NCLEX-RN
NCLEX RN Nursing Exam Questions
Extract:
Question 1 of 5
A client with a history of breast cancer is admitted with complaints of bone pain. The nurse should give priority to:
Correct Answer: B
Rationale: Bone pain in breast cancer may indicate bone metastasis, a common complication, so monitoring for metastasis is the priority.
Question 2 of 5
The nurse is caring for a client with a history of a spinal cord injury who is experiencing autonomic dysreflexia. The nurse should:
Correct Answer: C
Rationale: Autonomic dysreflexia is often triggered by bladder distension. Inserting a Foley catheter relieves the trigger. Vasodilators and positioning are secondary, and prone position is unsafe.
Question 3 of 5
To correctly assess the oxygen saturation level of an adult client, the pulse oximeter should not be placed on the:
Correct Answer: C
Rationale: A pulse oximeter should not be placed on an extremity with a blood pressure cuff, as cuff inflation can interrupt blood flow and cause inaccurate readings. Fingers, earlobes, and the nose are acceptable sites when circulation is adequate.
Question 4 of 5
The nurse is teaching a client with a history of GERD about dietary modifications. The nurse should tell the client to avoid:
Correct Answer: A
Rationale: Spicy foods can irritate the esophagus and relax the lower esophageal sphincter, worsening GERD symptoms, so they should be avoided.
Question 5 of 5
The client is diagnosed with a pneumothorax. Which finding is most expected on auscultation?
Correct Answer: B
Rationale: A pneumothorax causes collapsed lung tissue, resulting in diminished or absent breath sounds on the affected side. Crackles, wheezing, and rhonchi are not typical.