NCLEX Questions, NCLEX Practice Test PN Questions, NCLEX-PN Questions, Nurselytic

Questions 164

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Question 1 of 5

A new mother is two days postpartum, is breastfeeding her infant, and now is preparing for discharge. She states that for contraception she is going to use her diaphragm, which she still has. The nurse's response should be based on which information?

Correct Answer: A

Rationale: Postpartum pelvic changes require diaphragm refitting to ensure effective contraception, as size may differ after childbirth.

Question 2 of 5

The nurse is feeding a 3-month-old client with tetralogy of Fallot. During the feeding, the client becomes cyanotic and has difficulty breathing. Which action should the nurse take first?

Correct Answer: D

Rationale: The knee-chest position increases systemic vascular resistance and reduces right-to-left shunting in tetralogy of Fallot, immediately improving oxygenation during a tet spell.

Question 3 of 5

A 9-year-old with type 1 diabetes takes insulin glargine and NPH regularly. While at school, the client becomes shaky, diaphoretic, and pale. What is the most appropriate action by the nurse?

Correct Answer: D

Rationale: Shakiness, diaphoresis, and pallor indicate hypoglycemia. Providing 15 grams of fast-acting carbohydrates, such as 4 oz of a regular soft drink, is the first-line treatment.

Question 4 of 5

A 9 year-old is taken to the emergency room with right lower quadrant pain and vomiting. When preparing the child for an emergency appendectomy, what must the nurse expect to be the child's greatest fear?

Correct Answer: C

Rationale: For school-age children, major fears are loss of control and separation from friends/peers.

Question 5 of 5

The unlicensed assistive personnel notifies the charge nurse that the client is reporting feeling short of breath. What should the charge nurse do first?

Correct Answer: C

Rationale: Directing the primary nurse to assess the client ensures a timely, qualified evaluation of shortness of breath, a potentially serious symptom.

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