NCLEX-RN
ATI NCLEX-RN Practice Questions Questions
Extract:
Question 1 of 5
A client with AIDS asks the nurse why he cannot have a pitcher of water left at his bedside. The nurse should tell the client that:
Correct Answer: D
Rationale: For a client with AIDS, immune suppression increases the risk of infections from stagnant water, which can harbor bacteria or fungi. Leaving a pitcher of water at the bedside is discouraged to minimize this risk.
Question 2 of 5
The nurse is caring for the client with a mastectomy. Which action would be contraindicated?
Correct Answer: A
Rationale: Taking blood pressure on the mastectomy side is contraindicated due to the risk of lymphedema from compromised lymphatic drainage post-surgery. Elevating the arm, positioning on the unaffected side, and fingersticks on the unaffected side are safe.
Question 3 of 5
A client had a ruptured abdominal aortic aneurysm that was repaired surgically. Her postoperative recovery progressed without complications, and she is ready for discharge. Client education in preparation for discharge began 7 days ago on her admission to the nursing unit. Evaluation of nursing care related to client education is based on evaluation of expected outcomes. Which statement made by the client would indicate that she is ready for discharge?
Correct Answer: C
Rationale: Postoperatively, clients with major abdominal surgery are instructed to avoid driving, riding in the front seat, and wearing seat belts because any sudden impact may injure a fresh incision. She should ride in back seat without a seat belt. Clients should not sit in the tub and allow the incision to soak in water because this may predispose the client to infection. A short, cool shower would be preferable. Allowing soap to come in contact with the incision would not harm it and is frequently used as postoperative wound care at home on discharge from the hospital. Activity instructions include: avoid sitting for long periods and get exercise by walking. Lifting more than 5 lb of weight is also prohibited. The client must also learn her diet. Her husband cooking is probably a temporary measure unless he did the cooking prior to her hospitalization. A statement such as this may indicate the need for further exploration of feelings regarding her illness, dependence, and self-care expectations.
Question 4 of 5
At 30 weeks' gestation, a client is admitted to the unit in premature labor. Her physician orders that an IV be started with 500 mL D5W mixed with 150 mg of ritodrine stat. The RN prepares the IV solution with the medication. The RN knows that clients receiving the medication ritodrine IV should be observed closely for which one of the following side effects:
Correct Answer: C
Rationale: Ritodrine is a sympathomimetic β2-adrenergic agonist that can cause vasodilation, leading to hypotension. The body compensates by increasing heart rate, resulting in tachycardia.
Question 5 of 5
An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
Correct Answer: B
Rationale: Bright red urine with many clots post-TURP indicates significant bleeding or clot obstruction, requiring immediate reporting to prevent complications. The other findings are less urgent.