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Questions 158

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NCLEX-RN Test Bank

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Extract:


Question 1 of 5

A client with a history of pancreatitis is admitted with complaints of nausea. The nurse should give priority to:

Correct Answer: A

Rationale: Antiemetics relieve nausea in pancreatitis, improving comfort and preventing dehydration.

Question 2 of 5

A client with a history of chronic venous insufficiency is admitted with complaints of leg ulcers. The nurse should give priority to:

Correct Answer: A

Rationale: Wound care is critical for leg ulcers in chronic venous insufficiency to promote healing and prevent infection.

Question 3 of 5

The nurse is caring for a client who is receiving oxytocin (Pitocin) to induce labor. Which finding would prompt the nurse to discontinue the oxytocin infusion?

Correct Answer: D

Rationale: Late decelerations indicate uteroplacental insufficiency a serious complication of oxytocin-induced hyperstimulation. Discontinuing oxytocin is necessary to restore fetal oxygenation. The other findings are normal or expected during labor induction.

Question 4 of 5

A vaginal exam of a laboring client reveals that the fetus is at 0 station. This assessment means that:

Correct Answer: C

Rationale: A 0 station means the presenting part of the fetus is level with the ischial spines indicating engagement in the pelvis. It does not indicate a lack of descent transverse lie or immediate risk of precipitate delivery.

Question 5 of 5

Home-care instructions for the child following a cardiac catheterization should include:

Correct Answer: B

Rationale: A small bruise may develop around the insertion site and is not a reason for alarm. It is best to keep the child out of the bathtub until the sutures are removed. Acetaminophen, not aspirin, is the drug of choice if there is pain at the insertion site. The insertion site should be kept clean and dry and open to air.

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