NCLEX-RN
NCLEX RN High-Yield Questions Questions
Extract:
Question 1 of 5
A multiparous client 48 hours postpartum who is breast-feeding tells the nurse, 'I'm having a lot of cramping. This didn't happen when I nursed my first baby,' which of the following would be the nurse's best response?
Correct Answer: D
Rationale: Breast-feeding stimulates oxytocin release, causing uterine contractions and cramping, which is normal and often more noticeable in multiparous women.
Question 2 of 5
The nurse is assessing a client with a suspected tension pneumothorax. Which of the following findings is most indicative of this condition?
Correct Answer: B
Rationale: Jugular vein distension is a sign of tension pneumothorax due to increased intrathoracic pressure compressing the vena cava.
Question 3 of 5
The nurse is assessing a client with suspected meningitis. Which of the following findings would support this diagnosis? Select all that apply.
Correct Answer: A, B, D
Rationale: Nuchal rigidity, positive Kernig's sign, and photophobia are classic signs of meningitis due to meningeal irritation.
Question 4 of 5
A client has a prescription to take magnesium citrate to prevent constipation after upper and lower gastrointestinal (GI) barium studies. The nurse tells the client that which is the best way to take this medication?
Correct Answer: D
Rationale: Magnesium citrate is available as an oral solution. It is commonly used as a laxative after certain studies of the GI tract. It should be served chilled and taken with a full glass of water. It should not be allowed to stand for prolonged periods. Allowing the medication to stand would reduce the carbonation and make the solution even less palatable. The remaining options are incorrect.
Question 5 of 5
A client has had a left mastectomy with axillary lymph node dissection. The nurse determines that the client understands postoperative restrictions and arm care when the client states the intention to engage in which activity?
Correct Answer: A
Rationale: The client is at risk for edema and infection as a result of lymph node dissection. The client should use a variety of techniques to avoid trauma to the affected arm. Examples include using gloves when working in the garden, an electric razor to shave under the arm, and pot holders when cooking to prevent burns. The client should also avoid activities that increase edema, such as carrying heavy objects or having blood pressures taken on the affected arm.