shock is characterized by circulatory collapse, with failure of vital organs due to inadequate perfusion, a critical finding to document.

Question 4 of 5

A 4-year-old child is admitted with dehydration due to gastroenteritis. Which assessment finding indicates severe dehydration?

Correct Answer: C

Rationale: Sunken fontanelles in a young child are a sign of severe dehydration, indicating significant fluid loss requiring urgent rehydration.

Question 5 of 5

The nurse is preparing to implement emergency care measures for the client who has just demonstrated signs and symptoms of a pulmonary embolism. Which primary health care provider prescription should the nurse implement first?

Correct Answer: A

Rationale: The client needs oxygen immediately because of hypoxemia, which is most often accompanied by respiratory distress and cyanosis. The client should also have an IV line for the administration of emergency medications such as morphine sulfate. An ECG is useful in determining the presence of possible right ventricular hypertrophy. All of the interventions listed are appropriate, but the client needs the oxygen first.

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