NCLEX-RN
NCLEX RN Nursing Exam Questions
Extract:
Question 1 of 5
A client with a history of a stroke is being taught to use a quad cane. The nurse should teach the client to:
Correct Answer: C
Rationale: The quad cane should be used on the weak side to support the affected leg post-stroke, improving balance. Holding in the strong hand or advancing with the strong leg is incorrect.
Question 2 of 5
A 16-month-old infant is being prepared for tetralogy of Fallot repair. In the nursing assessment, which lab value should elicit further assessment and requires notification of physician?
Correct Answer: C
Rationale: Normal hematocrit in infant is 28%-42%. A 60% hematocrit may indicate polycythemia, a common complication of cyanotic heart disease.
Question 3 of 5
The client is admitted with a diagnosis of postpartum endometritis. Which symptom is most characteristic?
Correct Answer: A
Rationale: Postpartum endometritis causes foul-smelling lochia due to uterine infection. Painless bleeding suggests other causes fetal distress is irrelevant postpartum and hypotension occurs only in severe cases.
Question 4 of 5
A 35-year-old client is admitted to the hospital with diabetic ketoacidosis. Results of arterial blood gases are pH 7.2, PaO2 90, PaCO2 45, and HCO3 16. The nursing assessment of arterial blood gases indicate the presence of:
Correct Answer: D
Rationale: Metabolic acidosis is determined by low pH and HCO3.
Question 5 of 5
The client has an order for sliding scale insulin at 1900 hours and Lantus (glargine) insulin at the same hour. The nurse should:
Correct Answer: B
Rationale: Lantus (glargine) is a long-acting insulin and should not be mixed with short-acting sliding scale insulin (e.g. regular insulin) due to differing pharmacokinetics. Administering them in separate injections ensures proper action profiles.