NCLEX-RN
RN NCLEX Practice Questions Questions
Extract:
Question 1 of 5
A labor and delivery nurse is caring for a client in active labor. The fetal monitor shows late decelerations. The nurse should first
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency. The left lateral position improves placental perfusion, addressing the immediate cause.
Question 2 of 5
The nurse is performing discharge diet teaching to a client with a stage 1 decubitus ulcer on the coccyx. Which diet selection by this client would indicate that the client has a clear understanding of the proper diet for healing of a decubitus ulcer?
Correct Answer: C
Rationale: Healing a decubitus ulcer requires a diet high in protein, vitamins (especially C and
A), and minerals like zinc. Baked chicken (protein), broccoli (vitamin
A), wheat roll (carbohydrates), and orange (vitamin
C) support tissue repair. The other options lack sufficient protein or include high-sugar/fat items that don't aid healing.
Question 3 of 5
The nurse has performed nutritional teaching on a client with gout who is placed on a low-purine diet. Which selection by the client would indicate that teaching has been ineffective?
Correct Answer: D
Rationale: Spinach is high in purines, which can exacerbate gout. Cabbage, apples, and peach cobbler (if low in purine ingredients) are suitable for a low-purine diet.
Question 4 of 5
The nurse is monitoring a client's cardiac rhythm when an abnormal rhythm occurs. Which of the following cardiac rhythms does the ECG strip (see image) indicate?
Correct Answer: B
Rationale: Without the ECG strip, ventricular tachycardia (
B) is a common abnormal rhythm requiring urgent intervention, characterized by wide QRS complexes. Other rhythms (A, C,
D) have distinct patterns.
Question 5 of 5
A client with deep vein thrombosis is receiving a continuous heparin infusion and Coumadin PO. INR lab test result is 8.0. Which intervention would be most important to include in the nursing care plan?
Correct Answer: A
Rationale: An INR of 8.0 is dangerously high, indicating a risk of bleeding. Assessing for abnormal bleeding is the priority to detect and manage potential complications.