NCLEX-RN
NCLEX-RN Exam Questions
Extract:
Question 1 of 5
A female client has married recently. A month ago she visited her physician with complaints of burning on urination. She was given a prescription for trimethoprim-sulfamethoxazole (Bactrim) DS bid for 10 days. She was admitted through the emergency room on Saturday evening complaining of flank pain. Her temperature was 104°F. A preliminary urinalysis revealed 31 bacteria along with red and white blood cells Rankings blood cells in the urine. A preliminary diagnosis of pyelonephritis was made. During a nursing admission assessment, which statement by the client demonstrates a possible cause for pyelonephritis?
Correct Answer: C
Rationale: Although it is important that the client drink adequate fluids while treating a bladder infection with trimethoprim-sulfamethoxazole, the failure to do so will not cause pyelonephritis. A stricture or abnormality may cause the progression of bladder infection to urinary tract infection, but this is rare. There is no indication in this situation that this has occurred. The most common cause of pyelonephritis is improper treatment of bladder infections. The client typically feels better after several days, discontinues the medication, and saves the remainder for the next occurrence of a bladder infection. For this reason, it is imperative to provide client education related to completion of the prescribed medication. There is no evidence that infection in another body system could cause pyelonephritis.
Question 2 of 5
A client is admitted with a blood glucose level of 740 mg/dl. Which actions should the nurse take at this time?
Correct Answer: C, E, F
Rationale: Hyperglycemia (740 mg/dl) requires physician notification (
C), sliding scale regular insulin (E), and consciousness assessment (F) for potential diabetic ketoacidosis. Peripheral neuropathy (
A) is chronic, not acute. Dextrose (
B) worsens hyperglycemia. NPH insulin (
D) is long-acting, unsuitable for acute management.
Question 3 of 5
When preparing a client for magnetic resonance imaging, the nurse should implement which of the following?
Correct Answer: C
Rationale: Removing jewelry and checking for metal implants prevents MRI-related injuries due to magnetic fields. Consent and atropine (
A), scrubbing (
B), and Benadryl (
D) are not standard for MRI prep.
Question 4 of 5
A client with polycythemia vera is admitted with complaints of difficulty breathing and pleuritic pain. Which lab finding is expected in the client with polycythemia vera?
Correct Answer: A
Rationale: Polycythemia vera is characterized by excessive red blood cell production, leading to an increased red blood cell count, which can cause hyperviscosity and symptoms like dyspnea.
Question 5 of 5
A 6-month-old infant has developmental delays. His weight falls below the 5th percentile when plotted on a growth chart. A diagnosis of failure to thrive is made. What behaviors might indicate the possibility of maternal deprivation?
Correct Answer: B
Rationale: Normal infant attachment behaviors include responding to touch and wanting to be held. Maternal deprivation behaviors include poor feeding, stiffening and refusal to eat, and inconsistencies in responsiveness. Attachment behavior includes maintaining eye contact. Maternal deprivation behaviors include displeasure with touch and physical contact.