NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
A client with a history of liver cirrhosis is admitted with ascites. Which intervention would the nurse expect to implement?
Correct Answer: A
Rationale: Furosemide reduces fluid overload in ascites by promoting diuresis. Increasing fluids (
B), heating pads (
C), and high-sodium diets (
D) worsen ascites.
Question 2 of 5
Which of the following statements relevant to a suicidal client is correct?
Correct Answer: A
Rationale: This is a high-risk factor for potential suicide. A previous suicide attempt is a definite risk factor for subsequent attempts. Every threat of suicide should be taken seriously. The client should be asked directly about his or her intent to do bodily harm. The client is never hurt by direct, respectful questions.
Question 3 of 5
The nurse is caring for a client with a history of Ménière’s disease. The nurse should expect the client to have:
Correct Answer: A
Rationale: Ménière’s disease affects the inner ear, causing vertigo, tinnitus, and hearing loss due to fluid imbalance.
Question 4 of 5
For the past several months, an elderly female client with Alzheimer's disease has experienced paranoia; hallucinations; and aggressive, disruptive behavior. The family is utilizing haloperidol as needed to control her behavior. On nursing assessment, you note that the client demonstrates involuntary movements of the tongue and fingers. This may most likely indicate:
Correct Answer: A
Rationale: Tardive dyskinesia is a common side effect of antipsychotic medications such as haloperidol. Discontinuing the medication can alleviate symptoms. Although mild tremors are an early sign of Parkinson's disease, haloperidol must be discontinued first and the client further evaluated. These symptoms do not necessarily indicate a more advanced stage of Alzheimer's disease. Most antipsychotic drugs are chemically similar and will produce the same side effects.
Question 5 of 5
The nurse is caring for a client with a history of atrial fibrillation. Which finding requires immediate intervention?
Correct Answer: C
Rationale: Dizziness and syncope in atrial fibrillation suggest hemodynamic instability, possibly from rapid ventricular response, requiring immediate intervention. Mild tachycardia, normal BP, and saturation are less urgent.