NCLEX-RN
NCLEX RN Exam Questions Questions
Extract:
Question 1 of 5
A client with a history of heart failure is admitted with complaints of edema. The nurse should give priority to:
Correct Answer: A
Rationale: Diuretics reduce edema in heart failure, improving fluid balance and symptoms.
Question 2 of 5
The nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD). The nurse should expect the client to have:
Correct Answer: A
Rationale: COPD causes air trapping, leading to a barrel chest due to hyperinflated lungs.
Question 3 of 5
A client is admitted with a ruptured spleen following a four-wheeler accident. In preparation for surgery, the nurse suspects that the client is in the compensatory stage of shock because of which clinical manifestation?
Correct Answer: A
Rationale: Compensatory shock involves normal BP (120/70), tachycardia (HR 120), and early neurological changes (confusion). Options B, C, and D indicate progressive or irreversible shock with severe symptoms.
Question 4 of 5
A client who is 7 months pregnant is diagnosed with pyelonephritis. The nurse anticipates the physician ordering:
Correct Answer: C
Rationale: Ampicillin is a safe antibiotic for pyelonephritis in pregnancy, with no known teratogenic effects.
Question 5 of 5
When assessing fetal heart rate status during labor, the monitor displays late decelerations with tachycardia and decreasing variability. What action should the nurse take?
Correct Answer: D
Rationale: This is not a normal occurrence. Late decelerations need prompt intervention for immediate infant recovery.
To increase O2 perfusion to the unborn infant, the mother should be placed on her left side. IV fluids should be increased, not decreased. Immediate action is warranted, such as reporting findings, turning mother on left side, administering O2, discontinuing oxytocin (Pitocin), assessing maternal blood pressure and the labor process, preparing for immediate cesarean delivery, and explaining plan of action to client.