NCLEX-PN
NCLEX Trainer Test 6 Questions
Extract:
Question 1 of 5
A cooling blanket is ordered for an adult client who has a temperature of 106°F. What nursing action is essential because the client has a cooling blanket?
Correct Answer: B
Rationale: Turning every two hours prevents skin breakdown from prolonged cooling blanket contact.
Tongue blades, ice, or heavy coverings are inappropriate.
Question 2 of 5
To prevent symptoms of Raynaud's, the client should:
Correct Answer: C
Rationale: Avoiding cold exposure is key to preventing vasospasms in Raynaud's disease, which cause symptoms like numbness and color changes in the extremities.
Question 3 of 5
The nurse is caring for a client with a history of type 2 diabetes who is receiving insulin aspart (NovoLog) 10 units subcutaneously before meals. Which of the following findings would be of GREATest concern to the nurse?
Correct Answer: C
Rationale: Sweating and shakiness indicate hypoglycemia, a serious complication of insulin aspart, requiring immediate treatment with carbohydrates. Options A, B, and D are less concerning: glucose 80 mg/dL is normal, heart rate 90 bpm and blood pressure 130/80 mmHg are stable.
Question 4 of 5
Which of the following findings is consistent with a diagnosis of congestive heart failure?
Correct Answer: A
Rationale: Jugular vein distention reflects increased fluid volume and right-sided heart failure, a hallmark of congestive heart failure. Other options are not specific to this condition.
Question 5 of 5
The nurse assesses the use of coping mechanisms by an adolescent 1 week after the client had a motor vehicle accident resulting in multiple serious injuries. Which of these characteristics are most likely to be displayed?
Correct Answer: B
Rationale: Helplessness and hopelessness may contribute to regressive, dependent behavior which often occurs at any age with hospitalization. Denying or minimizing the seriousness of the illness is used to avoid facing the worst situation. Recall that denial is the initial step in the process of working through any loss.