NCLEX-PN
NCLEX PN Prep Questions Questions
Extract:
Question 1 of 5
A client with acquired immunodeficiency syndrome is admitted with a diagnosis of pneumocystis jirovecki pneumonia. Shortly after his admission, he becomes confused and disoriented. He attempts to pull out his IV and refuses to wear an O2 mask. Based on his mental status, the priority nursing diagnosis is:
Correct Answer: B
Rationale: The client's confusion and attempts to remove medical devices indicate a risk for self-injury, making this the priority nursing diagnosis.
Question 2 of 5
The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?
Correct Answer: C
Rationale: Turkey contains the least amount of fat and cholesterol. Cheese, shrimp, and beef should be avoided by the client on a low cholesterol, low fat diet; therefore, answers A, B, and D are incorrect.
Question 3 of 5
The nurse is caring for a client who has no pulse and is experiencing the cardiac rhythm in the ECG strip shown below. The client has a do not attempt resuscitation directive. The health care provider (HCP) orders initiation of resuscitative measures. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: A client with a Do Not Attempt Resuscitation (DNAR) or Do Not Resuscitate (DNR) directive has legally chosen not to receive resuscitative measures, such as CPR or defibrillation, in the event of cardiac arrest. The nurse has an ethical and legal obligation to honor the client's advanced directive.
Question 4 of 5
The unit secretary notifies the nurse that 4 clients called the nurses' station reporting pain. Which client should the nurse assess first?
Correct Answer: A
Rationale: Shoulder pain radiating down the arm post-amputation suggests a possible cardiac event (e.g., angina), a life-threatening condition requiring immediate assessment. Other pains, while severe, are more likely related to known conditions.
Extract:
Vital signs
Temperature 98.4 F (36.9 C)
Blood pressure 124/78 mm Hg
Heart rate 46/min and irregularly irregular
Respirations 22/min
Question 5 of 5
The nurse is preparing to administer medications to a client admitted with atrial fibrillation. The nurse notes the vital signs shown in the exhibit. Which medications due at this time are safe to administer? Select all that apply.
Correct Answer: A,B,E
Rationale: Without specific vital signs, diltiazem (rate control), heparin (anticoagulation), and timolol (glaucoma, not cardiac) are generally safe in atrial fibrillation unless contraindicated (e.g., severe hypotension). Lisinopril and metoprolol require caution if hypotensive or bradycardic, but no exhibit data suggests otherwise.