NCLEX-RN
NCLEX RN Test Bank with Rationales Questions
Extract:
Question 1 of 5
A client with a history of schizophrenia is prescribed ziprasidone (Geodon). The nurse should monitor the client for which of the following adverse effects?
Correct Answer: A
Rationale: Ziprasidone can cause prolonged QT interval, increasing arrhythmia risk.
Question 2 of 5
A client has had a cardiac catheterization. The left femoral dressing has a moderate amount of bloody drainage, and the client has severe pain in that area. The nurse should first:
Correct Answer: C
Rationale: Applying pressure to the site controls bleeding, which is the priority in this scenario.
Question 3 of 5
A 12-year-old boy has a fractured femur and is immobilized in traction as shown in the fi gure. The nurse should:
Correct Answer: D
Rationale: The traction is set up correctly. Additional weights are not needed. A well-balanced diet with fiber should be offered. A pillow under the leg would negate the effects of the traction. Because the adolescent is positioned this way for an extended period, the nurse can help by fi nding activities that interest the client.
Question 4 of 5
The nurse instructs a female client about collecting a midstream urine sample for culture and sensitivity. Which should the nurse include in client teaching?
Correct Answer: B
Rationale:
To prepare properly for collection of a sterile urine specimen, the client cleanses the perineum from front to back using antiseptic swabs. Bathing before a midstream urine collection is unnecessary; however, proper specimen handling is critically important because improper specimen handling can yield inaccurate test results. The specimen should be labeled with the client's name, date, time, and medical record number in addition to the provider's name. The client should begin the flow of urine and collect the sample after starting the flow of urine, and then send the specimen to the laboratory as soon as possible.
Question 5 of 5
A client reports having pain in his casted left arm that is unrelieved by pain medication. The nurse assesses the arm and notes that the fingers are swollen and difficult to separate. Which action is most appropriate for the nurse to take at this time?
Correct Answer: D
Rationale: Swelling and unrelieved pain in a casted arm suggest possible compartment syndrome, requiring immediate physician notification. Elevating the arm or applying ice may help but is secondary to reporting.